Mental Disorder: Autism and Learning Disabilities

Lord Addington Excerpts

Tuesday 5th November 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

My noble friend puts this very clearly. The Government accept completely that autism and learning disability are not mental disorders. The question is whether being excluded from the legislation would cause challenges or difficulties for those who may have autism and mental disorders. We will have to consider that carefully as we go into the process of considering a review of the Mental Health Act. As my noble friend just said, we recognise that we will have to go through a careful process. We also recognise the strong feelings—and the correct view—that autism and learning disability are not mental disorders. There is no disagreement on that point.

[Lord Addington (LD)]

My Lords, does the noble Lord—I am sorry, does the Minister agree that we are confusing disability with illness, something which has gone on for far too long? Are we going to have a programme to train people in recognising the different facets of the two and how they interact? The treatment of many people with autism has undergone is probably the best way to induce poor mental health in many of them. Can we please do something to stop that?

[Baroness Blackwood of North Oxford]

I thank the noble Lord and I recognise the challenge to my gender today. He and my noble friend are absolutely right that we must ensure that all health and social care staff have appropriate training on autism and learning disability. A number of Members of this House have campaigned long and hard to ensure that this happens. Some £1.4 million of government funding has been put in place to develop and test some new training packages and today we published the government response to the consultation on mandatory learning disability and autism training which confirms the intention to introduce mandatory training for all health and social care staff. I think that that is an excellent step forward and I am absolutely sure that this House will scrutinise it for its effectiveness. That is right, but it marks a steps forward and should be welcomed.

Queen’s Speech

Lord Addington Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Lord Addington (LD)]

My Lords, before I make my remarks it would be appropriate—given what they will be—to remind the House of my declared interests and the fact that I am dyslexic.

I wish to address the subject of how people from neurodiverse groups and those with other disabilities get through exams, given that, in the new culture, they must have good spelling, punctuation and grammar. We have got to the nub of it quickly. This new culture is here: people must all have these largely technical skills, even if they have a brain like mine. I have a bad short-term memory and bad language-processing ability, which means that I acquire these skills slowly.

This is most manifest in the apprenticeship system, or the new T-level system that it is threatened will follow it. I thank the noble Baroness, Lady Berridge, who has said that she will write to me to confirm this. This puts pressure on the people I have mentioned. From the information I have picked up, at the entrance-level requirement—which you must pass to get the qualification—between 30% and 40% of the marks will be removed if you use assistive technology that allows you to take the rest of the exam.

Once you have a job and the qualification, assistive technology will be provided through Access to Work. You will be provided with it if you are going to university with a disabled students’ allowance, but you will not get any marks for it if you happen to be doing an apprenticeship.

Many noble Lords will be thinking, “Why is he going on about this again? Didn’t we deal with it all those years ago in Children and Families Act?” The noble Baroness laughs, which is probably appropriate. We went through it all once because of the idea that you had to pass English to get through exams to become a carpenter or a hairdresser. Hairdressing was the first occupation that drew me to this issue because someone who had won a national prize was failing their apprenticeship because they could not pass the English test.

On 7 January 2014, the noble Lord, Lord Nash, said that,

“we will include new text in the skills funding statement to remind education and training providers of their duty to support young people with learning difficulties or disabilities and of their responsibility for providing reasonable adjustments, including the use of assistive technology where appropriate”.—[Official Report, 7/1/14; col. 1474.]


Which is true? Is it this new obsession with making sure that you can spell properly, even though you have a disability that says you cannot?

Let us go a little wider. If you have a visual impairment and depend on similar types of technology, differently formatted, or if you are dyspraxic—another big group; between the two, that covers 15% to 20% of the population —which of those commitments is dominant?

All those in this House involved in education are on the Front Bench at the moment. The noble Baroness, Lady Blackwood, will be justified in asking for support from them—I appreciate that that is the situation—but how are we are going to deal with this issue? I do not want to spend another three years boring this House senseless trying to get another solution to this problem. Something has gone wrong. Can the Government give us an assurance that they will put it right—and as soon as possible?

Childhood Obesity

Lord Addington Excerpts

Monday 15th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Lord is quite right that the national plan must be implemented locally. Public Health England works with local authorities to do that and has set up a number of tools, such as the Change4Life plan, which includes food scanners that have been downloaded several million times to help parents and families make better food choices. We have more to do on this, and we very much welcome proposals to do it. I know that the Amsterdam model has been particularly effective; indeed, my noble friend raised this with the previous Public Health Minister, and I am sure she will continue to raise the issue.

[Lord Addington (LD)]

My Lords, does the Minister not agree that activity is an important part of tackling obesity? We have had some wonderful examples of sporting success in women’s football, cricket, netball and other activities at the moment. What are we going to do to make sure that these examples of sporting success are fed down to children and made available on free-to-air when possible?

[Baroness Blackwood of North Oxford]

We should all be incredibly proud of the sporting achievements over this weekend; we should not hesitate to do whatever we can to promote them throughout our schools and make the most of the moment. The noble Lord is absolutely right that regular physical activity has been linked not only to improved physical health but to improved mental health and academic achievement. That is why the Chief Medical Officer has recommended 60 minutes of physical activity every day. We know that only one in five achieve this; that is why the money from the sugar levy is going into schools activity. But we have more to do. We have announced the national plan and now need to implement that effectively, and I hope that the noble Lord will hold us up to the mark in delivering it.

Mental Health of Children and Young Adults

Lord Addington Excerpts

Thursday 16th May 2019 Lords Chamber

[Lord Addington (LD)]

My Lords, the fairest question we can ask any Minister in this debate is, “What are you doing to lead the action that is required here?” No one department can deal with this. When you talk about young people, clearly you will be talking about education—there has already been a great deal of emphasis on that. However, if you look across at the things that are working, take a leaf out of your own sports policy. Exercise is reckoned to be incredibly good for most people with mental health problems. Taking part in a sports team is a good way to prevent mental health problems, as you get a positive attitude and company, and the endorphins and stress release of sport help.

What are we doing to encourage that? What is the Department for Education—which, let us face it, is one of the few departments which is not quite as tightly squeezed as the rest of government at the moment—doing to lead this? That is the question that it is fair to ask the Minister; I am afraid that it comes with the job. What are you doing to help make sure that we get things right? If you do not, the Department for Education and everyone else will merely shuffle the problems on to you. What does not come to the Department of Health and Social Care will go into the criminal justice system. Where people fail to function in society is where it ends. On every occasion, when there is somebody who cannot function in respect of mental health or anything else—you name it—that is where you pick it up. You are the catch-all for what goes wrong.

Can the Minister gave us some idea of what encouragement the department is giving to make sure that in the field of education the Department of Health is saying to the Department for Education, “Will you make sure that people are educated in such a way that they can thrive?” I refer to the groups that were mentioned in the good and comprehensive opening remarks from the noble Baroness, Lady Royall: those with special educational needs. I remind the House once again of my interests in this field.

The All-Party Group for Dyslexia and Specific Learning Difficulties, led by Sharon Hodgson, flanked by myself and Henry Smith MP, has just produced a document in which we looked at the personal costs to dyslexics as a group and the amount of stress experienced by an individual and their parents if they are dyslexic and their needs are not being met as they go through the educational system. Stress is a great trigger mechanism for mental health problems—I think that is agreed. What are we doing to make sure that the Department of Health and Social Care says to the Department for Education, “You’re shovelling your problem on to us”? These trigger mechanisms are in place, but because of recent education reforms people are saying to dyslexics, my group—which is not the only one that is suffering—“You must get English”, and are putting an emphasis on taking more spelling tests, which is probably the world’s worst thing to do to a dyslexic. If you have a bad short-term memory and bad language processing, it does not matter how many times you do a spelling test—you will still forget. I know, because I have done it. What are we doing to say, “Stop doing these things that aggravate this very large group”—roughly 10% of the population?

As I said, they are not the only group. The National Autistic Society reckons that 70% of those with autism have mental health problems in the school system because of this pressure. It is not those with the most obvious problems—the low-functioning autistic or very severe dyslexic—but those who probably could just function in the system whom we must worry about. They are the people who will be overlooked and who will not get help automatically. I always use the example that if you have a car at the side of the road with smoke coming out of the bonnet and somebody shrieking, people will stop and help. If you are stuck in third gear, you are a pain.

What are the Government doing to lead this activity? Those are only two small examples covering two areas. How are they bringing this together? If the department does not do that, we will have high, pious words. Everyone will say, “Oh, it is terribly difficult”. Most of the reaction in the education system will be, “If we wait a few years, it will be another bit of the education system’s problem. Then it will be the Department for Work and Pensions’ problem—and then it will be a problem for the criminal justice system and then for the Department of Health”. That is what happens. We need co-ordination, and the Minister’s department must lead it.

Obesity

Lord Addington Excerpts

Wednesday 18th July 2018 Lords Chamber

[Lord Addington (LD)]

My Lords, the noble Lord, Lord McColl, is going down a fairly well-trodden path when he speaks on this subject. My steps will not be exactly new to anybody who has been listening to debates on this subject either. This is an interesting debate, and I look forward to hearing the newer voices: the noble Baroness, Lady Boycott, will, I hope, prevent ourselves repeating ourselves for ever.

There is one very odd aspect of the current obesity problem, which has never occurred in history before: it seems to be concentrated among those who are less well-off. For the first time in history food is very cheap. It may be the wrong type of food, and consumed in the wrong way, but it is very cheap. It is also odd that the poor are those in society who take the least exercise and are the most obese. It is difficult for people who live in poorer communities to organise themselves to do the right amount of activity or sport, or to be in the right environment to take casual exercise. If people live in nice areas with wonderful walks, they may walk either with or without a dog; they will take that amount of exercise. But if people live somewhere where it is difficult, unpleasant or even dangerous to walk around, they will not. Nobody does something that is unpleasant unless they have to.

Sitting at home with a full-fat, or fully leaded, cola—or fizzy drink; let us not be brand-specific—and a packet of crisps is a nice thing that everybody will do every now and again. The difference is whether someone thinks that they are having a guilty pleasure every now and then, or whether that is the norm. People also have to adapt what they think they should be getting out of this. Simon Stevens, CEO of the NHS in England, described exercise as a miracle cure or wonder drug. It works. People burn up calories and put on muscle mass, and as they put on muscle mass they burn up more calories, and make themselves much healthier.

Throughout our lives, especially towards the end of life, those with the least muscle mass and those who cannot move very well are much more likely to be ill in later life. That is a fact. As for the ideas about weight, I have news for you, my Lords: every single prop forward should be dead, according to the height/weight index, as should anybody who does any form of exercise like sprinting or canoeing—you name it. Weight is not the best guide; it is carrying the wrong type of weight that matters. A sprinter, or someone whose sport requires sprinting, will be taking a different type of exercise and acquiring muscle mass. All these things come together.

What are the Government going to do to allow people to get the best out of all this? Education and information about the right types of food is an important factor, and that is being provided. There are also tax incentives. The action taken on smoking has shown us what can and cannot be done, and told us about the long timescale and lead-in. Things can be done. There is also a NICE policy about bringing together sport and exercise, and involving local government and the Department for Education. The department of health is probably the only department that has sufficient power and gravitas within government to make sure this happens. Local government is under tremendous stress at the moment, and the DCMS just does not have the bite when it comes to budget and power. It has to be led by the department of health. When the Minister replies, will he say how the department is leading this exercise and bringing its colleagues in? We cannot do it unless we bring them all tighter—unless we make sure that everybody has the same hymn sheet.

Health Inequality: Autism and Learning Disabilities

Lord Addington Excerpts

Thursday 10th May 2018 Grand Committee

[Lord Addington (LD)]

My Lords, I put my name down for this debate because I am afraid I recognised the issue. The problem that the NHS has with groups who do not handle the basis of diagnosis—that is, the one-to-one interview—is one that is very well established. The idea that you will go to talk to your doctor and he will try to get from you what you think the problems are and to talk through them is a very good model for most people, but not for all. Two groups for which this model breaks down are talked about here. Somebody who is autistic, who may not relate to that person, is always going to have slightly more problems than somebody else. Of course, anybody who knows anything about autism—I do not know anywhere near as much as many people in this debate—knows that no two people with autism will relate in exactly the same way.

You are asking an incredible amount of a doctor or any other health professional to get that diagnosis correct, without giving them guidance and training—including, importantly, guidance and training on when to call in an expert. That is something that we need to hear about. When do you call in the person who really knows? How do you give the health professional the confidence of saying, “You will not be marked down as a professional by calling in someone who knows more”? The same will be true for those who have learning disabilities. It is a different set of skills, but still one that is required. Will you train those health professionals to call in the support of an expert and give them the room and flexibility to do it?

I finish on the need for early diagnosis in all hidden disabilities. Autism is something that is so well known that we only need to say “Me too” on it. Once the person knows it, you cut down on anxiety and stress, which are the fast track to mental illness. Let us make sure that we cut down at least that one shortcut.

Children and Young People: Obesity

Lord Addington Excerpts

Tuesday 17th April 2018 Lords Chamber

[Lord Addington (LD)]

My Lords, I thank my noble friend for bringing this debate forward. It is one we have dealt with for a while. It is also one where we can start by being a more cross-party group, because the Government have had a policy on this and they have done something. Indeed, I congratulate them. A warm waft of nostalgia came from my desk at about 2 o’clock this afternoon when I received an email telling me how we must not go too far, not to be excessive and everything else. It was from the Advertising Association. It reminded me so much of the stuff we got when we were discussing the ban on smoking. Shall we say that a record of past success seems to be being trodden by the Government here? Okay, they have not done it fast or thoroughly enough and anything else, but they seem to be taking the first few steps.

The noble Lord, Lord McColl, and I have differed slightly on the role of exercise in weight control, but he is right on one thing: a sugar-saturated diet is a great way to pile on weight. Some fizzy drinks are basically two litres of sugar-enhanced, carbonated liquid. The only way you can burn that off is by tramping across the Arctic in mid-winter, when you need that degree of sugar. I have also disagreed with the noble Lord on whether you burn up calories by rebuilding muscle after exercise, but let us not go into that now.

However, when it comes down to exercise, I ask the Government to remember one thing very clearly: the obesity epidemic is most pronounced in low-income bits of the economy. The highest degree of exercise is seen in the high-income bits of the economy; there is a divergence there. People who stay active or who are allowed to become active have the least problems. I would suggest that this is because those on higher incomes have better opportunities to take up activity. If you play a sport regularly, you are more likely to take some control over your diet. If you have not become terribly obese in the first place, you are more likely to take up your exercise. If the cheaper foods you are buying are not laden with fat, there is a relationship. It is statistically proven that the groups who take the most exercise have the least problems—there is no real argument about that.

What can the Government do to break into this? First, they should make sure that schools and those who provide sport to school-age children receive all the support they can, so that they can get on with the process of being physically active and having a reason to maintain their weight. At the moment, there is a problem. If you are dependent on the facilities of a local authority, and that local authority has closed down parks, gyms and sports fields, you are not going to be taking any exercise, are you? You just cannot; there is not the opportunity. If you are dependent on a private gym and cannot afford it, you do not go to the gym. If you have not established that exercise pattern, you will be a very unusual person if you then take that on.

However, we have one wonderful utility that we should go back to: the amateur sports structure of this country. I know that steps have been taken and we have talked about this, but unless we encourage those links and manage to get the whole of government—education, health and local government; it takes everybody, even the Home Office, which is involved in vetting coaching staff—actively to support such groups, things will go wrong. I am afraid that was the case with the school sport partnerships, where we more or less got rid of something which at least showed signs of promise.

Why is this so important? If one has links with clubs outside, you are not dependent for your sporting activity on educational institutions. They break down linkage between the stopping of sporting activity and the ages of 16, 18 and 21, when you leave educational establishments—the age of 16 is the biggest one. So you have to get in there. All governing bodies in sports should take seriously the job of educating to keep people involved, safe and fit, and of trying to get them to engage in participatory activity. We are not talking about elite-level sportsmen here; we are talking solely about the weekend warrior, as my entire sporting career was apparently spent. Unless government finds a coherent way to encourage that, we will not be utilising this wonderful resource which is available for free and wants to be given the job. I hope that the Government will look at this to make sure that we have a coherent strategy for using those who want to help.

Queen’s Speech

Lord Addington Excerpts

Thursday 29th June 2017 Lords Chamber

[Lord Addington (LD)]

When I was anticipating speaking in this debate, I was expecting to talk about the creation of grammar schools, as many other people were who have an interest in education, and I was relieved but also slightly annoyed that it had not got in, because I thought it would be a little way in to looking at how the education system deals with those with hidden disabilities. I had hours of thought about how you would devise a system that selects people for grammar schools, or grammar schools plus, which takes the best, a system that takes into account those with dyslexia, dyspraxia and the other neuro-diverse conditions. How do you have something that conforms to the Equality Act and allows people to get through? Indeed, I got fairly far along this path and further and further away from the idea that a test that you take once should decide your future. But as that is not in the Queen’s Speech, I thought that we could look at another aspect of how the system and the systems generally across government affect this group. Once again, I make the House aware of my interest in this field.

One area that we have not really addressed here and are not going to address in any of the speeches, although there is a kind of second-hand reference to it in the Queen’s Speech, is the Government taking further steps to increase—I am sorry, but I have discovered that having middle-aged trombone eyesight is a bigger problem than dyslexia. I might have taken a step forward. The Speech refers to the idea that we will remove disability in life generally—and we have a two-year Parliament. To go back to the group to which I referred earlier, we have two years to start doing the boring bits: the fine detail in all forms of disability legislation and all legislation that addresses equality.

I say that, because I am undertaking some work with Barry Sheerman MP in the House of Commons through a group called AchieveAbility, whose work is based on dyslexia and the other neuro-diverse conditions such as dyspraxia, dyscalculia and autism. It is about how you get further in life. We are looking at recruitment, and the big thing that we have discovered is that, with modern recruitment practices, big recruitment firms and the larger firms that are dependent on them really do not know how to recruit the best people with these conditions, because they do not have systems that are flexible enough. The modern recruitment pattern asks whether you would do everything to get in, whether you would be thrown if you had to man a phone for the day, and so on. People in that group cannot say yes to the question whether they have all those generic and wide-ranging skills, so either they do not declare their condition and get into trouble, or they declare it and do not get through the process. That was the first revelation. Having dealt with disability for many years, I know that when it comes to the more obvious disabilities, such as movement impairment and wheelchair access, the bigger firms are better, because of investment. But when they suddenly get a group that they do not understand or know about, those people do not get through. Recruitment for people like this is in smaller firms, where you can interact with the person in the first place and get referred along.

So there is this group of people who they do not understand and who do not go through. We need reassurance that the means to get through are readily available. There are examples, such as in education, where the situation is not perfect but is improving for many. There is better awareness coming through, so we will actually be able to take steps. It is when the big machine does not understand its responsibilities that we make mistakes. Also, these larger firms are turning down opportunities, because these groups can do these jobs. The advert at the start usually bears no reference to the actual job. Can you man the phone? Yes, but you are doing something miles away in a big organisation and you probably will not have to do that. There is technology that will help you, but they do not know about it. I therefore hope that over the course of this Parliament we will start to take the small, boring steps that mean that we look at how we implement and get the best out of this group so that they can get through, taking best practice from one section and applying it to another.

AchieveAbility’s most recent discussion was with the DWP. We had one wonderful moment that made me quite worried, because we were told that almost every job centre has one expert on disability. My rather glib reply was, “Well, that’s almost good enough, then, isn’t it?”, which may have been a little unfair to the individual, but the point was made. In education, what we have discovered, which should be applied across the piece, is that having one trained person, a SENCO, who understands this is no substitute for having teachers who have some understanding and who know how to use the SENCO. In other words, unless you get somebody who understands the problem and what somebody is talking about, you will not access the other support.

So I hope that over the next two years when we are not dealing with Brexit that we will take time to look at the implementation of policy that we have all agreed to. Let us get into the fine detail. In the absence of large Bills, and given that we might want some light relief from discussing major changes in international law and trade patterns, we can look at how we implement things that we have all agreed to. The area of disability in which I am interested is only one facet of it, but if we get into this area and take on some activity, we may have a real legacy to take away, which no matter what else we do will make lives better for a large section of our society and, indeed, for those who have to live and work with them.

Child Health: Play

Lord Addington Excerpts

Monday 12th October 2015 Lords Chamber

[Lord Prior of Brampton]

Clearly, my noble friend is right: nutrition and diet are fundamental to the whole debate about obesity. That does not alter the fact that exercise is also very good for you.

[Lord Addington (LD)]

My Lords—

--- Later in debate ---

[Lord Prior of Brampton]

The noble Baroness makes a powerful and strong point. All I can do is agree with her 100%.

[Lord Addington]

My Lords—

[Baroness McIntosh of Hudnall]

My Lords—

[Baroness Stowell of Beeston]

My Lords, I suggest on this occasion that we go to the Lib Dems as this Question started with the Lib Dems, although I acknowledge that there were two Conservative speakers in a row, which should not have happened.

[Lord Addington]

My Lords, does the Minister agree that if we are dealing with a sports policy that talks about competitive sport, getting some idea of creative play and competitiveness within play is vital? If we have a sports policy, it must have a foundation based on something like my noble friend suggested.

[Lord Prior of Brampton]

There is no question that competitive sports have a huge role to play, but many children do not wish to participate in competitive sports, so having resources and time made available for less competitive activities such as yoga, pilates or dance is also very important.

Mental Health Services

Lord Addington Excerpts

Wednesday 25th February 2015 Lords Chamber

[Lord Addington (LD)]

My Lords, this is one of those debates where we find ourselves addressing the ground very close to the subject we are covering tonight, because we have been there before.

The primary thread through this is the fact that those who have stressful lives are going to experience a slightly higher occurrence of mental health problems. The noble Baroness, Lady Uddin, and I have taken part in several debates where we talked about people with disabilities and how they are going to have a slightly higher occurrence of mental health problems because their lives are more stressful. Every time that occurs, we are going to find more mental health problems. The problem is the fact that we have not, until very recently, acknowledged that this is what is going on. We have a historical problem which we are now starting to address. I do not know if we are coming up with more solutions with this Government, but at least we are acknowledging the problem and taking the first step.

Will the Minister give us some assurances about where we are improving training in recognising this problem? We have identified the fact that where people are under greater stress, anxiety and depression are going to be more common. What are we doing to make sure that those who are dealing with this recognise the underlying problems and intervene early? Every time we delay dealing with these problems, behaviour gets entrenched and educational problems become more pronounced.

The problem with the education system is that children and young people are on a conveyor belt. If they slip at any stage, they have to run very fast to catch up. Mental health will account for some of that slippage. When mental health issues occur with a special educational need, a situation is created where the child is under even more stress and dropping out is only the short-term survival mechanism. What are we doing to address this?

The noble Earl, Lord Listowel, addressed the point that care workers are undertrained to recognise this problem. They do not know what is going on. I think the Government have recognised that GPs do not have enough training to spot the problem early enough to push clients towards services. It may be the case that, as in many of these things, if you are going to have a problem, choose your parents well, and they will battle through for you. But, without that backing, children do not get that thrust to intervention and we end up with this point of crisis intervention and it tends to be papering over the cracks. Will my noble friend give the House some idea about the general strategy of making sure that there is greater awareness of the importance of early intervention? Without that we will carry on papering over cracks.