Autism Bill

My Lords, I, too, join noble Lords in congratulating my noble friend Lord Freud on his very eloquent maiden speech. It is obvious that my noble friend will be an exceptional addition to your Lordships’ House, to which no doubt he will bring great experience and wisdom. I thank the noble Baroness, Lady Pitkeathley, for introducing this important Bill. It is heartening to witness the high level of cross-party support that the Bill has received. The National Autistic Society has called the response by Members of Parliament "unprecedented". My honourable friend Cheryl Gillan is to be congratulated on her central role in bringing this Bill forward, and I am pleased to see her here today. I also thank the noble Baroness, Lady Pitkeathley, for setting out so clearly and eloquently its provisions in this House. I will of course have to repeat a number of points that have already been raised by noble Lords, but it is important to do so. We all recognise the importance of supporting those suffering from autism in our society and the need to ensure that they can enjoy a quality of life that we would wish for ourselves. At Second Reading, my honourable friend Cheryl Gillan described some of the shocking detail of the lives of more than 500,000 children and adults with autism. It is worth repeating some of those statistics today. Some 42 per cent of children with autism have no friends, and the proportion rises to 75 per cent for adults, while 40 per cent of children with autism have been bullied or harassed. The number rises to 50 per cent among adults. This suggests that not only is there a failure to support and understand children with autism, but that this gets progressively worse as they grow up This is a story of exclusion and alienation that leads to unacceptable outcomes for people suffering from autism. Evidence shows that 27 per cent of children with autism have been excluded from school and that only 15 per cent of autistic adults are employed. We must engage with all the related partners to ensure that appropriate information and support is available to children right through to adulthood. For a great many of us, it is self-evident that the Bill should enforce statutory requirements on the National Health Service and local authorities to look after people with autism, rather than only guidance. I celebrate the consensus that has been developed as the Bill has progressed. Earlier, in debates in another place, Phil Hope suggested that a Bill was not needed. Mr Hope’s statement that, ""legislation can be a very blunt and crude instrument for driving through change",—[Official Report, Commons, 27/2/09; col. 545.]" seemed almost unbelievable coming from a Government characterised by a 12-year long addiction to legislation. It is therefore gratifying to see that this is no longer the Government’s position and that the Bill has been approached in a real, meaningful fashion. A good example of where specific guidance is necessary is in the statutory guidance for joint strategic needs assessments. Currently, only 21 per cent of all JSNAs include any mention of the needs of people with ASD. Thus the vast majority of local authority and PCT partnerships are failing to consider the needs of people with ASD. The Government have confirmed that good practice guidance will be published this year to help assessors identify the needs of people with autism in their areas. I do not think it is enough to produce only good practice guidance. Can the Minister confirm that statutory guidance will specify that JSNAs must take into consideration the needs of people with ASD? Can I press her for a further assurance that community assessments will be carried out by professionals who have received appropriate levels of autism-specific training? Can the Minister also assure the House that this will be part of the strategy and statutory guidance? The timing of the publication of statutory guidance, set currently at no later than 31 December 2010, means however that there could be a possible nine-month time lag between that and the publication of the autism strategy. Would it not be better for them to be published together as this would aid local authorities and PCTs in working out which elements of the strategy will be in statutory requirements? Can the Minister say why there is this delay? The statistics regarding the lack of local information about both children and adults with autism make for chastening reading. According to the National Autistic Society, two-thirds of local authorities do not know how many children with autism live in their areas. This in itself is worrying, but, sadly, it rates better than the fact that, in comparison, only two local authorities in the country know how many adults with autism live in their areas. This chronic lack of information makes any coherent approach to tackling the difficulties faced by those with autism quite impossible. If these numbers are not known, local authorities can, quite simply, not address the needs of people with autism in their areas as they plan their commissioning of services. I am certain that we are all aware that such a situation is unacceptable. We on these Benches wholeheartedly support the Bill’s aim to improve this information. On a more specific note, while I acknowledge the view in another place of Phil Hope that the details of improving the identification of adults with autism spectrum disorders will be determined during the consultation period, can the Minister inform the House of the steps that the Government will take to ensure that taking such measures will be proactive and focus particularly on those adults who are currently unknown to the services? It is important that co-ordination between children and adult services offers a seamless transition for children with autism as they reach adulthood. If children with autism are to reach their full potential, there must be improvement in the support they are offered by local authorities and in the information that they and their parents are given. As the NAS has stated, 40 per cent of adults with autism live with their parents, relying on them for much of their support. This is a pernicious situation for these people and their families which can be alleviated with the proper support from their local authorities. A seamless transition requires a holistic strategy for people with ASD. How can the Government ensure that all relevant departments will participate? Will the support demonstrated by the DCSF for children with autism be built on by working effectively with the Department of Health and the Department for Works and Pensions? We agree that this joint approach is vital for the success of the autism strategy. For better employment opportunities, it must be a key priority for this process. What measures do the Government intend to take to ensure that the DWP plays a central role? It is reassuring that the Government have already begun work on the adult autism strategy in line with the duty the Bill will place upon the Secretary of State to introduce such a strategy. The Bill offers us a huge opportunity to positively affect the experiences of adults with autism. In its current form the statutory guidance provides for access to diagnosis, needs assessments, strategic planning of services and transition planning, and for local partnerships to meet the needs of adults with autism. The success of this guidance and of the strategy will surely depend upon the quality of their implementation. The implementation plan proposed by the Department of Health will be central to this. Can the Minister tell us whether the implementation plan is being consulted on as part of the strategy consultation? If this is not the case, what action is the Department of Health taking to develop a robust and practical implementation plan? It is an indictment of the approach that has pertained in this country towards autism that over three-quarters of local authorities do not currently have an autism training strategy. Will the Minister assure the House that there will be appropriate guidance and training in local authorities? It is encouraging that the Bill has provisions to ensure that statutory guidance includes the training of staff who provide the relevant services to adults with such conditions. "Relevant services" do not include such professionals as disability employment advisers. Can the Minister give assurances that these DWP professionals will have the training to enable them to support adults with ASD in finding employment, and how this will work in practice? Can she also confirm that the Government intend to provide appropriate training for all professionals with a significant role to play in supporting adults with autism? How will this be supplied? Is she able to outline whether any measures are to be put into place to ensure that appropriate housing, such as warden-controlled accommodation, will be available for adults with autism to encourage independent living? It can make the difference between people with autism fulfilling their potential or remaining excluded from mainstream society. The National Autistic Society makes a valid point when it argues in its press release that, ""exclusion from support increases isolation and can escalate to mental health problems and other serious difficulties"." The commitment from the Government to placing a legal duty on local authorities to collate and share data on disabled children, with autism as a specific category, is to be applauded. Clause 1(4) requires the Secretary of State to keep the autism strategy under review and to revise it if necessary. This will require monitoring at local, regional and national levels. It will also require effective frameworks for evaluation and guidance. For this to be implemented successfully, it is important that there will be a designated person. Can the Minister say how the Department of Health intends to monitor the process of the strategy and what indicators will trigger a review? Will she commit to having a named individual within the health service who has a responsibility for successful implementation? It is particularly pleasing that the interpretation clause of the Bill gives responsibility for both diagnosis and provision of support to local authorities and the National Health Service. It is crucial that there is no fudging of responsibilities or a lack of clarity. I am sure that noble Lords will offer the benefit of their great expertise to ensure that no opportunity to strengthen, clarify or improve the Bill is missed. I look forward to the Minister’s response.