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8.22 pm
Lord Addington: My Lords, we must thank the noble Lord, Lord Maginnis, for bringing this subject to our attention and hope that we can go into slightly more detail at some later point because, due to time, I am afraid that we are skating over the surface. I will take some of the background here as read, as other noble Lords have covered it. I will simply quote and paraphrase a small section from the policy summary on page 15 of Better Services for People with an Autistic Spectrum Disorder. It goes on about who is responsible for helping a person, asking:
“Does the person have: An eligible need for support? A diagnosed, or undiagnosed, mental health need? (Mental health services should take financial responsibility)? A learning disability? (Learning disability services should take financial responsibility). A physical disability or sensory impairment? (Physical disability services should take financial responsibility)?”.
The silos that the noble Lord talked about here are brought beautifully forward. The next part says that they should pool the resources and pay for it. That is the administrative equivalent of water going uphill, and everyone here knows it. Everyone here knows that organisations defend their budgets. We would like to hear how big a stick the Government are going to take to these organisations, because there does not seem to be a carrot in the world that will make them do it.
Moving on to the National Autistic Society’s document I Exist, I will go back to the examples that the noble Lord, Lord Astor, spoke about. Ninety-eight per cent of local authorities and 100 per cent of primary care trusts said that they needed more guidance. Let us go through that again. We shall take the call for extra funding as read in both cases. Some 81 per cent of local services wanted more training and professional development—75 per cent of the primacy care trusts. Of primary care trusts, 88 per cent want specific guidance. It is only 64 per cent for local authorities.
It is clear that those bodies that have to administer this system do not think that they have the tools available. Can the Government give us some description of what they are doing to bring these bodies together? If the Celtic fringe has an example of better practice, when are we going to implement it? The most depressing part of this is the incredible similarities between the struggle to get the right help to the right people in this group—those with autistic spectrum disorder—and every other description that I have heard about any group with a disability. It is the same every time social services come to dyslexia, which of course is the one that I know best, although the conditions are almost diametrically opposed in some aspects. The administrative chase is almost the same. Have the Government not learned enough to be able to avoid that at least?
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8.25 pm
Earl Howe: My Lords, let me say immediately to the noble Lord, Lord Maginnis, that I have very considerable sympathy for his case. We are dealing here with a condition—autism—on which the corpus of knowledge remains exceedingly slim. That very basic point argues, in my book, for a sharing of best practice and a joined-up approach to policy-making, based on the best available evidence. This is not to question devolution; it is to highlight the need for strategic consistency in an area where services are patchy and the cost to the nation enormous.
Policy-making on services for autistic people straddles departmental boundaries. It straddles the boundaries between government and the voluntary sector—let us remember that much of the voluntary sector operates UK-wide—and between different local authorities. I pay tribute to the Government in what they have done to pull together the various strands of policy and good practice in this area. In November 2006, the Department of Health published Better Services for People with an Autistic Spectrum Disorder, which encourages those in the health and social care fields to develop local action plans to meet the needs of older children and adults with autism. There are other initiatives too, at a national level, which we can applaud: good practice guidance, the inclusion development programme and transition support for the over-16s.
Local priority-setting based on guidance is right. The question that the noble Lord, Lord Maginnis, is asking is whether, on a matter like autism, it is enough. In January, he asked the noble Lord, Lord Adonis, whether the Government would support the Celtic Nations Autism Partnership, which is trying to create a joined-up approach to service provision across administrative boundaries. The answer that he got was that:
“If there are lessons that we can learn for practice in England, we will do so”.—[Official Report, 16/1/08; col. 1293.]
Again, that is fine, but it slightly misses the point, which is not simply whether England has something to learn from the devolved Administrations, but whether we can usefully share our own knowledge and best practice with them.
The “I Exist” campaign by the National Autistic Society is based on the finding that nearly two-thirds of adults with autism in England do not have enough support to meet their needs. Some 76 per cent of teachers said that the lack of appropriate professional development is a barrier to teaching children with ASD. These are the sorts of reasons why TreeHouse and the Autism Awareness Campaign run by Ivan and Charika Corea have campaigned so vocally for the kind of strategic approach that the noble Lord, Lord Maginnis, is asking for. The big question for the Government is whether the collaborative joined-up way of working, which they urge on others, is something that they themselves are willing to embrace at a national level. I hope that the Minister will treat the idea seriously.
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8.28 pm
Baroness Thornton: My Lords, I begin by thanking the noble Lord, Lord Maginnis, for initiating this debate and other noble Lords and Baronesses for their contributions.
Autism is devastating, leaving autistic people isolated and their families afraid for their future, and it is a condition about which not enough is understood. I know that this fact will be highlighted on World Autism Awareness Day on 2 April. My noble friend Baroness Uddin, among others, has been active in campaigning for the Government to take even more action, urging us to consider a national strategy and taskforce.
One point I think that we can all agree, and it has been eloquently expressed by the noble Lord, Lord Maginnis, is that early diagnosis and early intervention is increasingly being recognised as very important for improving the outcomes for children and into later life. I learnt this, in particular, when I worked for ICAN, the organisation that works for children with communication disabilities, including autism.
Mentioning all the considerable work that is going on and answering all the questions raised in the debate will be difficult, but I shall do my best and write to noble Lords if necessary.
The noble Lord, Lord Maginnis, the noble Baroness, Lady Tonge, and others mentioned early years. The 2002 guidance includes pointers to good practice on early years. The special educational needs code of practice promotes early intervention. Under the Education Act 1996, local authorities can make provision for children up to their second birthday and, where necessary, must assess and draw up special educational needs statements for children from that birthday onwards.
The Early Support programme is the central government mechanism for improving the consistency and co-ordination of services for young disabled children and their families across England at national, regional and local level. Included in the information that Early Support makes available to parents is information for the parents of children who have just been diagnosed with autism or who are being diagnosed. The autism information booklet for parents was drawn up with the National Autistic Society and TreeHouse. It has been revised again in consultation with NAS and TreeHouse. According to the latest figure that we have, more than 75,000 copies have been distributed. The joint National Health Service and DCSF exemplar sets out what should happen in early years, describes what joined-up support should be necessary and takes us on the journey that a child and their family should follow.
The DCSF is providing £200,000 over three years to the National Autistic Society to help parents whose children have recently been diagnosed with autism, so that NAS can offer one-day as well as six-session courses. The NAS has found that people from rural areas—for example, fathers—have found it difficult to attend the six-session courses. The programmes provide parents with an overview of autistic spectrum
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As my noble friend Lady Gale explained, work is certainly afoot in Wales and the other Celtic nations. We welcome the opportunity to be involved in the consultation on the strategy being taken forward by the Welsh Assembly. I have stated that we are in discussion with Welsh Assembly officials and will monitor closely the implementation of the strategy to see what lessons may be learnt. England and the devolved Administrations are involved in the European Agency for Development in Special Needs Education. The group has a chance to discuss autism provision at the European agency level.
I turn to services for children with ASD. The Department for Children, Schools and Families has a well established programme to improve teachers’ skills in meeting children’s special educational needs, including those with autism, and we are working with partners to bring about improvements—there is no doubt that that is necessary. In November last year, Ministers launched the Autism Education Trust, which is being established by the National Autistic Society, the TreeHouse Trust and the Council for Disabled Children. I know that the noble Lord, Lord Clement-Jones, has been closely involved with TreeHouse. The DCSF has given the Autism Education Trust £160,000 in the current financial year to help it become established. The trust aims to involve all those from the voluntary, independent and statutory sectors who have an interest in autism education and to promote improvements in it.
Children with autism and their families will also benefit from more than £430 million of funding for the Aiming High for Disabled Children Programme. In particular, it should bring about improvements to the provision of short breaks and the transition support programme mentioned by several noble Lords.
Moreover, this Government are committed to independent living for all disabled adults, including those with autism. Independent living is an important part of enabling disabled people to attain equality and social inclusion, to fulfil the roles and responsibilities of citizenship and to have choice and control over the way they live their lives.
The Office for Disability Issues launched a cross-government independent living strategy on 3 March. The aim of the five-year strategy is for disabled people, including adults with autism, who need support in going about their daily lives to have greater choice and control over how the support is provided. It aims for disabled adults to have greater access to housing, education, employment, leisure and transport opportunities, and to participation in communal and family life.
In 2006, the Department of Health published Better Services for People with an Autistic Spectrum Disorder, which improves guidance and points to better provision for adults with autism. I am delighted to say that the department’s specialist adviser on autism, Sarah Austin, will be one of the advisers on
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Research was mentioned. I am pleased to report that the Autism Research Co-ordination Group’s first annual report states that autism research funding should be focused on identifying the gaps around biomedical research, interventions in research—especially in adults—quality of life and economic impact.
The noble Lord, Lord Maginnis, raised universal screening. The national autism plan for children drawn up by the Royal Colleges of Psychiatrists and of Paediatrics and Child Health did not recommend universal screening, because, at the time of writing it, they felt that screening instruments were not precise enough.
The noble Lord quite properly raised teacher training. We have a programme to improve teachers’ and early-years providers’ skills in meeting children’s special educational needs, including those with autism. We are working with partners to bring about improvements. The next phase of this programme, beginning in April, will focus on ASD.
The noble Lord also asked how many specialists there are. We do not collect the data centrally, but there should be a multidisciplinary team in every locality with an expertise on autism, including Asperger’s, as was recommended in the autism exemplar to which I have already referred.
The noble Baroness, Lady Bottomley, referred to the closure of specialist schools. Decisions on closures are made locally and not by central government. Closures need to be balanced by the opening of other units or provision. During the last few years, 18,000 children have been in such provision, receiving behavioural, emotional and other support. Autism is a significant part of this provision.
The noble Baroness, Lady Warnock, mentioned children with Asperger’s and whether there are enough local schools. As she will know, it is up to local authorities and voluntary and independent groups to decide on new provision for children with autism. Guidance last year encouraged local authorities to develop a range of provisions to meet the range of children with disorders. The Autistic Spectrum Disorders—Good Practice Guidance also recommends this range of provision.
The noble Lord, Lord Astor, asked what happens to adults on the ASD spectrum. He quite rightly raises the need for greater co-ordination locally and the problems of transition. There is no doubt that more work needs to be done and more pressure brought to make sure that there is greater uniformity of provision.
This debate would not be complete were I not to mention some of the organisations who work so hard for autistic children and adults. The National Autistic Society recently launched its adult campaign, “I Exist”,
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I hope I have been able to reassure noble Lords of this Government’s continued commitment to improve the response that autistic children, adults and their families receive. There is much more to do—of course there is. We all need to continue to strive to deliver a modern, responsive social care and education system that supports people with autism and to make sure that they have greater choice and control in their lives, greater empowerment and the ability to lead fulfilling lives.
Baroness Crawley: My Lords, I beg to move that the House do now adjourn during pleasure until 8.44 pm.
Moved accordingly, and, on Question, Motion agreed to.
[The Sitting was suspended from 8.40 to 8.44 pm.]
Regulatory Enforcement and Sanctions Bill [HL]
Consideration of amendments on Report resumed.
Lord Bach moved Amendment No. 45:
The noble Lord said: My Lords, Clause 29 will play an essential role in encouraging a more co-ordinated, strategic and consistent approach to local authority inspection of multi-site businesses. Inspection plans will present a primary authority with the opportunity to share with all other local authorities its strategic knowledge of the businesses with which it has a partnership. It is our expectation that primary authorities will be experts in the operation of the businesses that they partner and in particular will have detailed knowledge of compliance and quality assurance processes.
A primary authority will know those areas where a business presents a low risk, where it has a strong record of compliance, where it has improvements in hand and where improvement is needed. To give a primary authority an evidence base to develop this expertise, we believe that when an enforcing authority departs from the recommendations in an inspection plan it must inform the primary authority of this departure and give reasons for it.
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“If businesses and primary authorities are to go to the expense of drawing up agreed inspection plans, it is not reasonable for local enforcing authorities to be able to disregard those plans without having to justify that”.—[Official Report, 28/1/08; col. GC 256.]
We agree with that and understand that businesses in particular will expect that they should not be subject to arbitrary inspections based on spurious grounds when an inspection plan has been drawn up. With this in mind, we believe that it is more appropriate for local authorities to notify the relevant primary authority when they depart from the recommendations in an inspection plan before the inspection is carried out. That is what Amendment No. 45 will do. I beg to move.
On Question, amendment agreed to.
Lord De Mauley moved Amendment No. 46:
The noble Lord said: My Lords, Amendments Nos. 46 and 47 aim to ensure, without excessively eroding the powers of local authorities, that the primary authority is useful and effective and that multi-site businesses are keen to enter into such arrangements. Government Amendment No. 45 is very welcome and goes some way towards satisfying us, but it does not explain what happens next. Under the Bill as drafted, a primary authority and the business for which it is the primary authority will draw up an agreed inspection plan relevant to the company. This is intended to be a painstaking activity that goes to the heart of the business and its operations. It will take time, effort and resources on both sides—business and the authority. The plan will then have to be agreed with the LBRO and be brought to the attention of local authorities, which will be obliged to have regard to it.
It is in the event of a disagreement with this plan by a local enforcing authority that the problem arises. As drafted, even following government Amendment No. 45, the Bill means that the local authority will need to notify the primary authority before it undertakes an inspection outside the terms of the plan and to give its reasons for doing so. But that is the end of the matter. If the plan can simply be ignored, or if that is the perception, our contention is that that will undermine the value of drawing up the plan in the first place. The odd thing about how the Bill is drafted is that this is in contrast to what happens when a local enforcing authority wishes to take enforcement action against a business. In that event—and perhaps the Minister can confirm this—it must notify the primary authority and the primary authority can direct it not to take the action if it is inconsistent with advice that it has previously given the business, subject to appeal to the LBRO.
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