Autism: In-patient Care in Mental Health Hospitals

Debate between Lord Touhig and Lord Markham

Tuesday 14th November 2023 Lords Chamber

[Lord Touhig (Lab)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper and declare an interest as a vice-president of the National Autistic Society.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, this year we are investing £121 million in community support for autistic people and people with a learning disability. This will support reductions in the numbers of autistic in-patients in mental health hospitals in line with the NHS long-term plan commitments. To ensure that autistic people receive quality care in these settings, we are rolling out a National Autism Trainer Programme and have published guidance on sensory adaptations in health environments.

[Lord Touhig (Lab)]

The King’s Speech was an opportunity for the Government to introduce the mental health Bill, ending the scandal of autistic people being locked up in mental health hospitals, sometimes for decades. By shelving the Bill, the Government have failed thousands of autistic people and their families, who are devastated that there continues to be no legal protection against unnecessary detentions; I believe that is an attack on their human rights. The Minister is well respected across this House as a caring and compassionate individual, but I must press him on this. Will he please explain why His Majesty’s Government do not see the Bill as a priority, and as an opportunity to end a most evil practice?

[Lord Markham (Con)]

I thank the noble Lord for his kind words about me; I understand the situation. The Government are committed to implementing those changes and we are looking for opportunities to introduce them. I understand his disappointment that the Bill is not in the current programme of legislation. What I am committed to doing is making sure that as many features as possible from the Bill are implemented through action on the ground; the care and treatment reviews are a vital part of that today. Following the report from the noble Baroness, Lady Hollins, we are also making sure that we have regular CQC reviews over the next few years. We are delivering good action in this space, but I understand his feelings.

Autism: Diagnosis Targets

Debate between Lord Touhig and Lord Markham

Tuesday 16th May 2023 Lords Chamber

[Lord Touhig (Lab)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and I declare my interest as a vice-president of the National Autistic Society.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

We recognise that not all areas are meeting the NICE recommended maximum of 13 weeks between a referral for an autism assessment and a first appointment. In 2022-23, we invested £2.5 million to test and improve autism diagnostic pathways. In 2023-24, there is a £4.2 million grant to improve services for autistic children and young people. In April, NHS England published a national framework and operational guidance to help the NHS and local authorities improve autism assessment services.

[Lord Touhig (Lab)]

My Lords, by next year 190,000 patients are expected to be waiting for an autism diagnosis—it is already 130,000, and 67,000 of them have been waiting for more than a year. Research shows that there is a widening gap between the number of people who need to be seen and the number of staff available. In the last four years, we have managed to recruit just 19% more staff. The letter that the Minister helpfully sent us in April indicates that he is as concerned about this matter as any of us in this House. We appreciate that, but my question is simple: what is being done to recruit more staff?

[Lord Markham (Con)]

I thank the noble Lord, both for his question and for his interest and work in this space. The House will know that this topic is quite close to my heart as well. It is an area of challenge. We have more demand than ever. We are committed to recruiting more staff. We have a recruitment target for next year of 27,000. Very promisingly—I hope I will have time to go into this in more detail later, or I will speak to the noble Lord afterwards—there is a pilot scheme in Bradford looking at children’s early years scoring and how that can be used as a precursor to screening and testing.

Mental Health Act Reform

Debate between Lord Touhig and Lord Markham

Thursday 26th January 2023 Lords Chamber

[Lord Markham (Con)]

First, I thank my noble friend and all noble Lords who took part in the pre-legislative scrutiny committee. I think all noble Lords agree that what we are trying to do with the mental health Bill is a very good thing. We would like to bring it forward as soon as we can. From my side, I know that we are ready to go, but we are working with the parliamentary authorities to make sure that we can get the legislative time. We want to do it as soon as possible.

[Lord Touhig (Lab)]

My Lords, due to the current mental health legislation, autistic people are being detained in hospitals not because they have a separate mental health issue but because they are autistic. Autism is not a mental health condition, but more than 2,000 autistic people are currently locked up. This is a stain on Britain’s reputation for defending human rights and a challenge for us to define the liberty and freedom of some of our most vulnerable citizens. So will the Minister ask his noble friend sitting on the Bench with him, the Government Chief Whip, for a debate in government time on this matter, so that the voices of some of these people, some of whom have been locked up for decades, can at last be heard?

[Lord Markham (Con)]

I have some personal experience in this space, so I understand exactly what the noble Lord is saying. I think we all agree on its importance. We have a commitment to decrease the number of in-patients with learning disabilities and autism by 50%. It is something that every ICB must have a lead on, so that they can really tackle it, and I personally would be happy to meet the people the noble Lord mentioned to understand further.

Social Care: Integrated Care Systems

Debate between Lord Touhig and Lord Markham

Wednesday 11th January 2023 Lords Chamber

[Lord Markham (Con)]

It is, as the noble Lord says, a statutory requirement that the local authorities are represented on the ICBs. In the last few months, I and other Ministers have met and had discussions with all the ICBs. Every ICB is asked to put up a few people. I have had the local authority representative there as one of only three or four people in the meeting—that is key to all of this. They have been critical participants. They are very involved, and it is vital that they remain so.

[Lord Touhig (Lab)]

My Lords, the Government are to be congratulated on amending the Health and Care Act to ensure that responsibility for integrated care systems addresses the needs of children and young people under the age of 25. However, children with special educational needs or disabilities have lifelong problems. How will providers ensure that there will be integrated health and social care for disabled children and their families?

[Lord Markham (Con)]

This is the whole point and the way that we are moving; the real decision-makers running their local areas should be the ICBs. They know their areas and the needs of the people—including people with special needs and learning disabilities—more than anyone. It is absolutely their responsibility to understand the needs in their areas and to ensure that they are provided for under the commissions.