My Lords, I speak in support of Amendments 79K, 80A, 80B and 87G. At the outset, I pay tribute to the noble Baroness, Lady Greengross, who did an excellent job in chairing the commission on ageing and autism. We look forward to the publication of the report very shortly. It was certainly an eye-opener for a great many of us, and the many who thought they knew a lot about support and social care learnt a great deal during that time.
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Social care must no longer be the service of last resort. Under the current system, too many people become eligible for support only when their needs become acute and they require intensive high-level care and crisis management. Here, I declare an interest as a vice-president of the National Autistic Society,
whose recent research shows that only 10% of people with autism said that they receive social skills training, yet 55% would like to receive it; that only 10% people with autism said that they receive employment support, but 53% would like it; and that just 17% of people with autism said that they have access to social groups, yet 42% would like to have it.
Many adults with autism would benefit greatly from low-level services such as befriending or social skills training. These would help them to avoid isolation and allow them to participate fully in society. A lack of access to these services can have a devastating impact. A third of adults responding to a previous National Autistic Society survey said that they developed serious mental health problems as a result of a lack of support. Crucially, evidence from the National Audit Office shows that providing low-level services is cost effective and prevents people developing more complex problems—a point just made by the noble Baroness, Lady Greengross. Its report stated:
“Beside the negative impact of such crises on a person’s life, acute services are also expensive, with inpatient mental health care costing between £200 and £300 per day”.
New economic modelling by Deloitte, published earlier this month, shows that every £1 invested in support for people with autism—and any other difficulty—who have moderate needs can generate a return of £1.30. The benefit is spread across central government, local government and disabled people and their families. Services such as the National Autistic Society’s Horizons day centre, which is based in Surrey, support adults with autism to develop social and communication skills, to access the job market, to improve health outcomes and to prevent the development of further needs.
Enshrining prevention in the Bill is important also where older people are concerned—that will certainly show up when the report of the commission of the noble Baroness, Lady Greengross, is published. Many middle-aged or older people reach a “crisis point” when their parents or carers pass away. Appropriate identification, awareness and assessment of needs before this point is reached are vital. I welcome the emphasis on the principle of prevention that is already in the Bill, but for it to have a real impact on the provision of services, it must be further entrenched. I hope that the Minister will see the wisdom of the amendments proposed by the noble Baroness, Lady Greengross.