Robert Buckland (South Swindon) (Con) It is with great pleasure
that I rise in my first end-of-day Adjournment debate in the better
part of eight years, but it is a topic that I am very happy to
return to from this position. It is one that I championed in
Government and one that I worked very hard on when I was a Back
Bencher prior to my ministerial office. I am hugely grateful to Mr
Speaker for granting me today’s debate. Many hon. and right hon.
Members will know that...Request free
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(South Swindon) (Con)
It is with great pleasure that I rise in my first end-of-day
Adjournment debate in the better part of eight years, but it is a
topic that I am very happy to return to from this position. It is
one that I championed in Government and one that I worked very
hard on when I was a Back Bencher prior to my ministerial office.
I am hugely grateful to Mr Speaker for granting me today’s
debate.
Many hon. and right hon. Members will know that this issue has
been close to my heart for many years: autism and the range of
brain conditions that can be summarised by the word
neurodiversity. From my own direct family experiences, which I
spoken about in this Chamber when we held the first Chamber
debate on autism back in 2013, and from the plethora of
constituency casework that I have worked on over the years
helping families of children and young people with autism and
associated conditions, I have developed a certain knowledge and
experience of these issues. As a Minister and a Secretary of
State, I was glad to be able to push the agenda even further.
One of the privileges of being a Back Bencher is that I can put
on record my thanks to local organisations in my constituency
which do so much to support and work with people with autism,
whether it is officers of the local authorities, volunteers in
local carers’ groups such as the Swindon Carers Centre, or
organisations such as the Uplands Enterprise Trust, which is
pioneering and developing more post-19 support for young people
with autism and other disabilities in my area, working with the
excellent special schools network and the Brunel multi-academy
trust in Swindon. It is really innovative work.
My debate today is the beginning of a process that was made clear
in my exchange of letters with my right hon. Friend the Prime
Minister on my departure from Cabinet two months ago: to bring
about a sea change in how autism and other brain conditions are
not only diagnosed, but supported and treated throughout the
lives of those people. Our country is one of the most advanced in
the world when it comes to these issues, but there is still a
huge amount to do.
My successor as chair of the all-party parliamentary group on
autism, the late, great , will always be remembered as
the author of the groundbreaking Autism Act 2009, which was a new
departure for health, in that a specific condition was delineated
in legislation, much against the initial resistance of the then
Government, but the strength of feeling in this place and outside
was such that Dame Cheryl thankfully got her way. The autism
strategy, which was revised in its latest iteration only in July
this year, is the direct result of that important legislation.
Twelve years on, I think we can safely say that awareness and
diagnosis levels have risen dramatically, but the situation
remains stark.
About 1 million people in the United Kingdom are autistic, but
they still have some of the worst outcomes in our society. First,
the death rates mean that they die on average decades before the
rest of us. Secondly, with two in 10 in employment, they have the
lowest employment rates of all disability groups. Importantly,
and deeply worryingly, disproportionate numbers of autistic
people and people with brain conditions end up in mental health
detention or, even worse, in our criminal and youth justice
systems. They are being locked up by a system that represents
barbaric practices from a generation ago. I have certainly found,
from my professional and ministerial experience, far too many in
our prison system, our young offenders’ institutions and our
criminal justice system generally with those conditions.
(Strangford) (DUP)
I know the right hon. and learned Gentleman has had a particular
interest in the issue for a number of years, for both personal
and other reasons, so I congratulate him on securing this debate.
I give an example from Northern Ireland, which to be fair is not
the Minister’s responsibility, but shows what is happening: an
increase of 148% in the number of children waiting for an
assessment for autism and a 687% increase in the number waiting
more than a year for an assessment. This is a system where the
capacity is nowhere near meeting demand, as I think the right
hon. and learned Gentleman has also said. Does he agree that a
corresponding increase in funding to get to the root of autism
and how best to treat and live with it must be a priority for the
Government?
I am grateful to the hon. Gentleman, who rightly outlines some of
the pressures on the system—the increase in diagnosis, which in
many ways is a good thing, and the personnel and capacity issues
that cause many of the delays in diagnosis, which are all too
familiar a pattern for many families, including those in England,
Wales and Scotland.
It is interesting to note that research by, I think, the Northern
Ireland Assembly calculated the estimated cost to the country of
the failure to deal with autism at a staggering £32 billion. Let
us just think about that. What a cost to our country: resources
wasted, lives wasted and lives lost as a result of these
omissions. It does not have to be like this.
(Winchester) (Con)
It is such a shame to see my right hon. and learned Friend not in
Government, but such a pleasure to have him on the Back Benches
and to be here for his first speech from the Back Benches in what
I suspect is a number of years. Seeing that we have a lot of time
in tonight’s Adjournment debate, does he, as a former Lord
Chancellor, agree that the way we look at people on the autistic
spectrum within the secure estate, and the way he is proposing we
might look afresh at that, might affect the way we look at the
secure estate as a whole—to understand a lot more, and condemn a
lot less? We have such a high prison population, many of whom,
especially women, should not be in the secure estate. Could this
be the issue that causes us to look afresh at our prison
system?
I am grateful to my hon. Friend. In 2020, he and I visited his
local prison in Winchester, a prison with many challenges and,
there is no doubt about it, a share of the population with a
brain condition, sometimes undiagnosed and often an acquired
brain injury. Many people who are in for offences of violence
have themselves been the subject of violence. Those issues are
frankly endemic within the criminal justice system.
That is why, when I was Lord Chancellor, in last year’s
sentencing White Paper, I announced a call for evidence on
neurodiversity in the system. I was hugely grateful to Charlie
Taylor, Her Majesty’s Chief Inspector of Prisons, and Justin
Russell, Her Majesty’s Chief Inspector of Probation, for leading
that independent call for evidence. Charlie Taylor was a public
servant who came from the education sector, specifically the
special needs sector, had real frontline knowledge and experience
of autism and brain conditions and previously ran the Youth
Justice Board for England and Wales.
The good news is that, thanks to the published results of the
call for evidence, the Government committed—I am pleased to say I
committed—to training for frontline staff and the upskilling of
those staff right across the criminal and youth justice system,
as part of a new custody and detention apprenticeship that is
being offered and that will be completed by all prison officers.
Her Majesty’s Prison and Probation Service is developing a
revised policy framework and guidance all about those issues, but
in particular about children in custody with those conditions.
This work is carrying on. I will develop those points a little
further. I know people are anxious to come in.
(North Dorset) (Con)
rose—
(Bromley and Chislehurst)
(Con)
rose—
I will let my hon. Friend the Member for North Dorset () in first before my hon. Friend
the Member for Bromley and Chislehurst ( ).
I echo what our hon. Friend the Member for Winchester () said in that it is a travesty
that my right hon. and learned Friend is not speaking still from
the Front Bench, but it is a delight to hear him speak this
evening.
To go back to the point made by the hon. Member for Strangford
(), what is my right hon. and learned Friend’s
assessment of the impact of covid on diagnosis, assessment, the
provision of support and the crucial need to link up the Ministry
of Justice, the Department of Health and Social Care, the
Department for Education and the Department for Work and
Pensions?
I am very grateful to my hon. Friend. There is no doubt that
covid has had an impact on backlogs in all parts of the health
system, including diagnosis. Having said that, there are
significant advantages in the use of remote technology for people
with autism and brain conditions. For them, very often the
journey to a clinic, hospital or health centre is in itself
traumatic and anxiety forming. I see remote technology as a real
liberator for many people with autism, so the potential there is
immense.
Sadly, the point my hon. Friend makes about the impact of covid
is one that, without increased capacity and increased staffing,
we will have to wrestle with for a number of years. On the point
he makes about joined-up Government, I well remember saying on
many occasions to anybody in Government who wished to listen that
Justice could not do this on its own. As a downstream Department,
it needed Education, Health, the DWP, the Ministry of Housing,
Communities and Local Government and, frankly, all arms of
Government to work together to identify some of these problems at
the root to prevent them from becoming part of criminal justice,
but I will speak more about that in a while.
My right hon. and learned Friend is making the case most
powerfully and demonstrating, as other hon. Members have said,
why it is a tragedy that he is not still on the Front Bench.
I welcome the very significant initiative that my right hon. and
learned Friend made in relation to this when he was the Secretary
of State—something that, as he will know, the Justice Committee
warmly welcomed. Does he agree that it is very important now that
we maintain the momentum for this, and in particular that the
moneys available to the Ministry of Justice in the spending
review are put into important areas of this system that for too
long, until his work, were overlooked?
I am very grateful to my hon. Friend the Chair of the Select
Committee. It was encouraging to see that the revenue settlement
for the Ministry of Justice over the next three years was a
pretty good one, with a just over 4% increase year on year.
Obviously, it is now going to be for Ministers, in their
allocation process, to work out precisely what they want to spend
within that envelope. I very much hope that the announcements we
made as a result of the call for evidence—published as part of
the autism strategy document in late July, which I cleared
together with my right hon. Friend the Secretary of State for
Health—will be followed through on.
More than that, it became increasingly clear to me, as I read the
response to the call for evidence and as I followed the debate,
that screening people coming into the criminal justice system and
the prison system is an essential prerequisite of understanding
the best way to handle them. I think a screening process for
brain condition would reveal acquired brain injuries. It might
reveal an undiagnosed condition—maybe attention deficit
hyperactivity disorder, attention deficit disorder, dyslexia
even. Let us do that at this stage and work out what is going on
in people’s minds, so that we can not just better manage them,
but actually help them along the path of rehabilitation.
Do you know, Madam Deputy Speaker, that my worry is that, time
and again—not just in the prison system, but in the probation
service—regimes are set up and orders are made with the best of
intentions, and the people with these conditions are set up to
fail, because they are not able actually to access, understand or
compute that in a way that perhaps neurotypical people can? That
is not their fault; it is a fact of who they are and what they
are. That is why we need to change the approach that we take. I
do not want to see people set up to fail. I certainly do not want
excuses for criminal behaviour, but I do want smart answers on
ways in which we can meaningfully rehabilitate people. I have
seen it happening. In Parc prison—a private prison, I have to say
to those on the Labour Benches—in south Wales I was awestruck by
the work being done on the neurodiversity wing. Prison officers
trained in the right skills were working with some of the most
difficult and complex prisoners in that estate and achieving
results that might not to the naked eye look terribly remarkable
but which, by the measure of the people they were dealing with,
were extraordinary. We need to replicate that sort of work, which
is being done in one corner of the estate, across the entire
prison estate.
The wider debate is all about replicating the best practice we
see across Government and local government, and across private
enterprise and business as well, because I do not want this
debate to be just about what the Government can do—me with my
metaphorical hand out, saying, “More money please.” This is about
society realising that if we are going to crack the issue and
make a difference, we need carefully targeted research into what
works.
(Cities of London and
Westminster) (Con)
I welcome my right hon. and learned Friend back to the Back
Benches. I am sure we will be hearing more from him over the
coming weeks and months. Does he agree that as well as research,
on which I agree entirely, societal support is needed?
Organisations such as the Caxton Youth Organisation, a brilliant
youth club in my constituency for children and young people with
autism and learning difficulties, can play their part in
supporting young people with autism. Society and Government also
have a part to play because this is about us all working together
to support these young people.
My hon. Friend is right. Drawing on her local government
experience and having been directly responsible for many of these
services she encapsulates the best practice we see in many local
areas. The trouble is that we do not see it everywhere and there
is, to use the dreaded phrase, a postcode lottery, which is just
not good enough for so many families across our country.
I see where we are now as a moment to make a choice. There is a
golden opportunity for Government and indeed for society, and I
deliberately wanted to include neurodiversity in this debate
because I believe it is hugely important. Diagnostic descriptions
are vital for many families. Speaking from my own experience,
they open a door to statutory services and
obligations—statements, as we used to call them, or education,
health and care plans as they became under the Children and
Families Act 2014. However, the system is in danger of becoming a
prisoner of that process. In the natural concern that public
authorities have to conserve resources there is a danger that we
start to become overly obsessed with labels and then find that if
somebody is not labelled there is, to mix my metaphors, a cliff
edge and nothing for the person who does not happen to get
through the door marked “autism”.
Let us think about that for a moment—think about how wrong that
is in terms of the lives we are dealing with. No one person just
presents as autistic; they might have a range of conditions and
challenges including, for example, epilepsy, which, sadly, is a
very common comorbid condition with autism. There are also other
conditions that might fall short of autism but if undiagnosed the
consequences can be baleful, such as attention deficit
hyperactivity disorder, attention deficit disorder, dyslexia and
other types of impairment that mean that people cannot access
education, for example, in the way that neurotypical people can.
These conditions might not be seen as acute compared with some
other conditions that are diagnosed but can lead to disaster for
the individual if they are not diagnosed.
School exclusion—I see the hon. Member for Croydon Central
() in her place—is the most
obvious consequence. That is a particular issue, and the
disengagement with the system that it can lead to all too often
leads to a descent into criminality, which, frankly, then brings
us back to the criminal justice outcomes that I have been
wrestling with all my professional life and in my ministerial
incarnation. In devising the right type of support, we need to
try to put the process in its proper context. We must remember
that this is about the person and centre something on the
individual and their needs.
I am delighted after many years to renew my association with
Autistica, our country’s leading autism research organisation.
Today, by happy coincidence, it published an excellent support
plan on autism. Having read it very carefully, I think it is
groundbreaking. It is targeted, and it tries to move the debate
in a direction in which I think all of us, including the families
and those who have autism, would like to see it go. That
contribution follows from the Government’s own commitment, in the
revised autism strategy published at the end of July, to improve
autism research, to improve innovation and to look for examples
of best practice.
As we near a very important moment in the life of our country,
with the Department’s publication later this year of the
long-awaited White Paper on social care, Autistica has identified
a gap in research—and guess where the gap is, Madam Deputy
Speaker. It is in social care. We have learned so much about
genetics and about the causes or the reasons for autism. That has
been incredibly important in understanding that this is a
condition, not an illness or a disease, and that there is no
cure, and in moving away from all that redundant language and
understanding the condition for what it is—and celebrating it
too, by the way. We do not do enough of that. We tend to view it
as some sort of wicked problem. For many people, it is actually
their life; it is who they want to be and how they want to be
recognised. We must never forget that.
(Tunbridge Wells) (Con)
My right hon. and learned Friend is making a powerful speech, and
it is good to have him free to contribute in this way. Does he
agree that, in so far as there are problems, they can be in
people’s responses to those with autism, and that if people were
to respond in a better informed and more generous way, then such
problems as exist today may not be there in the future?
My right hon. Friend is absolutely right. There is no doubt that
an inappropriate response, or a response, however well
intentioned, that results from a lack of evidence or a lack of
understanding, can make a bad position much worse for somebody
with a condition such as this. Therefore, for me, research is not
a luxury or an optional extra; it is essential. If we, as public
services, as private enterprise, as business—as an economy that
needs a supply of new talent, bearing in mind the announcement
today that there are 1.2 million job vacancies in our country—are
to really release the potential of people with brain conditions,
then this is, to use the phrase, a no-brainer.
I am grateful for my right hon. and learned Friend’s
indulgence—
Madam Deputy Speaker ( )
Order. I did not correct the right hon. Gentleman the first time,
but it is essential that he faces the Chair rather than the right
hon. and learned Member for South Swindon (), because he cannot be
heard if he is speaking to the back of the Chamber. I never
understand why, when there is all this space, people want to sit
where the occupant of the Chair cannot see them. There must be a
reason for it.
I will address you directly, Madam Deputy Speaker. I accept your
ruling on that.
One problem people with autism sometimes face is that, when they
come to an age where they are looking for jobs, work experience
is increasingly important and some employers are reluctant, based
on lack of familiarity and nervousness, to give work experience
opportunities to young people with autism and other conditions.
Work experience is an essential gateway to employment. Will my
right hon. and learned Friend join me in encouraging employers to
open up and give work experience opportunities to a wider range
of young people?
My right hon. Friend is absolutely right. We have seen that in
other areas, for example mental health, where there has been
concerted work, including by excellent organisations such as the
Mindful Employer Network in my area, to demystify the issue and
remove the stigma. Such work allows employers to understand
autistic people, some of whom see the world in ways that you and
I could not dream of. Going back to my celebratory point, it is
all about the potential of people with neurodiverse conditions
and what they have to offer.
(Croydon Central) (Lab)
I congratulate the right hon. and learned Gentleman on the debate
and on his cause. It is incredibly exciting that he has chosen
this subject to focus on after his ministerial career—not that it
is the end of his ministerial career; I am sure it will carry
on—and I just want to stress how important it is that we talk
about autism and educate people about it. In my constituency, we
had a five-year-old boy who was excluded from school. He was on
the path to being diagnosed, but had not quite been diagnosed.
His classroom was moved around over half-term and when he came
back, he did not understand where anything was. He kicked off and
was excluded. The language used in the letter to his mother
included strange adjectives—it said that he was being
“manipulative”—and other language one would not use about a
five-year-old, because his teachers did not understand his
condition. Now he is in a good school that does understand and he
is thriving. He will have a lot to contribute to society. I just
wanted to congratulate the right hon. and learned Gentleman and
say that I am very happy to support what he is doing.
I am very grateful to the hon. Lady. I think we formed a pact on
Sunday night that we would work together cross-party on these
issues. There are plenty of others on the Labour Benches—the hon.
Member for Stalybridge and Hyde () has a similar experience
and knowledge of autism—who I know will put their shoulder to the
wheel, and that will be incredibly powerful. She has done work on
the issue of knife crime. All too often, there is a sad
correlation between the isolation of people who might be
suffering from anxiety driven by an undiagnosed condition and
what I call a cycle of isolation that can often lead to the
decision to arm themselves for their own protection. That is an
aspect of knife crime—we always think and talk about gangs—that
we misunderstand at our peril, so I am grateful to her for taking
part in the debate.
I was talking about the golden opportunity we have. We are
between the autism strategy as published and the White Paper,
which I am waiting for with relish. The Prime Minister knows that
that is another issue I will be pressing him and the Government
on in the next few months. Many of us identify social care as an
issue not just for older people, important though that this, but
for adults with disabilities who need lifelong support. They must
be part of the mix. More than half of local government
expenditure is on adults with disabilities. If we do not pay
regard to that in the plan, we are failing. Although I supported
and am happy to support difficult decisions on national insurance
and on funding issues, we have to make sure that the system that
we are funding is well evidenced, produces the outcomes that we
all want to see and has an element of accountability that, at the
moment, is lacking. People talk about the black hole of health
and social care funding. With respect to everybody concerned with
that, that is what it feels like to us on the outside, and we
have to change. That is why research on care will be so
important.
I am so pleased that my right hon. and learned Friend made the
point that social care is not just about older people. That is so
important. What he is actually talking about—who knew that the
Back Benchers and Front Benchers were so joined up?—is levelling
up. He is talking about realising the potential of everybody in
our country. It is not that autism is therefore a condition to be
managed and kept in its box, as we seek to minimise the damage,
but that we want people to achieve their potential, and if
everybody can achieve their potential, that is just levelling up
really, is it not?
I could not have put it better myself. Levelling up is about
people and communities, not things. Things are important and they
deliver us levelling up, but levelling up is about people. That
is why the Government have to show seriousness of purpose. I am
with the Government on these things—I helped to author a lot of
the documents on which they will be held to account. This
matters, but if we do not focus on people, we are not going to
level up. That is the point that my hon. Friend made so well.
I commend the Autistica report to hon. Members, but if I may
crave the indulgence of the House for a little longer, I want to
outline what Autistica suggests the key stages of support should
be that will make a real difference. First, the report made the
important point that support for autistic families around and
shortly after the time that they receive a diagnosis has to be
improved, because it is big news for families. It is a big moment
when they get that diagnosis. I remember now the mixture between
relief that the system is listening and deep sadness, grief and
anger, and all the emotions that someone goes through as a
result. These are big moments for families. It sounds axiomatic,
but this does not happen, because we do not empower all families
of people with autism to understand the diagnosis and to come to
terms with what it means for them. This is a moment when services
have an opportunity to get to know these families better and to
ensure that their personal profile, which should be done, is
really understood.
Does my right hon. and learned Friend share my concern that, very
often, as with so many of these things, the children of the—let
me use this phrase—“sharp-elbowed middle classes” seem to get a
disproportionate amount of attention, care and support and those
who are often least comfortable with officialdom and challenging
professionals and asking questions usually get the smaller
section of the pie? Quite a lot of work needs to be done on that
to ensure that we have that uniformity of levelling up.
Again, that is a really important point. I do not make any
criticism of the sharp-elbowed middle classes; these people are
doing what they think is right for their children. I have been
there and I make no apology for it, but among all those
dedicated, wonderful, loving parents and carers, there are many
families who do not have that wherewithal, and they often come to
our surgeries and offices for help. We are the last port of call
and, very often, we can make a difference. Looking back on the
plethora of cases that I have dealt with, I am probably most
proud—I know that hon. Members will share this feeling—of bumping
into families years later and being told, “You helped our son. He
has just finished his education and is going to go off and pursue
a skill. If you hadn’t intervened six years ago, I don’t know
where we’d be.” That is wonderful, but it should not be
necessary: that is the big message that I want to convey
today.
Rather than just stand here and make a general cri de coeur, my
aim is to look at the bigger picture. Individual cases such as
the one that the hon. Member for Croydon Central mentioned are
symptoms of the problem, but it is all about dealing with the
challenge itself. Documents such as the Autistica plan really
help to tie the threads together and give us a blueprint that the
Government, working with the private and charitable sectors, can
run with.
I mentioned support around diagnosis. The document has some very
interesting proposals for pilots and initiatives relating to how
we can improve what is referred to as the diagnostic pathway. At
the moment, there is a lot of ambiguity about precisely what is
offered and what works, but the time of diagnosis is not a time
for ambiguity. It is no good making educated guesses at that
point; we want to know with certainty what pathways work.
Families embarking on this new journey need that certainty, so I
strongly commend to the Minister the document’s recommendations,
particularly in relation to the work of the National Institute
for Health Research.
As stage one, we need a framework that can be applied nationally,
rather than relying on purely local initiative. Stage two, as the
document describes it, is preparing for the future: after
diagnosis, what systems do we have to match the needs of people
with autism and brain conditions with the right therapies and
services? We need to make those connections better; we need to
connect people to safe practical advice, particularly from people
who have been through the system. Peer-to-peer support works in
so many contexts, and particularly in this one.
What we and Autistica are asking for is not a finger in the air,
but evidence-led systems. It is no good just saying that the
needs of autistic people are diverse. They are diverse, believe
me: when you have met one person with autism, you have met one
person with autism. They are all wonderfully unique, in my
experience, but that should not be an excuse to say, “We’ll let a
million flowers bloom and see complete diversity.” We need less
of an unguided mêlée and much more of a framework—a mechanism by
which, with evidence, we can ensure better support for people as
they prepare for life and work out the pathway.
Finally, the third element of the report is meeting in a
realistic and feasible way—we are not trying to create something
totally out of this world—the evolving, ever-changing needs of
people with autism. That is particularly important at the
transitions, be they from primary to secondary, from secondary to
tertiary, or from tertiary out of education. Age 25 is a big time
for people who have an education and healthcare plan, because it
is the moment when it stops—and what’s next? All such transitions
can feed anxieties that if left unchecked can develop into a
co-morbid mental health problem, with the concomitant waste that
I spoke about at the beginning of my speech.
The truth is that the needs of people with autism and their
families fluctuate and change. Instead of inviting crisis, let us
plan for it and avert it. The support that the report envisages
is all about services that will be there if things start to get a
bit heavy, but that can be light-touch in other circumstances.
The suggestions about nurturing expertise in the NHS and social
care with hubs of expertise to deliver specialised services seem
the most sensible way of developing those service models.
This is going to take investment, but, as I have said, I do not
believe that it should begin and end with Government, which,
hopefully, is good news for my hon. Friend the Minister. If she
has had a chance to see the report that I mentioned—it was
published only today, but I know that her officials will be
familiar with it, because Autistica works very well with the
Department, and I commend those officials for working with it so
constructively—she will know that it sets out a costed programme,
in which Autistica itself declares it will invest, or partner, to
the tune of nearly £16 million. That is money from the third
sector, but we ask the Government to step up, because the total
cost of the projects that Autistica envisages in its list is just
over £65 million. All those projects are designed to improve the
evidence base and hence to improve the way in which we can deal
with each of those three stages, and I warmly commend them to my
hon. Friend.
What, finally, is the context in which we should work? I have
talked—at the risk of stating the bleeding obvious—about the need
for Government Departments to come together: the Department for
Work and Pensions on employment, the Department for Education on
exclusions, the Minister’s own Department on diagnostics and
care, and my former Department on criminal justice. As I have
said, however, this will require an effort from all sections of
society, and the private sector must step up as well.
It is in businesses’ interest to get this right, if they are to
unleash the talent of autistic people not just because it is
good, but because it is damn sensible. It is to that sort of
enlightened self-interest in the wider community that I want,
through the House, to appeal tonight. I think that the offer of
finance from Autistica is significant, although I want to see it
scaled up. I think that the work we need to do outside this place
to harness philanthropy and the support of the private sector
could start to bring us much closer to the levels of research
investment that we see in, for example, the United States, which,
although it does not enjoy the wonderful national health service
that we have in our country, is very far ahead of what we are
doing here in terms of research investment.
If we are to succeed, that partnership between the third sector,
the private sector and the public sector will be essential. The
quid pro quo for Government is that our wonderful officials must
remember that they do not have a monopoly on wisdom. I have sat
in the Minister’s seat and worked with officials and worked well
with them, but sometimes there is an institutional reluctance to
go outside the tent because of fears about control, whatever form
it may take, and, inevitably, about accountability. We must
overcome that, because Government alone will not be able to crack
this.
The last two years have, in many ways, opened our eyes to the
potential that Government can offer. Government-led support and
declarations of Government funding meant that we were able to
create a vaccine manufacturing capacity virtually from scratch. I
am about to see 250 jobs come to Swindon—jobs that would not have
existed a few years ago, without the terrible crisis that we have
all had to live through. The Government rose to the challenge,
and I was proud to see them do so, underwriting, in effect, many
of these initiatives.
We heard words such as “moonshot”, did we not? We heard about the
Government’s big ambition to deal with the threat posed by the
pandemic, and rightly so. Let us remember that. Let us bottle it
and use it here. Let us have our autism moonshot; let us have our
neurodiversity moonshot. Let use the power of Government—its
convening power—to kick-start this research, and to lead our
society in the improvement of research. Through the gathering of
that evidence and Autistica’s work, we can reach some of
Autistica’s 2030 goals. Its realisable ambitions for 2030
include: halving the employment gap for people with autism;
services truly centred around the person with autism; proven
support from day one; public spaces being more accessible for
neurodivergent people; tailored health checks for people with
neurodivergence; and, yes, screening at an early age, whether in
the health system or the education system. That is a wider
application of the principle that I wanted to see in our criminal
justice system.
This could be a decade of achievement. It is up to all of us and
the Government to make it happen.
18:15:00
The Minister for Care and Mental Health ()
I thank my right hon. and learned Friend the Member for South
Swindon () for securing this
important debate on funding for autism and neurodiversity
research and for such a wonderful, heartfelt speech. It is truly
my honour to respond. I commend him on the incredible work that
he has done throughout his career to improve the lives of the
nearly 560,000 autistic people and about 5 million neurodivergent
people across the country. In his previous roles as Lord
Chancellor and chair of the all-party parliamentary group on
autism, he has been instrumental in driving improved awareness
and understanding of autism across Government.
We know that too many autistic people and neurodivergent people
more generally are ending up in the criminal justice system and
that much more needs to be done to improve people’s experiences.
The review that my right hon. and learned Friend commissioned as
Lord Chancellor in 2020 looked at this important issue and, as a
direct result of his contribution, I expect our newly published
national autism strategy will make a big difference to the lives
of autistic and neurodivergent people who come into contact with
the criminal and youth justice systems. We know that the strategy
needs to improve autistic people’s lives. It was informed by a
national call for evidence and incorporated the views of more
than 2,700 autistic people, their families and carers. It is
underpinned by an implementation plan for year one—that is
2021-22—and backed by over £74 million for the first year alone.
It sets out our vision for what we want autistic people’s lives
to be like by 2026. Over the next five years, we will improve
understanding in society, reduce diagnosis waiting times and
improve access to high quality health and social care for
autistic people.
My right hon. and learned Friend mentioned social care, and that
will be a key part of the White Paper along with the social care
needs of working-age adults. We will also publish further
implementation plans for year two and beyond that will build on
our actions this year. They will set out how we will drive
improvements across health and care, employment, education and
the criminal justice system.
We have made important strides across England in the last decade
since the introduction of the landmark Autism Act 2009. I pay
tribute to our friend for all her work in this
area. The Act includes improvements in public awareness of autism
and the availability of diagnostic services. To date, we remain
one of the only countries in the world to have such legislation—I
know that we are proud of that—but we know that we still need to
do more to ensure that autistic people have equal access to
services across their lives.
One of the biggest challenges that we face is, as my right hon.
and learned Friend outlined, gaps in our evidence about what
services and support work best for autistic people. I saw the
real-life impact of that recently when I was interviewed by an
impressive young woman called Immie. She told me about her
struggle and how long it took her to get diagnosed with autism as
well as the struggles faced by women and girls in getting the
right support due to under-diagnosis. While we know that that is
an issue and are taking action to address it, we need better
evidence about the effects of masking and under-diagnosis of
autism for women and girls.
When I was the Apprenticeships and Skills Minister, I met many
young autistic people who told me they struggled to find and get
into work. Recently, at the start of UK Parliament Week, I
visited Littlegreen Academy in my constituency, which specialises
in providing education to boys aged seven to 16 with autism.
Pretty much every single one of them asked whether I would help
them to get some work experience, to help them get on the ladder
towards employment. Like my right hon. Friend the Member for
Tunbridge Wells (), I took that as my action from
the meeting.
Through our new autism strategy we are strengthening and
promoting pathways to employment, such as supported internships,
traineeships and apprenticeships, but to make further headway on
closing the unacceptable autism employment gap we need to better
understand the barriers to employment and the other barriers
faced by people with autism.
We know that we have not reduced fast enough the number of people
with an autism diagnosis in in-patient care, which is important,
as my right hon. and learned Friend the Member for South Swindon
said. There are many reasons for that number, but a main reason
is that people are being diagnosed as autistic after they are
admitted. We need to make sure the number of autistic people in
such settings is reduced, as in many cases they are not the right
settings. We set up a delivery board across Government and across
system partners to make sure we monitor progress, identify
blockers and propose actions so that people are better supported
in their community, not in inappropriate in-patient care.
Many hon. Members mentioned the lack of understanding, and it is
so important that we have more general understanding. I am sure
many hon. Members remember the autism training that MPs and their
offices received, again at the behest of , who pushed and encouraged us
all to do that. I certainly learned a lot.
As set out in the “Right to be heard” publication in 2019, we are
also trialling the Oliver McGowan mandatory training in learning
disability and autism for all health and social care staff,
backed by £1.4 million of funding. The trials are under way, and
three providers are currently delivering the training. Hundreds
of staff have already been trained. There will be a final
evaluation report, which is due in the spring, and the outcomes
will inform the wider roll-out of the Oliver McGowan mandatory
training. We are working with his parents, Paula and Tom, to
introduce the training.
As part of our new autism strategy, we will publish a
cross-Government research action plan that lays out the steps we
will take to improve and embed a culture of autism research by
2026. We know that we need a strategic approach to ensure that
areas currently receiving less research investment, such as care
and support—my right hon. and learned Friend mentioned the
postcode lottery—are prioritised in future. We also need to make
sure we are prioritising the right areas for research and that
the research delivers the right change.
We will work with autistic people and their families, the
research and voluntary sectors and NHS England to carry out this
research action plan, which will ensure that we are building on
the important work already happening in autism research. For
example, we have already provided £81 million for autism and
neurodiversity research in the past five years, which includes
funding for a study on the impact of covid-19 on autistic people,
a project to improve the accuracy of adult autism assessments and
a systematic review to understand what mental health support
works for autistic people.
In addition, we were delighted to announce this year a three-year
partnership between the National Institute for Health Research
and the UK’s leading autism research charity Autistica—which my
right hon. and learned Friend mentioned—to fund research into the
social care that works for autistic people. The partnership will
encourage and support more research applications in this
important subject area and we encourage many people to make such
applications. I am glad we have had the opportunity today to hear
about Autistica’s fantastic work and to welcome its new support
plan. I am due to meet Autistica next week—that gives me some
time to read the report—and I look forward to working with it on
the development of our research action plan to transform the
autism research funding landscape over the next few years.
I again thank my right hon. and learned Friend for securing this
important debate and all Members for their contributions. I
recognise that we must ensure that the actions we take to
support and improve the lives of autistic people and their
families are grounded in evidence. Through our new autism
strategy and research action plan, we will level up support for
autistic people throughout the country. I look forward to working
with my right hon. and learned Friend and other Members to make
that happen.
Question put and agreed to.
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