in the House of Commons – 21 March 2019
Our thoughts are with Dame Cheryl Gillan, who is a true champion for those with autism. I also thank Huw Merriman for securing today’s debate and his excellent speech, which set the tone for a very constructive debate.
This is a timely debate not just because it comes in advance of World Autism Awareness Week, but because this year marks the 10th anniversary of the Autism Act 2009, passed under the last Labour Government, which put a duty on Ministers to publish and regularly review their autism strategy and to produce statutory guidance to implement at a local level. We have heard from several hon. Members on the all-party group on autism, which is holding an inquiry into the Act’s implementation ahead of the Government’s review. Ahead of that formal publication, I hope that the Minister will give us the Government’s views not just on the changes that we have seen over the past 10 years, but on what more can be achieved in the years ahead.
I am sure that the whole House will want to thank the National Autistic Society, Autistica and Ambitious about Autism—and all the other charities that represent and serve people with autism—for the work they do, the support they give and the services that they provide to all those people. There is a charity in my constituency called The Whole Autism Family, which is run by Martin and Anne-Marie Kilgallon in Mirfield, who do phenomenal work. They have two sons with autism, but the support they provide to other families is simply phenomenal and I am very grateful to them for their work.
In responding for the Opposition Front-Bench team, I think it is important to note that, although I am shadow Minister for mental health, autism is not a mental health condition, as Anne-Marie Trevelyan also mentioned. I hope that we all aspire to a society where people with autism have as good mental health as the rest of the population. Unfortunately, however, we are very far short of that aspiration. It is estimated that up to four out of five autistic people develop mental health problems such as anxiety and depression, and four out of 10 children with autism have multiple mental health problems.
In the worst cases, autistic people end up in mental health hospitals, which are usually not appropriate, and they are sometimes there for extended periods. The transforming care programme was aimed at tackling that problem, but we have heard evidence that it has fallen far short of its aims. The NHS long-term plan sets a target for reducing the number of autistic in-patients in mental health hospitals by 2023-24. But if we are to achieve that, there must be investment in better community mental health support that is appropriate for people with autism. The need to tackle this issue has been thrown into stark relief by the appalling cases of abuse of people with autism that have had significant media coverage in recent months, as Scott Mann mentioned.
There are still more than 2,000 people in totally unsuitable in-patient settings, when they should be supported in the community. That is not only unconscionable; it is exorbitantly expensive, with the average package costing £3,500 a week. The Government announced last year that they would be asking the CQC to conduct a thematic review into the seclusion of people with autism in in-patient settings, but this will take far too long to tell us what we already know—that these placements should be ended. Will the Minister today finally commit to ending placements in assessment and treatment units and to working with her colleagues to provide the kind of community-based support that people with autism deserve? The Minister will also be aware of the call to reform the Mental Health Act 1983, which defines autism as a “mental disorder”, allowing autistic people to be sectioned without having a separate, treatable mental health condition. Perhaps she can tell us what plans there are to address the legislation, as well as to provide the right kind of support services.
Perhaps the obvious starting point regarding support for people with autism is getting a diagnosis in the first place, and a number of hon. Members have quite rightly spoken about that today. The quality standard on autism recommends a maximum three-month period between referral and the first diagnostic appointment, but it is clear that the standard is not being met anywhere near widely enough, with reports of delays of years rather than months. I have certainly experienced that issue in my constituency surgeries.
When I spoke on this subject a year ago, I noted that we were about to implement new standards on data for waiting times, which had been patchy until then. We are now nearly a year on, and we should therefore have data for the first full year next month, with publication due this summer. The long-term plan also contained a welcome and specific commitment to reducing diagnosis times, so I hope that the Minister will update the House on any early findings, on when the final data will be published and on the Government’s plans to make improvements.
Similarly, in previous debates, we have heard about the need for better data on who is being diagnosed. The National Autistic Society found that over three quarters of those using their adult services are male, and there is a concern that the lack of recognition for women with autism may be partly behind those numbers. There are also age effects, given that autism was not a recognised condition when many older people with autism were growing up. In previous debates, the Minister has said that the Department expects GPs to include autism in the primary care register and will be working with NHS Digital to achieve that. Perhaps the Minister could update us on the progress in that regard.
Too often, there are significant barriers to accessing the right services after diagnosis. One recurring theme is the need for better training, which the guidance states all staff should have access to, but the reality sometimes sadly falls short. Last month, the Government launched a consultation on mandatory training, which is welcome, but for this to work it must be co-designed and co-delivered by people with autism. Can the Minister tell us whether this will be the case and, perhaps more importantly, whether her Department will provide funding so that the autistic people providing their experience to this training receive a proper wage for their labour?
Early intervention services are key for communication and language skills, which are closely linked to life chances for people with autism. In education, too, services for children with autism and other special needs have been first in line for cuts, as we have heard from other hon. Members. With the Government taking billions out of the schools budget between 2015 and 2017, I know all too well the pressure that schools in my constituency are under. As the vast majority of school budgets are spent on staff, this is the area of greatest pressure. For example, the support staff, who are so vital to children with special educational needs, are often the first to go, and one-to-one support for children becomes impossible when the money simply is not there. Thousands of children in England with approved education, health and care plans are still receiving no provision, and that proportion has increased fivefold since 2010.
If we let children with autism down in education, the impact is felt when they become adults seeking employment. My hon. Friend Thangam Debbonairespoke with great knowledge about the challenges of employment for those with autism. There is an urgent need for improved in-work support services for disabled people across the board, and the autism employment gap is even wider than the disability employment gap. Over the past 10 years, there has been no real change in the numbers of autistic people in full-time work, and the National Autistic Society found that less than a third of autistic adults are in paid work, even though more than three quarters do want to be in a job.
The NAS has called for an autism employment pathway, an awareness programme for employers and targets for getting people with autism in to work. I hope that the Minister can tell us the Government’s response and address points such as making sure that Jobcentre Plus staff understand autism and responding to the call for autistic people in work to be recorded in the labour force survey. Apprenticeships and other specialist schemes could also provide a route into employment, with tailored support for people with autism. Will the Minister update the House on progress in implementing the recommendations of the taskforce chaired by Paul Maynard and on what steps the Government have taken to expand the Disability Confident scheme?
Finally, there are the services aimed not just at people with autism but at the rest of us to ensure that we are aware and understand the condition. The research has long shown that most people with autism feel that their condition is not understood, as was recently highlighted by the National Autistic Society’s “Too Much Information” campaign. Only 16% of autistic people and their families think the public understand autism, and half of autistic people and their families are sometimes afraid to leave the home because they are worried about the public’s reaction. The contributions we have heard from Members across the House today show just how much more there is to be done to provide the services that people with autism need. I hope that the Government have heard that message and will now act on it.