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Westminster Hall

Wednesday 5 March 2014

[Katy Clark in the Chair]

Adult Autism Strategy

Motion made, and Question proposed, That the sitting be now adjourned.—(Norman Lamb.)

9.30 am

Mrs Cheryl Gillan (Chesham and Amersham) (Con): It is a pleasure to serve under your chairmanship, Ms Clark. As you know, I always approve of a woman being in the Chair. It is a great privilege to open this debate today. I am pleased to see so many colleagues from both sides of the House joining the debate, which reflects the importance of the subject.

I understand that the Department of Health plans to publish its revised version of the adult autism strategy for England on 2 April, coinciding with world autism awareness day. Today’s debate is therefore timely for us to identify for the Minister what we think and what our constituents have told us are the key priorities for the revision of the strategy. I look forward to hearing from the Minister about the Government’s plans, particularly those to take forward the actions that people require, because we need support for the estimated 460,000 adults with autism in this country.

It is just over four years since my private Member’s Bill on autism became the Autism Act 2009. I still thank colleagues on both sides of the House for making that possible. The passing of the Act was an important landmark in the battle to improve the lives of adults with autism in England. I want to thank everyone, including the people who at first opposed the Bill but who came round to my way of thinking, because they made the Act the first disability-specific legislation ever to be passed in this House.

As we all know, autism is a lifelong developmental disability that affects how a person communicates and makes sense of the world around them. It is a spectrum condition, meaning that it affects people in different ways, making awareness of the diagnosis even more important.

Back in the ’90s, my colleague, Angela Browning, now Baroness Browning—some hon. Members will remember her—made me only too well aware of what happens to adults with autism, particularly if they are being isolated or ignored. Over the years, awareness grew of the needs of adults and children with autism, but even by 2009, there was still no meaningful recognition at Government level of the challenges faced by adults.

Robert Halfon (Harlow) (Con): I congratulate my right hon. Friend on securing this debate on a subject that is incredibly important. Is she aware that 85% of adults with autism in the UK are not in full-time employment? Translating that to my own area, Essex, that is around 7,000 people. The Government have set up Disability Confident, which helps people with disabilities to get into work, but it does not focus on people with autism. My local autism charity—

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Katy Clark (in the Chair): Order. Interventions must be brief.

Robert Halfon: My local autism charity, Parents and Children Together for Autism, has set up a pilot apprenticeship scheme focusing on people with autism. Does my right hon. Friend agree that that should be rolled out across the country?

Mrs Gillan: I congratulate my hon. Friend’s local charity on setting up that apprenticeship scheme. That is important. When I started looking at autism all those years ago, one of the interesting things I realised was how valuable people on the spectrum can be. They can make a fantastic contribution to businesses right across the board. Apprenticeship schemes should be looked at quite carefully by the Government. If there is an example in my hon. Friend’s constituency, I am sure that the Minister will take it on board and perhaps even arrange a visit to see how it operates.

Adults with autism were still being overlooked by local services back in 2009. They were falling through the gap between learning disability and mental health services, because no one had responsibility for taking a lead locally to ensure that appropriate services and support were being developed for adults with autism.

The diagnosis can become more complex as a person gets older and often needs a referral to a specialist centre, for which out-of-area contracts are often needed. Some local authorities are doing that, but some, I am afraid, are not. That is why the Autism Act was so important. As a piece of disability-specific legislation, it set a legislative framework for that gap to be closed and for the responsibility to improve support for adults with autism to cover every local area.

Tim Loughton (East Worthing and Shoreham) (Con): I congratulate my right hon. Friend. I remember well the Autism Act and the many hoops that she needed to go through to get it passed. I am sure that she is aware of the findings from the National Autistic Society, which said that just one in three people said that, in their experience, social workers had a good understanding of autism. There is a big cliff edge between children and adults, with services completely changing or becoming non-existent when someone reaches 18. Does she agree that, given the big emphasis now being placed on the better training of social workers, particularly regarding vulnerable children, we need to do a lot better with training social workers to deal with adults as well, in terms of the sensitivities and requirements of people with autism?

Mrs Gillan: I agree entirely with my hon. Friend. When I come to talk about the actions I want the Minister to take, I will ask him to ensure that local community care assessors have autism training.

Kate Green (Stretford and Urmston) (Lab): I congratulate the right hon. Lady on securing this debate. I apologise that I will not be able to stay for all of it, but I am pleased that she secured it this morning. I agree with her that it has been a good product of the 2009 Act, for which she rightly claims credit, that local authorities now have to give special consideration to meeting the needs of adults with autism. As many local authorities

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have now raised their threshold for support to substantial and critical levels of need, does the right hon. Lady share my concern that that may begin to exclude some of those adults?

Mrs Gillan: That is a point to be taken on board. There is variation across the country that we are all aware of. The Minister will have noted the hon. Lady’s remarks, and it is important that we try to get more standardisation across the country.

The Act guaranteed the introduction of the first-ever adult autism strategy, setting out how adults with autism should be better supported. It was underpinned by guidance and placed duties on local authorities and the national health service to take action. The strategy has been well supported by the National Autistic Society; I think everyone in the Chamber and beyond would pay tribute to the NAS, which does the most amazing work right across the board. Its “Push for Action” campaign has captured people’s imagination. It calls for urgent action to end the wait for the everyday support that people with autism need.

Annette Brooke (Mid Dorset and North Poole) (LD): I was delighted to support my right hon. Friend’s Autism Act, which was an enormous step forward, and I congratulate her on securing this debate, because it is exactly a push for action on what we have achieved so far.

I want to draw my right hon. Friend’s attention to a point raised by a constituent of mine who said:

“I have a bright son who is now 21 and spends every day isolated at home as there is no support or help available for him. I would like him to find a job and make friends but he will need help”.

When we get down to those individual cases and almost the waste of lives compared with what could be done, I certainly hope that we can secure something for this next push.

Mrs Gillan: I am grateful for that intervention. This place is about making legislation, both primary and secondary, but for each and every one of us as MPs, it is those individual cases that strike home to our hearts. It is a valuable role for an MP to bring individual cases to the attention of the House, as the hon. Lady has done, because it makes both our laws and their implementation better. I think that we will all have stories of families and individuals in our constituencies who need more help, and there is nothing more moving than a parent coming to plead for help for their child.

Robert Halfon: The NAS has highlighted that only 10% of adults with autism receive employment support but 53% would like to receive it. Does my right hon. Friend agree that we need to focus on that issue?

Mrs Gillan: Yes. I rely a great deal on statistics from the NAS, which does detailed work in this area. It is still a crying shame that we have wasted capacity and wasted lives in this area, and we should not stand idly by and let that happen.

Having said that, I am gratified by what has been achieved so far in improving the support at the front

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line. Just for starters, almost all areas now have someone who is responsible for improving services for adults with autism. It might not seem much, but that development alone has been a mighty step forward. I will also highlight some progress in my own constituency of Chesham and Amersham where there are two clinical commissioning groups and they have agreed that one of them will take the lead on autism issues for the whole county, identifying within the two CCGs a GP who will take work on autism forward. That is the sort of activity that I want to see being replicated across the country.

Elsewhere, I know that some excellent and innovative practice has emerged on issues such as training and diagnosis. Sadly, however, as I am sure other colleagues will testify, progress is still patchy and many areas have not made progress as rapidly as we had all hoped for when the Act was passed.

Research by the NAS shows that, four years on from the passage of the Act, many adults with autism are still waiting—unjustly, in my view—for the support they need. Seventy per cent of adults with autism who responded to the recent NAS survey said they are not receiving the help they need from social services, and more than a third of respondents said that they needed help with simply washing and dressing. In addition, two thirds of respondents said they needed help to prepare a meal and 83% said that they needed support to pay a bill or to deal with letters. Those are things that we all do every day of the week, but in the majority of cases adults with autism are unable to get help from their local council to deal with them.

There is also a lack of clarification between low-level and high-level support. Low-level support services are often right for individuals, as they can prevent them from developing more complex problems and therefore can be almost disproportionately cost-effective. My grandmother used to have a saying about such situations: “A stitch in time saves nine.” That is exactly the principle that we should apply in this area.

The impact of such a lack of support is quite clear. The NAS research indicates that a third of adults with autism have developed a severe mental health problem because they lack support. Of course, the statistics vary slightly, but one statistic I will cite is that just 15% of adults with autism are currently in full-time work. We must urge our local authorities to press on, and the necessary support and impetus must come from Government.

The good news is that we are to have a refreshed strategy—it is the Heineken moment for the Minister. I will turn now to the priorities for that refreshed strategy.

Tim Loughton: Before my right hon. Friend downs the Heineken, may I take her back to the alarming statistic she just cited about the number of people with autism in full-time employment? Does she agree that there is an onus on businesses to do more, as many of the smarter businesses have done in the past? Those businesses particularly took on board the sensitivities and requirements of people with autism, and considered how they might be encouraged to apply for a job in the first place; many people with autism never even get to that hurdle. Not surprisingly, many of those businesses turned out to be rather good employers, and we need some rather more enlightened employment practices from some more of our businesses.

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Mrs Gillan: I agree entirely. I am amazed by the intellect and the unique and fantastic capabilities of some people on the autism spectrum. Many of them have the capability to repeat jobs that demand high intellect, such as the regular quality-checking of components. There are some really valuable people on the spectrum whose skills are being completely wasted, and if there is some way in which we can mirror the apprenticeship scheme and encourage employers to hire them and spread the word that they are the people they should be looking at, although they may require some rightly deserved special attention, that would be useful.

To start with, we must establish base camp. Therefore, I particularly want to hear some assurances from the Minister today that the core elements of the original strategy and statutory guidance will not be lost once the revised strategy is in place. Local authorities and the NHS are at differing points in implementing the current strategy. The strategy has set them on the right path to ensure that the needs of adults with autism are properly accounted for in local planning and commissioning, because it clearly sets out that there must be local leadership on autism to help bridge the gaps in local services and it also makes it clear that every area must have a pathway to diagnosis, as well as appropriately trained staff, which was the point made by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton).

We must make sure that the progress that has already been made on those issues is recognised as the strategy is revised. I need to congratulate those areas that have taken forward all the key actions that were originally in the strategy, and I hope that the Minister will ensure that those areas that are yet to make progress on the fundamental aspects of the original strategy are clear that that is not acceptable and that they need to take immediate action.

Can the Minister reassure me and the House that the revised strategy will restate the importance of every local area guaranteeing to take the following actions, if they have not already done so? They are: first, appointing a local autism lead; secondly, establishing a local autism partnership board; thirdly, ensuring that autism is included in local data collection and the joint strategic needs assessment; fourthly, developing a local plan; fifthly, ensuring that there is a local pathway to diagnosis; sixthly, ensuring that autism is included in standard equality and diversity training for all staff across health and social care; and lastly, making sure that the community care assessors in the area have autism training. Of course, the restatement of those core actions will not be enough to ensure that change is happening at a local level, but the Government should set a timetable to check that those actions have been carried out across every area of this country, preferably by the end of this year.

I know that the Minister will say “What of the money that is available?” One of the key challenges that I and other colleagues regularly hear about is the financial constraints that face professionals when they seek to develop new and innovative local services. Gaining funding approval has been especially problematic, as there are few evidence-based models of good practice on which to base such approval, even though financial modelling has shown that these types of services can and do save money; it is my grandmother’s old adage again. Investment

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in new and dynamic service models will not only help local authorities to improve the services that are currently available to adults with autism, but will help to develop an understanding of the best way to deliver services and highlight areas of best practice.

I, and many other people, also place high importance on data capture between health, education and social services, so that those services have a better understanding of the number of children who will move into adult services. Capturing that data is not rocket science and it will mean that the provision of transition services can be better planned for and budgeted for. When I look at this area, it always amazes me that there is no co-ordination of the transition from childhood to adulthood, and people just fall through the gap.

I know that the Minister has agreed to consider the proposal from the NAS for an innovation fund as part of the review of the strategy, and when he responds to this debate I look forward to hearing an update from him about that proposal. I hope that he will be able to respond positively to what, in one way, is an ambitious proposal but, in another way, is very modest.

In conclusion, each and every person deserves the best possible chance to make the most of their talents and fulfil their potential, including people with autism. As illustrated by various reports on autism, including the National Audit Office’s report, with which the Minister is familiar, we are not only wasting large amounts of taxpayers’ money, but not providing adequate support to people with autism, we are also wasting human talent and lives.

The Autism Act has, with a lot of help from colleagues, been a catalyst for change, but more work needs to be done. I urge the Minister to make sure that he seizes this opportunity presented by the refresher to take forward ambitious actions, such as increased investment, which will help ensure that adults with autism throughout the country can be supported to live the life they choose and the life they deserve.

Katy Clark (in the Chair): I remind hon. Members that interventions should be brief.

9.50 am

Jim Shannon (Strangford) (DUP): I am pleased to make a contribution to the debate, and I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on bringing this matter to the House for consideration. Autism is an issue that I have helped constituents with on many occasions, as an elected representative. I am mostly aware of it, probably, in respect of how we can help those with autism through the benefits system. That is perhaps people’s first introduction to the issue. The right hon. Lady clearly laid out the issues pertinent to those with autism, and also mentioned the pressure that families are under. I want to dwell on that.

Diagnosis of autism has been increasing. I have been involved in the support of autism services for many years in Northern Ireland, through my constituency work and, formerly, in my role as a Member of the Northern Ireland Assembly and as a local councillor. I am sure that all hon. and right hon. Members in this Chamber can think of examples of when they have fought to have a child statemented, so that they could

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receive the help that they and their family needed for schooling, and so that support could be given to the family. Although this debate is about adult autism, autism affects people from the very beginning. I shall try to speak about that as well.

I recently spoke to a young mother of three who, with her husband, was beginning to attend parenting classes to help them better deal with their daughter. It was not that they were not willing to deal with her, but they needed help dealing with the behaviour issues of those with autism. We are talking about lovely children—and lovely adults—but they need help. The couple have two other lovely children, a great family support network and a close group of friends who help out, yet they recognised at an early stage that they needed more help and needed to be better equipped to deal with this. They said that they needed help understanding autism, so that they could understand and interact better with their child.

Mr Gregory Campbell (East Londonderry) (DUP): Does my hon. Friend agree that even in 2014, after a number of years in which awareness of autism has increased significantly—it has done so particularly in the past 15 or 20 years—there is still a need for many statutory agencies to act and react much more sympathetically and proactively, particularly in dealing with parents who have autism and have difficulties with parenting skills?

Jim Shannon: I thank my hon. Friend and colleague for clearly setting out the issue for the bodies responsible for helping parents. The parents I mentioned came to me about parenting skills, and they got the help, by the way, which was good. They told me what a blessing these classes were. That is why I am happy to stand with my colleagues today and highlight the needs of sufferers of autism and their families.

I am familiar with the care of one autistic young man. Many hon. and right hon. Members here have personal knowledge of such situations, and I hope that some of them will have a chance to contribute to this debate. That young man’s parents do everything for him: they dress him, cook for and feed him, clean, bathe and toilet him, amuse him, and hug, kiss and love him. He depends on his parents entirely for his every need. When he is at his day classes, they do the washing, ironing, cleaning, and shopping and try to find time to work to pay the bills at the same time.

The pressure on the parents and on the family unit is greater because of the problems and behavioural issues related to the autism of their child. They love their son—that is never in dispute—but love is not enough to get the family through the sheer exhaustion and the emotional and mental strain. Sometimes help is needed on matters outside of parental skills—through social services, for example, giving a bit of respite. Difficulties in the benefits system are practical issues for parents and those with adult autism; they relate to how parents can help their child through the school years and into the early years of adult life. It is up to the community and us as elected representatives to step up to the plate and help that boy and his parents. We can do that by

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supporting them and offering them the best that our society can do to ensure that they do not reach the point of no return.

We can all relate to the story of Susan Boyle, who has Asperger’s syndrome, which is also autism. She found out that she had it later in life. After she was diagnosed, she said that she almost felt relieved to know, after all those years, what was wrong and why she was different. That is a practical example of how someone the nation knows has been affected. She said what she said because she felt it was important that other people knew that autism cannot and will not hold people back, but they need help to get along. That is the thrust of this debate.

Kate Green: Does the hon. Gentleman agree that we need to raise awareness across society of the circumstances of adults with autism? For example, a young man in my constituency, looked after by his parents in the way that the hon. Gentleman describes, got severely into debt because he did not understand what financial services companies were saying when they were pushing credit cards and loans on him. Does he agree that educating the business community, neighbours and community groups, and everyone in society, about how adults with autism respond and cope would protect people and prevent those things from happening?

Jim Shannon: I thank the hon. Lady for her valuable contribution. Yes, I agree; I think all hon. and right hon. Members would. Churches have intervened to help in a number of complex cases in my constituency. What is not complex for us is complex for people with autism. There is a clear role to be played in that regard. Only 15% of adults with autism are in full-time employment; again, that results from some of the issues that they suffer from, including epilepsy, sleep disturbance and mental health problems. Many out there are trying to help and assist.

I ought to give a Northern Ireland perspective, because we have done good, helpful work there, health being a devolved matter. The Minister is aware of that good work because he has visited a number of times. Perhaps he might comment on that in his response.

The Northern Ireland Assembly put in place the Autism Act (Northern Ireland) 2011, which is the most comprehensive autism and single disability legislation in the whole of Europe. The need to do something was recognised at an early stage, as was the fact that the power was there to do it within the devolved Administration, and that was done. It is the first legislation in Northern Ireland requiring by law all Departments to plan and work together on the delivery of the strategy. The cross-governmental attitude that the right hon. Member for Chesham and Amersham requested is there. My hon. Friend the Member for East Londonderry (Mr Campbell) and the hon. Member for Stretford and Urmston (Kate Green), who both intervened on me, have confirmed that that should happen. Departments worked together on the delivery of a strategy. No cross-Department barriers are allowed at all. When we say “comprehensive”, we mean it. I am delighted that the debate is calling for such a strategy.

Autism Northern Ireland was at the centre of the campaign for the Autism Act (Northern Ireland) with its grass-roots campaign. There was no money or external lobby company—just hard work, and determination to

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make it happen and to gain support from all parties, which was forthcoming. It had autism ambassadors—health and education party spokespersons—to build up expertise on issues of concern. It also formed a partnership with Autism Cymru, which was already working with the Welsh Government on implementing a Wales autism strategy. That was the foundation of the Celtic Nations Autism Partnership—Celtic as in “keltic”, and certainly not “seltic”. No offence to any Celtic supporters who might be here, of course. That is a partnership with the autism societies of Scotland and the Republic of Ireland, which has led to initiatives in the USA. The CNAP and Members of the Legislative Assembly visited the US Congress and the European Parliament.

When we say that the approach is comprehensive, we are talking about looking across Europe and the world; examples were considered and discussions took place. That led to the Autism Act (Northern Ireland). A partnership was initiated with Autism-Europe and MEPs to develop a comprehensive and well-thought-out European autism strategy.

In 2012, I highlighted the difference between the Autism Act (Northern Ireland) and the English Autism Act 2009: the Northern Ireland Act is equality-driven and lifelong-focused. Perhaps the Minister will indicate whether the Government are trying to achieve in England the equality and lifelong focus that we have in Northern Ireland through the Autism Act (Northern Ireland) 2011. That Act amends our disability discrimination legislation, too, to include those with social communication disabilities such as autism. That supersedes the Great Britain Equality Acts, which only give recognition and guidance in primary legislation. That is significantly different from how we did it back home, where we have attempted to address adult autism.

I again thank the right hon. Member for Chesham and Amersham for securing the debate. She, like me and everyone else in the Chamber, sees the gaps in the strategy and the need to enhance provision by including an adult strategy. I have raised today the cases of a young girl and a young adult male. The strain on families grows greater with time as the child becomes an adult and more difficult to handle. The legislation should be amended to provide more state help.

Andrew Selous (South West Bedfordshire) (Con): I apologise for not being here earlier, but I was unable to get out of a meeting. One of my constituents contacted me to say that now that her daughter is 20, none of the professionals dealing with her daughter will speak to the mother. Does the hon. Gentleman think that we should make changes, so that with the young person’s permission, if they are over 18 and want their parents involved, all the different organisations work with the parents, who are there for their autistic children as they get older?

Jim Shannon: I agree entirely with that most helpful intervention. In my experience as an elected representative, that is exactly what people want. We should help whenever we can. The Minister for Health, Social Services and Public Safety in Northern Ireland has been anxious to collaborate with the Department of Health on what is working well in Northern Ireland. I have great respect for the Minister of State, Department of Health, but perhaps things could work better. There are examples

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of good work on the mainland. I looked through the background notes this morning before the debate, and one thing that caught my eye is that there is a specialist autism unit at South Devon college called the LODGE—Learning Opportunity for Development and Guided Education—which has been shortlisted at a national award ceremony in recognition of the education it provides to young adults with autism. There are many good examples of how Departments can do better for young adults with autism, and we should be trying to make that happen.

I am keen to assist and work with the right hon. Member for Chesham and Amersham to ensure that adequate legislation is introduced to make changes that will greatly affect the lives of those with autism and their carers. Never forget the carers, who also need support. They love their children, but they need help, because things are not simple. They want their child to have the best future possible, which does not include an institution. How will we deal with ageing parents? I know that I am not the only one who is aware of ageing parents. What will happen to these children and young adults when their parents pass away? They may no longer be able to look after their children and young adults alone. The answer is clear: they need support, and we must put it in place. Hopefully today is a first step towards providing that support to families across the United Kingdom of Great Britain and Northern Ireland. I support the right hon. Lady and her proposal.

10.3 am

Mr Robert Buckland (South Swindon) (Con): It is a pleasure to serve under your chairmanship, Ms Clark. Indeed, it is a pleasure to follow the hon. Member for Strangford (Jim Shannon), who made some powerful points on cross-departmental working. I am glad to see the Minister is here with the lead civil servant on autism from the Department of Health, with whom I have had many conversations about cross-departmental working.

I have a quick example of cross-departmental working in relation to the transition period. We have all had casework in recent years involving 17 or 18-year-olds who are moving away from secondary education into further education and who find that their transition period is, frankly, stymied by lack of clarity on the funding of their FE places. I have had a number of such cases. Last year was particularly problematic in certain instances. That was through no-one’s ill will, but it was a result of the lack of genuine communication and cross-working between those responsible for the funding of further education and the other services that work with young people with autism. They are young adults coming into the adult world, and their first experience is negative. That is not a good sign of what is to come, not only for those young people but for their families and carers. There is a fear that I call the 4 o’clock in the morning syndrome, which is when a parent wakes up and thinks, “My child is young now, but what will happen when they grow up?” We keep having to ask ourselves that question. It is the exam question that I set for the Minister in today’s debate and at every opportunity we have to discuss the strategy for adults with autism.

I pay tribute to my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) for her sterling work to help to bring the Autism Act to the statute

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book, which was before I came to this place. The Act means that the autism strategy, which is now being revised, is the core document for local authorities and all providers and commissioners of services across England in working with and providing a proper strategy and service for adults with autism.

I have the pleasure and honour of chairing the all-party group on autism, and I enjoy working with Members from both sides of the House. The all-party group has had significant success in the years since it was founded in 2000 not only in campaigning but in achieving real change for children and adults with autism and their families. As my right hon. Friend said, the Act has, in certain areas of the country, delivered that real change. I am delighted that in my constituency in Swindon we now have not only an autism partnership board, the meetings of which I have attended, but an efficient adult diagnostic service. Our social enterprise, SEQOL, was commissioned to provide that diagnostic service, which is one of the best in the country. We are now able to identify adults in their 50s, who are getting a diagnosis for the first time. That is important for them and is an acknowledgement not only of the questions and issues that they have been raising over the years but that, for far too long, far too many people have lived without any support or diagnosis. Diagnosis, of course, is only the first stage. What comes next is as much a challenge, and it is a question that we need to answer.

Tim Loughton: My hon. Friend is a much greater expert than I am on autism. I was one of the founding officers of the all-party group on autism back in 2000, and it has done important work in this area, among the most important of which was our work with schools and local authorities to encourage early diagnosis, joined-up work and greater consistency in how we detect autism in the first place. If we can do that and tailor the school experience to the special needs of people with autism, we will not end up with people not being detected until as late as their 40s or 50s, which means that they miss out on a whole lifetime of support.

Mr Buckland: I entirely agree with my hon. Friend. I am grateful to him not only for his work on the all-party group but for his work as shadow children’s Minister and as children’s Minister in this Government. He played his part in ensuring that early diagnosis is a step closer to reality. The Children and Families Bill, which is shortly to be enacted, now incorporates education, health and care into one plan for young people who previously received statements of special educational needs. I am talking about children, but what my hon. Friend says is relevant. If we fail to take those early steps, the problems that manifest in later life become not only more difficult for the adults and their families but more expensive for the state. One example is that adults with Asperger’s are seven times more likely to come into contact with the criminal justice system than those without the condition. Why? Because Asperger’s is still a relatively unknown condition. It is not understood by many agencies that deal with it, and misunderstanding leads to sad results.

Mr David Burrowes (Enfield, Southgate) (Con): I thank my hon. Friend for his extraordinary leadership and for having a positive impact in a relatively short

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time on the understanding of autism. On Asperger’s, he will share my concern for those who unfortunately fall into the criminal justice system, but how far do we need to go to ensure that all agencies properly understand Asperger’s? Just last week, a constituent told me that Atos did not have a clue on how to deal with it. His older child was completely let down by the work capability assessment.

Mr Buckland: My hon. Friend, of course, has constituency experience with the Gary McKinnon case of how we can reach a dreadful situation where, because of a complete misunderstanding of the condition, serious consequences can flow. He makes an important point about Atos, and we have seen the difficulties that it has got itself into. It is unacceptable that we have a system that does not properly recognise these conditions. Frankly, it is a scandal. We can do far better than that, not only for adults with Asperger’s but for the range of invisible conditions—I do not call them hidden conditions, because the word “hidden” has connotations of its own—right through the gamut of mental health. We do not have a grip of that, either in the benefits system or with some other agencies.

Mrs Gillan: I pay tribute to my hon. Friend for his chairmanship of the all-party group. He has been driving forward progress in this area in a superb fashion. In my experience, the issue he is discussing also manifests itself in all sorts of strange areas. If a local authority or housing association dealing with an adult with Asperger’s has no idea of that individual’s sensitivities, it can positively harm that individual and others surrounding them, leading to immeasurable costs to the taxpayer and in the damage done to the individual.

Mr Buckland: I entirely agree. It is time that we recognise that conditions such as autism are particular disabilities that open a gateway to specialised housing. Unless we deal with that, we will carry on down the failed route of institutionalisation. We can see the logical conclusion of that in Winterbourne View and other serious examples. The Minister has a passion to deal with these issues, and I know he agrees that independent, supported living in properly tailored, properly built housing—it does not yet exist in any great measure—is what is needed for adults with autism if we are to avoid the tragedy that I and other hon. Members see week in, week out, whether we are canvassing or in surgery. We see young people sitting upstairs in the family home, without a job and they do not know what to do. They have no support, and their families are at their wit’s end in knowing what to do. We have to do better than that, and they deserve better.

On interface with agencies—I was talking about criminal justice—in many police areas, we now have autism alert cards. That system works well in Wiltshire, which is the police force area in which I live. We relaunched our autism alert card only last week. It is a simple thing: a bit of plastic with next of kin details on it. Importantly, the card tells the reader that the person carrying it has autism. That should trigger a series of events happening and make the police aware that autism is a factor. If various support services and care services are needed, they can be brought into the package and the family

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and the support network can also be informed about the incident or problem that the adult is having. Those simple measures can make a great difference.

Mr Henry Bellingham (North West Norfolk) (Con): My hon. Friend is being incredibly generous. Where do GPs sit in all this? He has mentioned awareness and the need for different agencies to work more closely together. Does he agree that GPs should be given more training on autism at medical schools?

Mr Buckland: In a word, yes. GPs would welcome it and it would, at a stroke, deal with a whole range of unidentified problems. With greater awareness among general practitioners, referrals can take place. Where there are existing diagnostic services, as there are in Swindon, they can be used and, as I have mentioned, SEQOL and other organisations in other areas can get to work, using the pathways and identifying the condition.

What is next? What else is needed? I am a great believer in advocacy services, and I can see their power in some excellent local examples. The Swindon Advocacy Movement has recently had more funding to extend its remit to help people with autism and Asperger’s. It is a wonderful organisation, with a one-stop shop in the centre of Swindon that gives support to adults with learning disabilities. Its motto is that it is not there permanently to do things for people, but to empower people to help themselves. With that little bit of help, support and advocacy, lives can be changed for the better, and I see that happening through its wonderful work.

We also have Discovering Autism Spectrum Happiness, a voluntary organisation set up by a group of like-minded individuals some years ago in Swindon. It is now working from the Pinetrees community centre, offering the Swindon autism information and advice service, which is an invaluable resource. It only started last year, and it has already reached out to more than 150 individuals with autism and their families. By its estimate, there might be a couple of thousand of people in the community who have not yet been identified. Through its support work and its network, it is giving advice and empowering people with autism. I had the pleasure of visiting it only two weeks ago to talk about some of the cases that it is finding and some of the cases that are coming across my desk. There is a lot going on in local communities, but there is much more that we can do on an overall strategy to identify best practice, to knit that together in a co-ordinated and coherent way and to give other commissioning bodies and other authorities a gold standard from which they can work.

The Minister knows that I am not into lowest common denominators or prescriptive measures when it comes to this sort of thing, because I believe in localism. There has to be, however, some standard to which all commissioning bodies should work. Like adults who are neurotypical, adults with autism should not be frightened or worried to move about. If they can move to another part of the country to secure employment, they should reasonably expect that autism services in their new town or city will be of a similar standard to where they have come from. When they have a family support network, the tendency is for people with autism

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to stay close to home, and in many cases that is not a bad thing at all. Bearing in mind the Winterbourne View example, bringing people with a disability closer to home and to their network is a good thing, but there will be many high-functioning people with autism who want to travel, want to move about and want to take that job at the other end of the country. Why can they not do that? At the moment, there is a fear that the support network that they might enjoy in Swindon would not exist in another part of the country. That is the function that the strategy could fulfil; it is an empowerment strategy, not some prescriptive “We know what is best for you, so we will tell you what to do” strategy.

On community autism awareness, I have talked somewhat about advocacy services and information, but I want to talk about the sense of isolation that many with autism and their families feel. In a survey conducted by the National Autistic Society, 82% of adults with autism said that they have days and 42% said that they have weeks when they do not talk to anybody outside their household. Just think about that for a moment. Some 72% said that they have been bullied or discriminated against. A survey by Ambitious about Autism found that 87% of parents and carers of people with autism felt unsupported by the community. Those are stark statistics, but some of the solutions are simple. Small adjustments are all that is needed to change things. In the supermarket, staff are often not trained to know how best to deal with individuals who have autism. In the hairdressers, a few sensory adjustments would allow someone with hypersensitivity to access those facilities. The cinema at Greenbridge in Swindon regularly hosts autism-friendly screenings for children and young people, which make all the difference in the world. Parents at those screenings do not need have to have eyes in the back of their heads or worry about whether their child will be seen as naughty or misbehaving. They can relax, secure in the knowledge that everybody around them is accompanying someone with autism. Such adjustments make a huge difference in the lives of not only the individuals who have autism but their carers and families.

Tim Loughton: My hon. Friend is making an important point. The large DIY chain B&Q made a virtue of employing older people and disabled people, who are sensitive to the needs of their older and physically disabled customers. As a result, more disabled or older people tend to shop there than at other DIY chains, because the staff understand them. There is a commercial advantage in training and employing staff who have greater sensitivity to, and experience of, autism and other learning disabilities.

Mr Buckland: That is a powerful point. Employing older people and disabled people is good not only for business but for employment. Doing so is not simply about being a kind employer; it is about being savvy. We have already heard about the huge potential that those with autism, Asperger’s and related conditions offer. They have qualities and gifts that we do not have, and they have incredible resources. If we only empower them, they can show us what they are capable of.

Robert Halfon: My hon. Friend is making an incredible speech. I have mentioned PACT for Autism, and the pilot apprenticeship schemes for people with autism.

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Given that the Government are investing so much in apprenticeships, does he agree that they should incentivise companies to hire apprentices with autism?

Mr Buckland: That is an excellent idea. As my hon. Friend knows, our hon. Friend the Member for Ilford North (Mr Scott) has pioneered a wonderful scheme in his area whereby employers are matched up to young people with autism in order to offer them apprenticeships and job opportunities. I commend that local initiative to my hon. Friend the Minister as a great example of what can be done to empower young people and adults with autism.

I have talked about local cinemas and hairdressers, but what about training bus drivers to be aware of the needs of passengers with autism? I am sure that bus drivers would be receptive, because such training would make their life much easier. A lot of useful measures, such as the provision of quiet spaces in shops, can be done very easily. As my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) said, they will open up business to new opportunities.

I draw a parallel with some of the excellent work that has been done on dementia awareness. The co-ordinated dementia-friendly communities programme has been supported by the Government since 2012, and the Prime Minister has commended it. In dementia-friendly communities, local people come together to decide how to include people with dementia. Transport providers, charities, schools and local authorities all open up their facilities to ensure that people with dementia and their carers—let us not forget them—are not discriminated against. Only two weeks ago, I opened a memory café in the Wyvern theatre in Swindon, where people with dementia and their carers can come on Thursdays to have some space, enjoy mainstream activities and feel part of life.

There is an important parallel to be drawn with autism. How are we going to achieve similar improvements for those with autism? Not only must environments be made easy to navigate, but businesses and services must be respectful and responsible; public and private service providers must receive better training; there should be volunteer-led public education in workplaces and schools; and we must work with venues to help them adapt their buildings. Things such as better signage, more information and befriending schemes are also important. All that has been done with dementia, and we must do the same with autism.

The National Autistic Society gave me an example from a blog of a mother who loves musicals but has not been able to go to see a show for some years because her four-year-old son has autism with hypersensitive hearing. Believe me, I know what that is all about. Last year, she bought tickets for an autism-friendly performance of “The Lion King” in London’s west end. The organisers provided accessible information about the venue to ensure that children with autism would not be overwhelmed on the day. When mother and son went to the theatre, they found that there was a relaxation area where parents could go. At the beginning of the performance, one of the actors came on stage to help children understand the difference between actors and characters in the play. That performance brought families together and beat isolation.

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That example relates to children, but there is no reason on earth why we cannot do the same for adults. For a few hours, children and family members were able simply to be themselves. That is the point I made about the Greenbridge cinema experience, which has been invaluable for so many families. Parents are not judged and they do not need to have eyes in the back of their heads. They are accepted and they do not need to apologise for their children or the person for whom they are caring. That is priceless, and I cannot describe how important it is for families of people with autism.

I have to contrast that with my experience some years ago at the Riverside theatre, where we went to see the musical “Salad Days”. As those of us who know and love it will be aware, it is all about a piano that makes people dance. Well, my daughter decided to dance. I thought that that was wonderful, but some in the audience, who did not really understand, did not, so that was the end of that. We really need to move away from such experiences. That has lived with me as a very bad experience for the family, and I hope that I never have to go through that again. I hope that one day we will no longer have to put up with the sort of phrases that I have encountered, or the lack of thought that people often show for those for whom we care.

I hope that the revised and re-published autism strategy will acknowledge what ordinary people and ordinary businesses can do better to make our communities autism friendly. My experience of talking to and e-mailing with many families across the country who are affected by autism indicates that there is a will for change. The right framework and the right resources from central Government could help us make the step change in society’s attitudes towards autism that we have championed, and on which we want to see real action.

10.27 am

Mr Jamie Reed (Copeland) (Lab): It is a pleasure to serve under your chairmanship, Ms Clark. I will be fairly brief, after an excellent debate. I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on securing this important and timely debate. Her close links with this important issue were demonstrated emphatically by her bringing forward the Autism Act 2009, and her work on that legislation should be commended. It is worth mentioning that the 2009 Act is the country’s only piece of disability-specific legislation, and the fact that it reached the statute book is a credit to not only the right hon. Lady but the hard work of Members from all parts of the House.

In preparation for the debate, I have immersed myself in the Official Report of the Autism Bill’s passage through this place. Although there were some disagreements, for the most part the debate was incredibly consensual, and the tone of today’s debate has been similar. The legislation has achieved a great deal, and I pay tribute to all Members who were involved. I have often said, particularly in Westminster Hall debates, that Parliament is at its best when we can put partisanship aside to achieve shared goals. The 2009 Act is a clear example of that. It is an Act of Parliament of which all Members, especially the right hon. Lady, can be proud.

Section 1 of the 2009 Act placed a duty on the Secretary of State to prepare and publish an autism strategy, which had to include a plan for meeting the

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needs of adults in England with autism, and a plan for improving the provision of appropriate services by local authorities and the national health service. My right hon. Friend the Member for Leigh (Andy Burnham), then Secretary of State for Health, published a strategy on 2 March 2010 called “Fulfilling and rewarding lives: The strategy for adults with autism in England”. That joined up all aspects of Government, with no fewer than seven Government Departments contributing, ranging from the Department of Health through to the Department for Communities and Local Government and the Ministry of Justice.

As colleagues have mentioned, the strategy heralded a new approach across Government, transforming the way that public services supported adults with autism, as well as illustrating what Whitehall can achieve when departmental silo thinking is rightly jettisoned. Despite some meaningful progress since it was published in 2010, there is clearly much work to be done. A report by the National Autistic Society revealed that 92% of adults with autism said that they needed some degree of support, yet 70% said that they were not receiving the support they needed. That meant that almost eight in every 10 people who were not receiving support were forced to rely on their parents.

In his foreword to the 2010 strategy, my right hon. Friend the then Secretary of State for Health remarked that

“Autism is sometimes described as a ‘hidden disability’, not only because it has no physical signs, but also because adults with autism are some of the most excluded, and least visible, people in the UK.”

The testimony we have heard this morning underlines that reality. My right hon. Friend also stated that people with autism have been falling through the cracks between different organisations. The 2010 strategy has done much to identify those adults who need support, and improvements are being made, but it is clear that the new autism strategy must look to build on that progress.

Since the 2009 Act and the strategy in 2010, there has been considerable change. Sadly, that has not been consistent throughout the country, and many adults are still not receiving the care or support that they need. Levels of change, and action on necessary improvements, have not yet been sufficient; I do not think that there is any disagreement on that. The forthcoming updated strategy is an opportunity for the Government to maintain national leadership on implementation, and to guide local authorities to enact effective changes and improve services.

It is clear that the identification of those with autism is essential to the success of any strategy, and, to that end, it is right that those in public services are given the tools and knowledge that they need to identify people who may need support. That could mean GPs, other health care workers, police officers, teachers, bus drivers—as we have heard mentioned—or MPs. As a Member of Parliament, I see more and more people in my surgeries who either present at some point on the autistic spectrum or have family members or friends who do.

Although the strategy refers specifically to adults, one key way to ensure that adults are given the support they need is to ensure that they are given the support they need as children. The classroom offers a lot of contact between teachers and pupils, and that relationship is extremely important. Properly trained teachers could

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identify the needs of children earlier, meaning that proper support systems can be put in place as a child reaches adulthood. That is so important—it is vital.

As a parent, I see my children’s primary school making real headway in that regard, but provision in secondary education appears insufficient. I fear that secondary schools in particular too often miss an opportunity with regard to pupils with autism, and that is a great shame. I hope that the Minister will attempt to allay that fear, particularly given the advent of changes in our education system—free schools and more—that have accelerated the use of non-qualified teachers. Will he tell us how the needs of autistic pupils are being safeguarded in the new educational landscape?

As I bring my remarks to a close, I want once again to pay tribute to the right hon. Member for Chesham and Amersham for securing this debate, and for all her work on this issue over many years. I also pay tribute to all the Members who have contributed to this excellent debate. I hope that the Minister can shed some light on the few issues I have raised. We are striving for the same ends, and there is a remarkable crossover in the means by which we want to achieve them. We have the opportunity for a strong political consensus on this issue, and it is one that I sincerely hope we do not waste.

10.34 am

The Minister of State, Department of Health (Norman Lamb): I congratulate my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) on securing the debate, but more particularly on her brilliant work over the years to secure the 2009 Act and the strategy that followed it. I know from my ministerial role that she continues to show an interest and pursue the case for change, and that is incredibly valuable.

Ministers are normally under pressure to respond to requests for meetings, but although I have not had one today, I would like to offer my right hon. Friend the chance to come to the Department, before we reach the final point of the refreshed, revised strategy, to discuss where we are going with it. My hon. Friend the Member for South Swindon (Mr Buckland) spoke passionately as well. I was with him yesterday at a meeting of his all-party group on autism, and he should be part of the discussion. Other Members are welcome too—that would be very valuable.

Mrs Gillan rose—

Mr Buckland rose—

Norman Lamb: I will give way to both colleagues, but first to my right hon. Friend the Member for Chesham and Amersham.

Mrs Gillan: I thank the Minister for his generous offer. He took the thought out of my head, because I was going to ask whether my hon. Friend the Member for South Swindon (Mr Buckland) could accompany me, alongside someone from the National Autistic Society. That offer will be taken up, and communities across the country will appreciate that. Even if the Minister is unable to meet all the demands we have set out today, it is important that he can set out a path forward, so that we can achieve what we have been asking for across the board, so I thank him for his offer.

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Norman Lamb: I thank my right hon. Friend for accepting my offer, and now give way to my hon. Friend the Member for South Swindon.

Mr Buckland: I am grateful to the Minister. I will not take up his valuable time, but I want to thank him for the meeting he had on the strategy the other day with me and my hon. Friends the Members for Salisbury (John Glen), and for Cambridge (Dr Huppert). We have already started the work here in Westminster, and I am very grateful to the Minister for agreeing to a further meeting with my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) to push the agenda forward.

Norman Lamb: I acknowledge my hon. Friend’s comments. I share the shadow Minister’s view that this issue is entirely bipartisan. There is a massive need to change and increase society’s understanding of autism. Awful things so often happen through ignorance of autism and the entire spectrum. It is crucial to raise awareness, as several Members have said.

My right hon. Friend the Member for Chesham and Amersham raised a number of queries about whether the revised strategy would reinforce the points from the original strategy, and I can confirm that it will do so on all the points she mentioned. It must also go further and look into other areas.

My hon. Friend the Member for South Swindon talked a lot about the criminal justice system, and we must look at how we can improve things there. He made the point that someone with Asperger’s is seven times more likely to end up having some contact with the criminal justice system. We have started to roll out the Government’s liaison and diversion service, which I announced back in January. By 2017, we aim to have a nationwide service for people with mental health problems, autism and learning disabilities who end up in the criminal justice system, often inappropriately and unnecessarily. Getting people diverted to diagnosis, which Members have talked about, and to the right treatment can often prevent further offending and potentially thereby transform someone’s life while protecting others.

Mr Buckland: I pay tribute to the Minister for the mental health pilot schemes that are being introduced in Wiltshire and other places; they were recommended by the Bradley review some time ago. Does he agree that community psychiatric nurses need training, particularly in cases of comorbid autism and mental health conditions, which are sadly quite common? We must ensure that the pilot covers autism when it comes to the diversion at the police station.

Norman Lamb: I absolutely agree with my hon. Friend. I wanted also to touch on the point made by my hon. Friend the Member for South West Bedfordshire (Andrew Selous) about the parents of adults with autism who, far too often, are told by clinicians that they cannot talk to them about their adult child’s circumstances. Clinicians often hide behind the absolute importance of confidentiality about a condition in order to refuse to talk at all to the parents—the people who know the individual better than anyone. That is an attitude of mind among too many clinicians. It has to change.

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I also wanted to refer to the points made by my hon. Friend the Member for Strangford (Jim Shannon). I think I can call him my hon. Friend. [Hon. Members: “Hear, hear!”] Thank you for that. He talked about the pressure on families, and he is absolutely right. Whether one is talking about learning disability, autism or dementia—there are parallels with dementia—the need to raise awareness in society is real. I am also happy to look at the Northern Ireland legislation and at what lessons can be learned throughout the jurisdictions.

Another point in response to the debate was to do with transition. Whether with mental health, learning disability or autism, we so often find that disasters happen at the age of 18. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) alluded to that important point. Too often, people are lost to the system. The age of 18 is the worst possible age to withdraw support, whether we are talking about mental health in general or autism in particular.

Robert Halfon: I thank my hon. Friend the Minister for giving way. I gave the figure of 85% of people with autism not having full-time employment, and I mentioned the apprenticeship for autism started by my charity, PACT for Autism. Will the Government’s apprenticeship ambassador, my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones), who is present, work with the Minister with responsibility for apprenticeships to look at introducing such a scheme and rolling it out across the country?

Norman Lamb: My hon. Friend beat me to it, because I was about to refer to his comments on apprenticeships. I am interested in that. I am proud of what the Government have done on apprenticeships in general, but their use for people with autism is an interesting area. I noted the points he made about the scheme in his local area, and I am happy to consider it further.

Mr Burrowes: On incentivising employers and leading by example, the Government, in the NHS, are among the biggest employers around and will no doubt want to be an autism-friendly organisation and employer. Does the Minister have any information about how autism-friendly the NHS is in employing people with autism? Will he look into how the NHS can take a lead by doing that?

Norman Lamb: I absolutely agree that the NHS ought to be an exemplar employer. I suspect that the truth is that it is variable, with areas of good practice, but we do not know enough about the position throughout the NHS. The message should go out from this debate that the NHS has an obligation to lead by example and to demonstrate what can be done. Several hon. Members made the point that employing someone with autism might be quite challenging to start with, but the potential that that individual can offer is often enormous. An organisation could end up with a loyal employee who can contribute massively. The NHS needs to demonstrate that by leading from the front.

Everyone with autism should be

“able to live fulfilling and rewarding lives within a society that accepts and understands them.”

That was at the heart of the “Fulfilling and rewarding lives” strategy, and I stand firmly behind it. Furthermore, the work of the National Autistic Society’s “Push for

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Action” campaign has been hugely valuable in helping the Government to focus on the issues that need to be considered. I pay tribute to the society for inspired leadership. Other organisations have worked with us as well, including the Autism Alliance, Autism Plus and Ambitious about Autism, and I pay tribute to the work of all those organisations.

During our review, we ran a comprehensive exercise to listen and learn how the strategy is working. Nearly 2,000 people, including some on the autism spectrum and some who are involved in planning, commissioning and providing services, took part in focus groups, events and conferences, and more than 1,100 people with autism took part in an online survey. Local authorities worked with their partners and local people to complete a self-evaluation exercise on their progress. All this information, including individual returns, will be made available by Public Health England when the update of the strategy is published. As well as cross-departmental discussions, there has been contact with the different parts of the United Kingdom to discuss all four strategies, including that of Northern Ireland, to find common ground and to improve standards across the board.

Foundations for change have been laid and people with autism have increasingly been engaged locally in planning and designing services. Clear national guidance has been issued on the care, management and diagnosis of autism. We have heard about some great experiences that people have had in further education or with particular employers. My hon. Friend the Member for East Worthing and Shoreham made a good point about the need for employers to take the lead and to demonstrate best practice.

In some areas, there are great local autism teams and excellent diagnostic services. I noted what my right hon. Friend the Member for Chesham and Amersham said about her area and the GP who was taking the lead in that county to commission services. That is exactly what needs to be happening everywhere. I also heard of some great services being provided in Swindon, so there are some good things happening, but it was only five years or so ago that low levels of awareness and a lack of services were what led to the Autism Act, back in 2009. There are some real successes, but there is also much more to do to see the foundations translated into a greater difference to peoples’ lives.

When I have talked to people with autism and to families at events that have taken place during the review, I was struck by how variable the position is. In some areas, very little has happened. We now have the legislation in a good place and a good strategy, which is being updated, but translating that into a difference to people’s lives is where an enormous amount of work still needs to be done.

Mr Jamie Reed: When the Minister comes to publish the refresh of the strategy, will any care be given—as it should, in my view—to the understanding of NHS front-line staff, in particular in emergency medicine, and their identifying patients with autism? I have a series of examples from my constituency of people with autism accessing emergency services, receiving suboptimal care and getting into some pretty dangerous situations.

Norman Lamb: The hon. Gentleman makes a good point. I was going to come on to give an example of that. Sadly, we have also heard from many people with

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autism, and their families and carers, that things have not yet changed enough, or at all, for them. Gaps in provision or waits for diagnostic services continue to be reported. As my hon. Friend the Member for South Swindon made clear, diagnosis is the start of what can then happen; it is a condition precedent to an improvement in someone’s life, and is of course not enough in itself. Many people have told us that they have skills to offer employers that they cannot use. That is totally frustrating for them, and a waste for the individual and for the economy, as my right hon. Friend the Member for Chesham and Amersham made clear.

Mrs Gillan: The Minister has slightly moved on from the point that I wanted to make, but I will make it nevertheless. Will he also look at an initiative that the NAS and I took in my constituency with some parents of children who have autism? I brought them together with the clinical commissioning group in a non-crisis atmosphere, because most of the contact with parents and families with autism happens when they are in crisis. We held a meeting in my office in a non-crisis environment and it was helpful to have an exchange in a calm atmosphere about the issues and problems faced by those individuals and families. They were able to put those across to the CCG and the local authority, which meant that the professionals were then so much better equipped to know what such families and individuals are facing, and to give them the help and assistance that they require. Will the Minister also look at that as a model to roll out across the country?

Norman Lamb: I would. Bringing people with autism and people who use services together with those who are commissioning the services is a necessary condition for any good commissioning, but far too often it does not happen. As my right hon. Friend has demonstrated, there is a role for us here: we can act as local champions to bring people together and put pressure on institutions to change attitudes. I very much share that view.

We are in the final period of finalising the update to the strategy and are giving active consideration to ideas that others have contributed, such as the innovation fund, which my right hon. Friend mentioned, to help develop good practice, and an autism awareness scheme to help local volunteers and community groups. Autism should not be seen as an add-on to services or work programmes, and with well over half a million people on the autism spectrum, everyday services will already be seeing or in contact with many people who have autism. Thinking about and engaging with those people more effectively and making reasonable adjustments or adaptations to existing services will lead to better outcomes for people and a better use of public resources, as other hon. Members have said.

Monday was NHS change day. I was made aware, via Twitter, of a short video about a doctor’s pledge to ensure that instructions given to patients are clear and not ambiguous. The video followed a girl called Lucy who has autism. After a consultation in a room in a hospital, she was told to wait outside A and E, and so went outside the building, because she had taken the instruction literally, and sat waiting for hours outside in the cold in the car park, left entirely on her own. I encourage hon. Members to watch it: it lasts about 30 seconds and was distributed via Twitter. That simple

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and straightforward pledge, made by a doctor who recognised that there had been a complete failure by his service, will help to raise awareness within the service and increase understanding of autism. The hon. Member for Stretford and Urmston (Kate Green) made the point that this is not just a matter for the NHS; other organisations such as banks and other financial institutions have a responsibility to see how they need to raise awareness among their staff.

Many of the changes under way in public services, such as increased personalisation and choice for individuals, are essential to giving people with autism the right kind of support. Support for people with autism may not require huge budgets to achieve improvements, and much can be achieved with a degree of creativity, flexibility and determination.

This issue is relevant not only to health and care, however. Again, we can draw a comparison with the dementia situation. The Prime Minister’s challenge on dementia is about how not only health and care services but society need to change, and how we need to raise awareness across society. The same applies for people on the autism spectrum. It is about changing people’s lives, both where they live and where they work. We know that so much more could be done to promote autism awareness, but our society is becoming more aware of autism. We hear about local schemes to make parts of the community more accessible and welcoming to people with autism. For example, as was referred to earlier, cinema screenings are being made autism-friendly by simple adjustments such as having the lights on low and the volume turned down.

Services based around low-level interpersonal support, such as buddying schemes, have enabled adults with autism—including people who do not qualify for support from their local authorities—to participate in different social and leisure activities and have promoted social inclusion. The example of the special showing of a musical in London is a good demonstration of an organisation prepared to go the extra mile to make life enjoyable for people in those circumstances. Exactly the same can be done for adults as for children, as my hon. Friend the Member for South Swindon said.

The Care Bill also puts a duty on local authorities to develop preventive services for people within communities. The shadow Minister and I have been devoting a lot of our time to the Care Bill. It is great and groundbreaking legislation that puts a focus on individuals’ well-being and happiness. If we can change the way in which organisations such as local authorities behave towards people with care and support needs, so as to focus on their well-being and not the needs of the institution, we can effect real change.

The Children and Families Bill will bring significant improvements to the transition of young people with autism from school, through college and into adult life—a point made by the shadow Minister. It will introduce education, health and care plans for people from nought to 25, which will put greater emphasis on long-term outcomes for young people. We know that caring for someone with autism can be extremely rewarding, but it can also be incredibly challenging, both emotionally

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and financially. The changes to carers’ assessments that will be introduced if the Care Bill becomes law will ensure that many more carers can get support.

It is also important to improve training on autism for front-line public service staff, a point raised several times in our debate. Since 2010 we have worked with a range of organisations to produce a comprehensive set of resources for staff in the health and care sector. Health Education England has a role to play, along with initiatives from the royal colleges, such as the Royal College of General Practitioners, whose adoption of autism as a clinical priority from April this year is very much to be welcomed. The regulations to support the Care Bill will also require community care assessors to be suitably trained—again, an issue raised in our debate. Having autism-aware police officers, courts and probation services can make a great difference. The existing statutory guidance made it clear that autism training should be available to all staff working in health and social care.

To plan effectively, local authorities need access to data on numbers and needs that are as comprehensive as possible. From April this year, as an outcome of the zero-based review of adult social care data, they will have to record a person’s primary reason for support and any health conditions that person may have, including autism. That provides a basis for possible future measures on autism in the adult social care outcomes framework.

A key challenge for many older adults with autism is that they will have had significant support from their families, but as families age that becomes less possible. We are considering how to build on the recent NAS report that followed work by the House of Lords autism and ageing commission.

As we have heard, most people with autism want to work, and have skills and talents that would be incredibly useful in the workplace. The policy paper “The disability and health employment strategy: the discussion so far” outlines a more personalised and tailored approach to employment support for disabled people, including people with autism. As well as challenging negative behaviours and attitudes, the Disability Confident campaign launched last year by the Prime Minister is designed to help employers who are unsure about the benefits of employing disabled people.

Adults with autism are entitled to benefit from all the Government’s wider initiatives to get working-age people into employment. The Department for Work and Pensions is aware that more can be done to help people with autism make the most of those programmes and of themselves. Only this week, the DWP held an event with my Department and the NAS, for people on the spectrum and for employers, to improve people’s experiences in applying for jobs at the jobcentre and with employers.

We are only at the beginning of the journey to improve all aspects of the lives of people with autism, including when they are seeking employment or are in education, as well as the support they get in health and social care. We need to continue with concerted action and commitment both nationally and locally to make a difference. The update of the 2010 strategy will mark the next step in that journey, but there is still a long way to go.

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Fatal Domestic Violence

11 am

Mr Robert Buckland (South Swindon) (Con): It is a pleasure to secure a debate on this sensitive and important issue. I am grateful that the Minister is in is place to hear the case for peer support and advocacy services for the families of domestic homicide victims.

Our understanding of the full effects of domestic homicide is still emerging, but I will give my perspective. I was a criminal barrister for many years, and I dealt with homicide, murder and manslaughter cases. I thought that I had a deeper understanding than most people of the effects on the families of victims, but I realised after discussions with expert advocate services that the family’s journey does not end at the door of the court when the verdict is passed and the sentence is handed down. Often, that is only the first stage of a long, arduous process through which families have to go.

A domestic homicide, whether it is murder, manslaughter or another form of death, profoundly changes a family’s life in an instant. For example, the surviving children may have witnessed abuse or the killing, or they may have lost a sibling. They may have lost both parents if the perpetrator parent either committed suicide or is held securely. The family property immediately becomes a crime scene, the criminal justice system must be navigated and the health and financial costs of that need to be challenged. Information that is vital to the family may have to be held back so they are not compromised as witnesses. At the same time, they must deal with the grief that results from the loss of their loved ones and the private personal details of their lives will be made public. It is a self-evident truth that the aftermath of such a death is traumatic. It raises issues that nobody the family knows has ever had to deal with before, and thrusts the family into contact with agencies with which they never thought they would have to engage. In an instant, they are in a strange, troubling new world.

Specialist advocacy and support is desperately needed for those families. There is a real concern that the Government’s well-intentioned proposal to give a grant to one prime service provider while withdrawing direct grants to smaller specialist and expert providers will reduce the number of families who are provided with specialist expert and independent support after domestic homicide. The Government recognise that that sort of support helps families to cope with and recover from the trauma.

The organisation Advocacy After Fatal Domestic Abuse is directed by somebody whom I regard as a friend, Frank Mullane. It is an award-winning service that is funded from a number of sources, and for a number of years it has received welcome and helpful contributions from the Government. It provides specialist services to some categories of families—in particular, families who were bereaved before April 2010, for whom Victim Support’s homicide service currently has no responsibility and for whom the homicide service provider will not have responsibility from October 2014, and families whose tragedy attracts a section 9 domestic homicide review. The Government brought that important provision into force, and I warmly welcome their decision. However, a number of organisations already refer families to AAFDA for domestic homicide reviews, and Victim

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Support’s homicide service signposts families to the organisation. The word “signpost” is important, because Victim Support uses the word “refer” only for organisations that it directly commissions using its budget. AAFDA has an excellent relationship with Victim Support’s homicide service, and the two organisations collaborate effectively on behalf of many families.

Victim Support’s homicide service signposts families to AAFDA for help not only with that issue, but also with inquests, serious case reviews, mental health inquiries and other matters. Families also directly approach the organisation, and it has an input into Independent Police Complaints Commission inquiries. It does a range of work, and engages with local employers, service providers and other agencies to provide a full package of support.

Andrew George (St Ives) (LD): My hon. Friend is making an excellent case. I entirely agree about the excellent work of Frank Mullane. As my hon. Friend is aware, the police must appoint a family liaison officer to support the families of victims on every occasion. However, a problem that has not been resolved is that in murder and killing cases, the perpetrator, until convicted, is treated as the next of kin of the deceased and the children.

Mr Buckland: That is right, and that relationship often leads to manipulation after the event. The intercession, the support and the advocacy service are vital if we are to prevent families from reliving the trauma, as has happened in many sad examples.

The Minister will be aware of the report that was completed in July 2011 by the former Commissioner for Victims and Witnesses, Louise Casey. It was the largest survey of bereaved families ever undertaken; more than 400 families revealed the toll of bereavement. Louise Casey concluded that the devastating effects of homicide manifested in many ways. She rightly concluded:

“these effects persist for many years.”

That is why I said that the criminal trial is often only the beginning of the journey for the family.

Louise Casey identified the enduring needs of families after homicide, and she provided several important conclusions. First, many families who were bereaved before April 2010 still need the support of specialist agencies after October 2014. There is a concern that the funding for the homicide services for those families has not been dealt with adequately. Secondly, many families who were bereaved after April 2010 still require ongoing support. They already seek out AAFDA and other small specialist organisations during the time that the current national homicide service provider is engaged and afterwards.

From 1 October, the prime service provider will have to have an exit strategy with families, or its capacity will eventually be insufficient because of the numbers that will come to the service. For many families, the journey through the criminal justice system alone may take several years. For example, some domestic homicide reviews are necessarily suspended until the end of the criminal trial, and some inquests may not take place until several years after the tragedy. I know of an example of a family who are about to face an inquest that will last for several weeks, two and a half years after the homicides.

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A further problem arises because families’ emotional and practical needs often do not emerge until years have passed since the homicide. It is then that the smaller specialist organisations such as AAFDA will be approached to help those families cope and recover. In reality, and as history shows, many families need help to cope and recover after the homicide service has exited the process. That is no reflection on the services provided by the homicide service, but it is simply a fact of life that the amount of time that people need to cope and recover often will not match the resources that are available. There is a concern that those families will not get the support that they need.

Although the Government’s aim is that from October this year, the prime homicide services provider will commission other services that families need, there is a worry that the expertise of small organisations such as AAFDA may be overlooked, and if it is not overlooked, that the funding available will be insufficient to make the service sustainable. That will result in fewer families getting the support that they need.

I cannot overemphasise the expertise and skill of AAFDA. It is a registered charity that was formed in 2008 and which has strong connections with Swindon, where my constituency is. It has become expert on domestic homicide, domestic violence and supporting families after these horrors, including support through the criminal justice system. It has been recognised by both the previous Government and this one as a leader in its field.

AAFDA has three specialist caseworkers, two of whom lost family members to homicide, and the other who has 30 years’ operational and strategic experience in the domestic violence sector. In addition, it has a volunteer criminologist and a volunteer barrister who give significant pro bono help. One of AAFDA’s caseworkers is considered to be a national expert on stalking, and the other two caseworkers, including the director, Frank Mullane, are Home Office accredited chairs of section 9 domestic homicide reviews. AAFDA is, of course, a member of the Home Office panel that quality assures those reviews.

Frank is rightly credited with being the driving force behind domestic homicide reviews becoming law in England and Wales and helped draft some parts of the statutory guidance. He has a now-growing academic expertise, being a visiting lecturer and assessor at the university of Gloucestershire, and he works closely with universities both at home and abroad. He is continually learning about developments in the sector. Having attended, for the past four years, the annual conference of AAFDA, held in Swindon, I too, have learnt a lot about this area. I have met some of the families being helped by the organisation and I have listened to speakers from as far afield as Sweden, Ireland and indeed, from many parts of England. AAFDA is also a member of key national forums, advising the College of Policing, the Association of Chief Police Officers, the Crown Prosecution Service and those of us—me included—who are looking to develop legislation on domestic abuse.

In the brief time I have left, I want to give some case examples of the importance of the ability of the organisation to stand in the shoes of those who have been victims of domestic homicide. The fact that we are

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dealing with immeasurable grief almost goes without saying, but let me give an example of one family. A woman—a mother and sister—was killed by her husband. The family had to summon up the strength to clean the bloodstains from the house where the victim was killed—just imagine that for a moment. As one family member said to the media,

“it's like being told—it's not your mess, but you clean it up.”

That is a graphic, I accept, but important illustration of the ordeal that people have to go through, not only in losing somebody, but in physically dealing with the aftermath of a homicide.

That family are being helped and have been helped for more than three years. They have been given expert advice and guidance on which organisations they needed to go to to get the information that they needed, otherwise they would have been in isolation. That family have channelled their resilience into providing well thought through and skilful challenges to the various bodies in the system, and it is an important example of what can be achieved to the benefit of those who have suffered.

Another example is where uninformed advice had been given to a family about a domestic homicide review, and because of that uninformed advice, they had declined to participate. As a result of signposting to AAFDA, they were given proper, expert advice. The process was explained and the family changed their mind. They participated in the review, and the review itself has benefited hugely from the involvement of the family. It has given them an opportunity to participate and to explain from their point of view the challenges that the system posed to them.

It is all about identifying and achieving the objectives of the family while managing their expectations, because for many families, finding out the facts of the case and what happened can be a huge difficulty, for some of the reasons I outlined earlier. Helping families to acquire that information may serve at least two purposes. First, as the Prime Minister acknowledged when he gave evidence to the Liaison Committee in 2013 about the awful case of Jacintha Saldanha—the Bristol nurse who took her own life after the very sad hoax call from broadcasters in Australia—the family absolutely need the truth. They need the facts.

Secondly, and this is important, significant public resources may later be avoided as a result of the resumption of inquiries that have been justifiably sought by the families because the initial inquiry had been wholly inadequate. Many of these families cannot afford solicitors, but they need—this is undeniable—help from those who have considerable experience of the system. As I have said, the work that AAFDA does with regard to inquests is very significant. It is an advocacy service that helps a family to understand the process and how they can participate and prepare for the ordeal itself.

I have given a few family examples, but I want to give one further example of a family who talked with passion about the action plan that was set out by AAFDA. That action plan gave that family a sense of where to go and what to do and allowed them to move forward. AAFDA helped to make sense of the process to the family in a way that just was not happening for them without its input.

As I have said, AAFDA is influencing the practice of domestic homicide reviews to include family and friends. It first influenced the Government to ensure that that

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was stated clearly in the statutory guidance, and its caseworkers continue to advocate strongly on behalf of families, so that reviewers understand that the family is to be given space and to be integral to the reviews, rather than lip service just being given to their involvement. Without families being able to influence the reviews, frankly, they become meaningless. They become talking shops and they become ineffective.

As I said, there are concerns about the way in which funding will be configured from October this year. Although AAFDA is already working with police and crime commissioners such as Angus Macpherson in Wiltshire, there is a difficulty for them directly to fund the work because the incidence of domestic homicide in many police areas will be low. Therefore, the nature of that specialist work will, by dint of its relative rarity, have to be in a national framework. That is why, we understand, the funding is being administered centrally. I would be grateful if my right hon. Friend the Minister could not only acknowledge the value of the work by organisations such as AAFDA, but look carefully again at the funding mechanism to make sure that this invaluable service and others like it are not lost to those families in real need.

11.18 am

The Minister for Policing, Criminal Justice and Victims (Damian Green): In congratulating my hon. Friend the Member for South Swindon (Mr Buckland) on securing the debate, I very much echo his opening words that this is indeed a sensitive and important area. I also echo his closing words in paying tribute to AAFDA and the other organisations that work in this most difficult area. I have been aware for some time of his interest in and knowledge of the area from the various written questions that he has submitted on it.

I am more than happy to assure my hon. Friend that the Government remain committed to ensuring that victims of all types of crime have access to support to enable them to cope and, wherever possible, to help them to recover from their experience, or at least, to be able to have some kind of normality in their lives: for example, returning to work, re-engaging with outside interests and trying to rebuild their lives.

Domestic abuse and homicide are particularly abhorrent forms of crime. Such violence, as my hon. Friend said, ruins and destroys families. It is insidious and can take many forms: physical, emotional and sexual. Homicide is its most extreme manifestation. Clearly, for anyone to lose a loved one in such a way is a disturbing and traumatic experience.

Progress has been made over the years to raise the profile of the issue and, more importantly, to fight it. In 2011, the Home Office implemented section 9 of the Domestic Violence, Crime and Victims Act 2004. That means that local areas and agencies are expected to undertake a multi-agency review following a domestic violence homicide to help all those involved in the review process in identifying the lessons that need to be learned. In November 2013, the Home Office published a document setting out the most common themes that were identified as lessons to be learned.

I am obviously aware of the organisation Advocacy After Fatal Domestic Abuse, based in my hon. Friend’s constituency, and of the very good work that it does in

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supporting those affected by domestic abuse and homicide. More generally, support for those bereaved by homicide has been improved in the past few years. The Government remain committed to providing support for victims of crime and their families, and that includes provision of support for those bereaved by homicide.

Currently, the Ministry of Justice provides £2.4 million of annual funding to a national homicide service provided by Victim Support. That service provides an assigned caseworker who delivers and co-ordinates practical and emotional support and who can commission specialist support, including legal advice and counselling. In addition, the Foreign and Commonwealth Office currently provides up to £100,000 of funding a year for additional support when the homicide has occurred abroad. That funding helped 4,500 individuals to be supported by the homicide service between 2010 and the end of 2013. Currently, 2,588 people are being supported.

In addition, the Ministry of Justice currently provides a total of £350,000 of annual funding to a number of other specialist and peer support organisations that provide help for families bereaved by homicide. Advocacy After Fatal Domestic Abuse is one of the organisations providing peer support that we currently fund.

A new national homicide service is currently being commissioned by the Ministry of Justice and, from October 2014, the Ministry of Justice will be providing grant funding for a more integrated offer of support for those bereaved by homicide. It will provide access, where required, to practical and emotional support and to both specialist and peer support.

The principle of service provision is that it will be based on need. My hon. Friend mentioned Louise Casey’s review of the homicide service in 2011, and rightly so; it is an important document. One of the lessons that we have drawn from it and, indeed, from learning and feedback from the service providers currently funded, is that the needs of those bereaved by homicide can range from the short term to the long term and, in some cases, as he said, persist for many years or even be lifelong. In that regard, it is important to remember that Louise Casey’s report called for an integrated service for the bereaved; and, indeed, an integrated service commissioned and managed by one grant fund will be able and required to refer individuals to peer and specialist support. That is precisely because signposting, under current separate grant funds, is sometimes not in the best interests of families, so we are trying to address that specific point that my hon. Friend made.

We also know that individuals who need support will not inevitably fall into one category of support need. Individuals who need specialist advice may, for example, also need immediate practical support and advice, counselling support or help with claims for compensation through the Criminal Injuries Compensation Authority. We know that victims’ needs can both change and recur over time, so not only will the balance of what victims need across these various areas of support vary from individual to individual, but the balance of support that any individual needs may change over time. That is why we want support to be available to individuals for as long as they need it; we are not looking to exit individuals from the support that they need according to a pre-set time scale or proportion of the available budget. That is to say that victims who receive support from the national homicide service will be able to do so for as long as they

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need it. We also want the support offered to address and help to meet the range of an individual’s needs, so that in time the need for support reduces.

The Ministry of Justice therefore intends to provide one grant award for a national homicide service. We are inviting bids from organisations that can demonstrate how they will deliver support across the range of needs; it is important to ensure that this leads to a more integrated service than the current separate funding arrangements. We are inviting prime contractors with subcontractors, and consortiums, to bid. There is therefore scope for smaller organisations, including peer support groups, to take part in the process, either as bidders for the direct MOJ grant or as partners in service provision. This competitive grant process will allow the provision of support to families based on need and entitlement, and provision of the support is therefore not time-limited.

Let me be clear that although we are changing the way in which we fund the homicide service in order to provide a more efficient, effective and integrated service, we remain committed to ensuring that peer support is available to those victims who want or need it. It is expected that in bidding for and providing the service, the future recipient of this grant award will need to demonstrate how it will directly provide support and, where it cannot directly provide all support across the range of needs, it will put in place sustainable arrangements with other organisations that can help to ensure that the range of needs are met.

Let me address directly a point that I know AAFDA makes: what happens to those bereaved by homicide before the setting up of the homicide service in 2010? Among the essential features of the current service model is that it is designed to provide immediate support and then structured ongoing support. It provides a dedicated caseworker in the immediate aftermath of bereavement who conducts a needs assessment. Obviously, the needs of those bereaved before 2010 will not be best supported by this service model, so we do not propose to extend the scope of the new service to include support in cases that predate the current service, but organisations that currently support pre-2010 provision were advised in August 2013 that they would need to ensure that they made suitable funding arrangements, either to continue to support service users or to transition them to appropriate services once the current funding streams ceased. At the

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same time, the Ministry of Justice also gave organisations the opportunity to engage in work to consider how to help the victims sector build capacity and capability ahead of the move to local commissioning by police and crime commissioners in October 2014. Of course, PCCs will be able to augment nationally provided services locally as they see necessary.

The organisations have been told about this; they have been told about the new funding arrangement, and I hope that they will be able to use the new arrangements to ensure that they continue their essential services. If an organisation proves unable to develop such arrangements and that means that there is a risk of essential support ending, it can and should contact the Ministry of Justice to highlight that risk, the steps that it has taken to resolve it and information on the range, volume and type of support activities that would constitute the gap in service provision from October 2014, because the purpose of the new grant award arrangements is that resources can be distributed as effectively and efficiently as possible, which will ensure that organisations provide as much support as possible for individuals.

I again emphasise the importance, under the new arrangements, of commissioning by police and crime commissioners. That will mean that decisions about local services are based on local needs and made by individuals who have an understanding of those needs and who can be held accountable for the money that they spend on these services. Each PCC will therefore be able to look at the range of services being provided both locally and nationally and make their own assessment of how to provide additional, tailored support to victims based on local requirements.

I think that the new system will be better integrated than before and I hope that it will also be more flexible than before, so that the small specific charities that do such vital work will be able to continue doing it. I hope, therefore, that I have gone some way towards reassuring my hon. Friend that it is precisely because of the changeable and varied needs of individuals who are bereaved by homicide that a grant award for a co-ordinated and integrated provision of service is the right approach to ensuring that those bereaved by homicide have access to vital support.

11.30 am

Sitting suspended.

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Severn Bridges (Tolling)

[Mr Peter Bone in the Chair]

2.30 pm

Jessica Morden (Newport East) (Lab): It is a pleasure to serve under your chairmanship, Mr Bone, especially in view of your south Wales connections. I am grateful for the opportunity to debate the Severn bridge tolls. The subject has been debated regularly in this place in recent times and has been given keen cross-party scrutiny by the Select Committee on Welsh Affairs, of which I am a member. The level of tolls on the Severn bridges is a thorny issue. It is an ongoing frustration for constituents and businesses. That concerns me, because I have a toll booth on the edge of my constituency, and it concerns other hon. Members who have constituencies in south Wales and England. I am grateful for the turnout today.

Mr Mark Williams (Ceredigion) (LD): I congratulate the hon. Lady on securing the debate. I emphasise that there are ramifications for a much broader range of people than those who represent the M4 corridor. Those of us in west Wales, haulage industry contractors and the tourist sector have a deep interest as well.

Jessica Morden: The hon. Gentleman makes a valid point. As the Welsh Affairs Committee discovered during our inquiry, the tolls have major ramifications for the rest of south Wales. For that reason, I am glad that other hon. Members are here, and I hope that they get a chance to talk about how they have been affected.

As we approach the end of the concession with Severn River Crossing plc in 2018, we need an openness from the Department for Transport and the Treasury about the plans that are being made for when the bridges return to public ownership. The Welsh Affairs Committee published its report on the Severn crossings in 2010, which urged the Government urgently to set up a future strategy for the crossings and called for tolls to be reduced significantly. Four years later, however, we are no further on. The only progress has been to allow people to pay by debit or credit card on the bridges in time for the Ryder cup, and what a long-drawn-out, tortuous process that was.

The tolls continue to go up every year, regardless of the economic climate and people’s ability to pay, and my constituents need some kind of light at the end of the tunnel. It is generally accepted that tolling was necessary to fund the crossings on the Severn, but what was so unfair about the Severn Bridges Act 1992 was that it introduced a concession so rigid and inflexible that the toll cannot be varied to help in difficult economic times without the taxpayer incurring liability. Any request to modernise the bridges receives the stock response that the Government cannot make any changes without extending the concessionary period even further or charging the taxpayer. The situation is unfair, because Severn River Crossing plc is fully compensated for any change that comes along, and it can whack the tolls up year after year in line with the 1992 Act. The Treasury is happy because it keeps the VAT and other tax income, and it quietly does well out of the bridges, but bridge users are stung time after time, and they have to pay more for longer.

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I called the debate because I want to articulate the real frustration that bridge users feel, and to ask the Minister explain openly where we are and what the Government are planning. We have learned over the years that information on the finances of the bridges is hard to come by. Mysterious debts spring up, and dates and figures regularly change. I hope that today offers us a chance to get some clarity. If anybody is in any doubt about the effect that the tolls continue to have on the economy, they need only hear what a business man said to me this week:

“the majority of business visitors comment within the first few minutes of a meeting about the toll, never positively, and people feel that it develops a negative impression of Wales—both from a business perspective, but also for those who may return as a potential tourist.”

If every meeting in the offices and factories of south Wales starts like that, something has to be done. It is time that the Government listened.

Paul Flynn (Newport West) (Lab): Does my hon. Friend share my bitter disappointment that the hon. Member for Monmouth (David T. C. Davies), who demanded this week that the Severn bridges be nationalised, is not here to deliver his battle cry to build socialism in our time?

Jessica Morden: The hon. Member for Monmouth (David T. C. Davies), who is the Chair of the Welsh Affairs Committee, is away. I know that he would have been here otherwise. We note with interest his conversion to the cause.

Jonathan Edwards (Carmarthen East and Dinefwr) (PC): I congratulate the hon. Lady on securing this extremely important debate. She mentioned the hidden costs; the UK Government dropped a bombshell on the Welsh Affairs Committee a year or so ago, when they said that there would be an outstanding debt at the end of the concessionary period, when the bridges returned to public ownership. There is no clarity about the sums involved or how long it will take to pay that debt. Does she share my concern that many of our constituents believe that the Treasury is using the bridges as a cash cow? Without clarity on the matter, the people of south Wales will feel that the Treasury is intent on fleecing motorists for the foreseeable future.

Jessica Morden: I strongly agree, and I will say much the same thing in my remarks. The Severn bridge tolls are the most expensive in the UK. It now costs £6.40 for a car to cross the bridge, £12.80 for a van, and £19.20 for a coach or lorry. By comparison, it costs just £1.50 for a car to cross the Humber bridge or £2 to use the Dartford crossing. However, the Dartford crossing is free to use between 10 pm and 6 am, and a scheme was recently launched under which local residents can pay just £20 a year to cross the bridge as often as they like. Those are both examples of the Government stepping in after local campaigns and helping long-suffering road users. If they can help businesses and residents in those areas, why can they not take decisive action to help in the case of the Severn bridges?

The tolls are a cost-of-living issue for my constituents, especially those who commute daily over the bridge, and the cost is a big burden for many businesses that operate out of south Wales. Constituents constantly tell

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me how hard they find it to absorb the increased tolls each year when pay is frozen, hours are reduced and the cost of living continues to rise. A constituent e-mailed me a few weeks ago to say:

“I’m employed in Yate in Bristol which means I have the daily trip across the bridge. While I had budgeted for the bridge cost, the actual cost of commuting along with the increase in the cost of living is currently causing me great concern. I try to ride an old motorcycle as much as I can”—

a motorcycle can cross for free—

“but I have found the wind protection on both bridges to be unsatisfactory, even in the summer, leading me to balance the cost of taking the car with the danger of taking the motorbike. Therefore, I would really like to take the car every day but the cost is just too high, and as you know the cost has now increased again.”

There is little choice. It costs about £2,400 to commute to Bristol by train using a standard adult ticket. Some of my constituents feel that the yearly toll increases have a knock-on effect on alternative modes of transport, such as the bus or the train, which further restricts their choices. The train service from Severn Tunnel Junction station is frequently full, and commuters are sometimes left standing on the platform at peak times. Those who commute between Bristol and Newport East have a really raw deal, which is a significant barrier to those looking for employment in Bristol. It is one thing to pay the toll once a week or so, but quite another to pay it every day, just to go to work. The local anger and frustration was demonstrated just a few days ago on St David’s day, when 120 local singers re-enacted the Rebecca riots—the men were dressed in traditional women’s clothing, apparently—on the M48 bridge. That shows just how strongly people feel about the matter.

Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op): I congratulate my hon. Friend on securing an excellent debate on a crucial issue, and I endorse all the points that she has made so far. She has mentioned individuals, but does she agree that we are also hearing increasingly from businesses? In particular, the Freight Transport Association, which has 700 members across Wales—many of them in my constituency—has talked about the impact that the tolls are having on the small margins in its members’ businesses.

Jessica Morden: I thank my hon. Friend for his intervention. I was going to praise the Freight Transport Association for its campaign, so I am glad that he mentioned it, and I very much agree with him. The Newport business man I mentioned earlier also told me about the negative impression of the toll:

“the toll has a major effect on recruitment and retention of staff in both directions. The northern fringes of Bristol across to Cardiff are all very commutable (M4 allowing) but having to build in excess of the £30 per week in to commuting costs prevents a lot of skills transfer between the areas. As an example, an employee of one of my clients told me that the bridge tolls have risen nearly 50% in her time commuting, whereas her salary has risen less than 15%.”

Businesses, particularly those in the haulage industry—I make special mention of the Freight Transport Association’s campaign—say that the tolls mean they bear a cost that their competitors across the bridge do not have to deal

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with. They have to add the cost on to their bottom line, which hits their competitiveness. Some companies pay in excess of £250,000 a year.

A Welsh Government study, of which I am sure the Minister is aware, shows that scrapping the tolls altogether could improve the economic output of south Wales by some £107 million. The report also shows that for a car journey—excluding commuters and business travel—the toll represents approximately 19% of the costs of a trip between Cardiff and Bristol. For light goods vehicles the figure is 23%, and for heavy goods vehicles it is 21%. The total cost of crossing the bridge for businesses and consumers, once VAT is taken into account, is in excess of £80 million a year in 2009 prices.

That is the impact of the tolls, which I am sure other Members will also articulate, but what can the Government do to help? Every year, when it is announced that the tolls will go up, bridge users ask for them to be frozen, and the Government say that they cannot be, because of the concession. However, the Government wrote off £150 million of the £330 million debt on the Humber bridge, so where there is a will, there is a way. The Government could step in and compensate the concessionaire; they just choose not to. Will the Minister address that point when he responds?

Last year, the Welsh Affairs Committee asked the previous Minister, the hon. Member for Lewes (Norman Baker), to look at a scheme for business—for example, a toll-free overnight period that would help businesses with their costs, as well as easing congestion. The current Minister has replied that the concession would have to be extended to pay for that. I will say it again: the Government stepped in to help with the Humber bridge; why not do so here? Will he clarify his remarks about the TAG concession being the limit of the concession that the Government can offer under European law? It would be helpful to have that explained in person.

Will the Minister also give us some answers on what the Government are planning, as regards where we go at the end of the concession, when the bridge returns to public ownership? The Treasury has done pretty well out of the Severn bridges in previous years. In 2000, the European Court of Justice ruled that VAT must be charged on private bridges. Between 2003 and 2012, the Government accrued an unexpected windfall of £121 million as a result of that change. Estimates from the Scrutiny Unit suggest that by the end of 2013, the figure is likely to be nearer to £135 million.

The Finance Act 2007 started the abolition of the industrial buildings allowance, meaning that the Government held on to an estimated £21.2 million, in 1989 prices, which they would never have expected. I understand that in today’s prices, that would be nearer to £40 million. Although the Government argue that they must continue tolling to recoup the £88 million in costs from unexpected repairs to the first bridge, they have actually accrued more than £160 million from both changes, which is more than enough to write off the existing debt. Will the Minister please update those figures and confirm how much to date the Government have received from VAT, and how much has been saved as a result of abolishing the industrial buildings allowance? The Department for Transport does not seem keen to answer my latest parliamentary question, even though we have had the figures before.

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Will the Minister confirm that we are still looking at mid-2018—the last date we had—for the end of the concession? Previous Ministers have alluded to the fact that they would like to continue tolling for two years after the concession ends in order to recoup the Government debt that we have discussed previously—that was admitted to the Welsh Affairs Committee a couple of years ago. Is that still the case? Will the Government publish an updated full breakdown of the outstanding £88 million of debt and how and when it was incurred?

What is the current thinking on the level of the toll? The Minister has just written to the Select Committee to say that VAT would not be collected on a public bridge after the concession ends; will the tolls therefore reduce by at least that amount? If not, and the Government maintain the level of the toll, the Freight Transport Association has pointed out that businesses will no longer be able to reclaim VAT and so could effectively face a 20% hike in tolls. A specific answer on that possibility would be helpful, because we do not want businesses to end up in a worse position.

What serious work has been done on concessions for people who live locally? As I mentioned earlier, people who live locally can now cross the Dartford crossing an unlimited amount of times for £20 a year; that sounds extremely good to me. I hope that we do not hear, again, the stock answer to all such questions: “We have made no decisions about the tolling and do not know what the level will be. We are not there yet.” At the heart of the issue is a strong suspicion that the Government see the bridges as a cash cow, or even—as was suggested to me—a river of money. The concessionaire is in a win-win situation, as it can increase the tolls every year and be compensated for any changes. Meanwhile, the Government receive more than they expect through VAT and other income, while the poor old user has to pay more for longer.

In its 2010 report, the Welsh Affairs Committee recommended that, come 2018, tolls be reduced to a maintenance-only level, which would be very much supported by my constituents. We called for transparency on the financial arrangements of the bridges, and for discussions on ownership to be considered. We also asked the Government to consider off-peak rates for businesses, and local concession schemes for residents. Four years on, we have very little detail on anything. May we please have some answers today?

2.46 pm

Mr Mark Harper (Forest of Dean) (Con): It is a great pleasure to serve under your chairmanship, Mr Bone, and I am grateful to the hon. Member for Newport East (Jessica Morden) for securing the debate.

Anyone following this debate might wonder why I, as an English Member of Parliament, am here. It is worth reminding the House that the old Severn bridge is entirely in England—indeed, my constituency stretches halfway across the bridge and the constituency of the hon. Member for Thornbury and Yate (Steve Webb) stretches the other way. The new, second Severn crossing is of course half in England. My first plea to the Minister is for him to be clear that, because three quarters of the bridges are located in England, they must remain under the control of the United Kingdom Government so that the interests of both English and Welsh residents can be taken into account and balanced properly.

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I know that the hon. Lady did not do so, but many in Wales have advocated that the bridges should be under the control of the Welsh Assembly Government. Given the fact that they are in England, and that my constituents are as affected as the hon. Lady’s, it would be wholly wrong for the bridges to be under the control of a Government over whom my constituents have no democratic influence. I make that plea strongly and hope that the Minister can confirm that that is the case.

Perhaps the shadow Minister could also confirm that that is the Labour party’s policy? I am guessing that it is, on the basis that when it was in power for 13 years it left the bridges under the control of the UK Government’s Department for Transport, but it would be helpful to know whether the UK Labour party’s position is the same as that of the Welsh Labour party. The latter wants to take control of the toll revenue. The First Minister has said that one option should be that the Welsh Government should take full control and play

“a central role in determining future arrangements and in accessing and utilising any future revenue streams for the benefit of the people of Wales.”

As I say, that would be quite wrong. The bridges are three quarters in England and any changes will affect English residents just as much as Welsh. The control and decision making about any future tolling regime, or lack thereof, should be taken by the UK Government.

I agree with the hon. Lady that our constituents, and businesses in our constituencies, would rather there were no tolls. I have had conversations with my constituents and said that in an ideal world it would be lovely to have had estuarial crossings financed wholly out of general taxation with no toll. However, I know the world and the realities of paying for things. I know that the previous Government were not great at balancing the books, but it is better to have the estuarial crossings with a toll than to have no toll but no crossings. Of course, all previous Governments decided that tolling was the way we paid for significant estuarial crossings.

I know that when the bridges return to the control of the United Kingdom Government in 2018—I agree with the hon. Lady that it would be helpful if the Minister could confirm what the latest expectation of the date is—some decisions will need to be made. I would like the Minister to think about a range of things. First, I agree with the hon. Lady that it would helpful to know whether the Government will stop levying VAT once the bridges revert to public ownership, which would mean £1 off the price of the toll.

Secondly, decisions have to be made about the future maintenance of both the second Severn crossing and the old Severn bridge that has the M48 running across it. The old bridge has significant maintenance costs. I think the hon. Lady alluded to—the Minister will be able to confirm this—the costs of maintaining corrosion resistance on the cabling on that bridge, which are significant. However, it is important to keep that bridge functioning and benefiting, particularly, my constituency, which benefits most from that bridge as opposed to the second Severn crossing. I am sure that the Minister will be able to say a little more about that when he responds to the hon. Lady’s question.

Thirdly—this is relevant to the question of future tolling on the Severn crossings—the Highways Agency and the Government will have to think about whether there should be future crossings of the River Severn.

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In my constituency, as one goes up from the existing tolled crossings, there is a crossing at the Over bridge, after the junction between the A40 and A48. That bridge is a significant traffic bottleneck, causing severe tailbacks to my constituents—both commuters going to and from work and businesses in the area. Some short-term solutions have been proposed for the end of this year and for 2015, but the only long-term solution is a future crossing somewhere south of that bridge and north of the existing tolled crossings.

Neil Carmichael (Stroud) (Con): I have set up a commission focusing on economic growth on my side of the Severn. One of the options we should consider is a new bridge. Does my hon. Friend agree that any decisions about tolling in the future should take into account the need for a new bridge somewhere along the Severn?

Mr Harper: I agree, for this reason—I will be clear to the Minister—in an ideal world, I would like another crossing over the Severn. I would prefer that to be paid for out of general taxation and not require either tolling on that crossing or continued tolling on the existing crossings. However, I do not want the Minister to rule out, at this stage, considering whether at least some of the future tolling revenue should be used to fund a third crossing. I think the hon. Member for Newport East was tempting him to rule that out; she was tempting him to look forward something like four to four and a half years, to make some decisions about a future tolling regime on the crossings today and then to announce them to the House.

If I am given the choice of a crossing, I will take the crossing. However, if I am told that I cannot have a crossing for 20 years because it is unaffordable, but I could have one in a year or two if we were able to use some toll revenue, that is a debate I want to have with my constituents. I want to see whether that would be a good trade-off that my constituents might want to undertake—whether it can be balanced with the benefits to businesses, jobs, economic activity and relieving congestion. I at least want the Minister not to rule that out.

I have written to the Highways Agency, asking it to look at some options for further crossings and to set out the future useful life of the second Severn crossing and the old Severn bridge, to see how long they are likely to last.

Paul Flynn: Is the hon. Gentleman suggesting that the money from tolls on the bridge that he is suggesting should be tied in with the Severn bridges as they are now, which would guarantee tolls in perpetuity, but provide little service for the people of south Wales?

Mr Harper: All I am suggesting at this stage is that the Minister does not rule out considering that in the future. Of course, the tolls would not be in perpetuity, but I do not want to rule them out. The hon. Gentleman needs to reflect on the fact that the bridges do not affect just Wales. The bridges are three quarters in England; as I said, the old Severn bridge is wholly located in England, and it affects my constituents in England just as much as it affects his constituents in Wales. It is

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important for the House to remember that the debate about the Severn crossings and the tolling regime is not just a Welsh issue, but an English one too; and that it does not affect just south Wales, but, as the hon. Member for Ceredigion (Mr Williams) mentioned, the rest of Wales. This is a wider question, and we need to look at the economic impact on Wales and on England—in Newport West, Newport East and my constituency—and make a balanced judgment.

I was clear in my remarks: I would prefer another crossing over the River Severn that does not have tolling and that does not require tolling on existing crossings. However, I am realistic enough to know that, given the state of the public finances, caused largely by the Government whom the hon. Member for Newport West (Paul Flynn) supported, difficult decisions have to be made. There is a debate to be had about whether we can have the infrastructure sooner by funding some of it from tolling. That debate is worth having, and I want to put it on the table. I am asking the Minister not to make decisions today for a position four and a half years in the future and rule things out that we may have cause to regret. That is all I am asking him to do. I have asked the Highways Agency to undertake some option appraisals, so that we can have a sensible and balanced debate in the future.

Jessica Morden: It will come as no surprise to the hon. Gentleman that my priority is for the tolls to come down for my constituents and businesses post-2018, when the concession ends. However, does he think that the current level of tolling is acceptable?

Mr Harper: The debate I always have with my constituents is simply to remind them that both Severn crossings had to be constructed and paid for, and that the toll revenue simply repays the cost of providing and operating the crossings. There is a trade-off: if we did not increase the toll each year—of course I understand why that is unpopular; I would prefer it not to go up as well—we would extend the concession period. That is a trade-off the Government have to make. The option would be open to the Government, as it was—I remind the hon. Lady—to the previous Government, whom she supported. For 13 years, they did not make any amendments—by choice—to the tolling regime. They did not do any of the things that she is suggesting, just to put the issue into context.

While it is tempting, we must be honest with our constituents that things have to be paid for, and they can be paid for in only one of two ways, one of which is for the cost to fall on the general taxpayer. Although the public finances have been hugely improved by the difficult decisions taken by the Government, they are in a state because we inherited them from the previous Government. There is no magic money tree to pay for the toll revenue. If we sweep the toll revenue away—I know how tempting that would be—either cuts will have to be made elsewhere, or taxes will have to rise. Politicians owe it to our constituents to be honest and frank with them. There is no magic money tree, and the bills have to be paid.

Jessica Morden: If we are to be honest with our constituents, does the hon. Gentleman accept that we should point out that the Government have now benefited by more than twice the debt on the bridge from unexpected

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tax income as a result of changes related to the bridges? The Government have actually done well in terms of VAT and other tax changes.

Mr Harper: That is a perfectly reasonable point, which of course has to be balanced—I am sure the Minister will set this out—against some of the costs. I am clear: I want the tolls to come down; they can certainly come down by the level of VAT. I certainly think that they can come down. All I am asking is that at this point the Minister does not suggest that the tolls are swept away, if the cost of removing them would mean that a future crossing over the River Severn either never happened or only happened at some far distant point in the future. I am only asking him not to make that decision today, given that we have not properly considered the arguments.

Paul Flynn: Will the hon. Gentleman give way?

Mr Harper: Let me just complete my point, and then I may take another intervention from the hon. Gentleman shortly.

I just want to respond to a point that the hon. Lady raised. I am sure that she did not do it deliberately, but she did not set out accurately for the House what the Welsh Affairs Committee said. I think that she said—I will take an intervention from her if I have misquoted her—that the Committee argued that the toll should be reduced to a level of £1.50, which would effectively just pay for maintenance. The Committee did not say that. It said that, if the toll was reduced to that level, that would allow

“the crossings to remain self-financing.”

It also said that

“the Government should seek to reduce the level of the toll at the earliest opportunity.”

However, it did not say that the Government should reduce the level to £1.50, because—this relates to my point about a future crossing—it said:

“We recognise…that at this level no “sinking fund” would be accumulated towards any future replacement of either bridge.”

The Committee also said, and I agree with the hon. Lady about this point:

“The Government must not be tempted to use the crossings as a ‘cash cow’.”

I agree with that, which is why if there is any future tolling over and above the level required for maintenance, the Government must be clear about its purpose. My view is that it must be used for infrastructure, which would benefit the hon. Lady’s constituents, my constituents and the economy of the UK. That would be the only scenario where future tolling, other than that required to pay for maintenance, would be acceptable. I agree with the hon. Lady about that, but I do not want the Minister to close any doors at this point.

Paul Flynn: The question that I asked the hon. Gentleman, which I am afraid he has not answered, was whether he foresees a repetition of what happened with the Severn Bridges Act 1992, which was that when the second Severn crossing was built, the two bridges were treated as one entity for financial purposes. Is he now suggesting that we should have another bridge that goes from one thinly populated part of England to another thinly populated part of England, which then becomes

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a financial burden on the people in south Wales, because those people will be paying tolls on it to use the main crossing from Wales to England? Can he please make it clear that he is asking for something that is entirely freestanding from one part of his constituency to another?

Mr Harper: At the moment, I have asked the Highways Agency to carry out some option appraisal work, to examine what options there might be for a further crossing over the River Severn, somewhere between the existing crossing at Over and the old Severn bridge. I asked because that detailed option appraisal work has not been done, so I have no idea where there may be sensible routes to cross the river, how much they might cost and what kind of traffic flows might be diverted. It is worth saying to the hon. Gentleman that, of course, there are significant traffic flows through my constituency that use my local roads, as people do not use the Severn crossings they ought to use because of the tolling. We have to look at all these issues in the round and make a proper judgment, which is another reason why the bridges need to stay under the control of the UK Government, so that different issues can be balanced. I accept that the hon. Gentleman and the hon. Lady will be completely focused on south Wales. Of course they will be; that is the part of the country that they represent. That is absolutely right, but I am focused on representing my constituents in England, and I want to ensure that all these judgments are properly weighed up. At this stage, I am not asking the Government to commit to tolling or to building another crossing. All I am asking at this stage is for the Highways Agency to respond to my request to consider the options, and for the Minister not to shut off future debate about what the tolling regime should be.

I have been quite clear—in an ideal world, I would like there to be no tolls on the bridges, or perhaps only those to cover maintenance. However, the fact is that if we want more infrastructure, it has to be paid for, either by general taxation, which is difficult given the difficult financial position that we inherited, or by the users of that infrastructure, or by a combination of the two. I simply want to ensure that we can have an open and frank debate in the future, and that we do not simply shut off any avenues. I think the hon. Lady was simply tempting the Minister to look forward four, four and a half years—or however long he will confirm to us—and make final decisions today that will shut off some of the opportunities for debate and for future infrastructure growth. All I am asking him to do is to keep those options open, so that we can have that debate, properly balance the needs of my constituents and his constituents, and the Government who are elected at the next election can make those sensible judgments. That is all I am asking for, and I hope that the Minister can confirm that that will be his approach.

3.4 pm