Summer Adjournment

George Mudie Excerpts

Tuesday 22nd July 2014 Commons Chamber

[Mr George Mudie (Leeds East) (Lab)]

The one thing I agree with the last speaker on is that Betty is wonderful. She deserves the congratulations and the compliments.

I want to raise the issue of adults with autism and the possible problems the Care Act 2014 may bring. The Department is consulting on the criteria for support, and there are fears that adults’ eligibility to receive support could be damaged. I do not think that I need to take up the House’s time describing the condition. It is a terrible, life-long condition that damages and constrains a person from childhood to death, with no cure in sight. The fact that support can be withdrawn from adults with autism should concern the House.

It is wrong to think that children with autism are in a better situation than adults with the condition, but they have the support of legislation and they are surrounded by professionals, for example in schools. If those professionals are doing their job, support should be forthcoming. If the local authority is doing its job, it will be encouraging support and paying for it. However, too many adults with autism slip below the radar once they reach the age of 25 and lose what support they had, often with disastrous consequences.

The national criteria propose that the present banding of low, moderate, substantial and crucial be substituted with a sole criterion comparable to the present “substantial” definition. Although that gives some comfort to people across the country that support will not be determined by postcode, there is a worry that those people with needs that could be described as lower than substantial will have their support withdrawn.

That raises the difficulty of withdrawing the existing requirement for local authorities to provide support to individuals at risk of abuse or neglect. Some adults with autism can struggle to understand the intention of others. That can lead to them being taken advantage of and even abused by people they often think are their friends. Low-level support, such as one-to-one counselling sessions on understanding relationships and boundaries, can reduce the risk of a vulnerable person with autism becoming a victim of abuse. However, under the criteria in the regulations, that low-level support could be withdrawn.

Let me give the House some figures. The National Autistic Society has found that

“49% of adults with autism… told us they had been abused by someone they thought of as a friend, 27% have had money or possessions stolen by someone they thought of as a friend, and 37% have been forced or manipulated to doing something they didn’t want to do by someone they thought of as a friend.”

It is therefore very important that the regulations are tweaked to stop that happening.

The regulations propose that the inability to maintain relationships should make a person eligible for assistance, but forming or developing relationships in the first place is something that people with autism often need specific help with. Without that support, they can be particularly vulnerable to social isolation. According to the National Autistic Society,

“65% of adults told us they need prompting to wash, dress or prepare a meal. 86% of adults who need prompting have not washed, 70% have missed meals and 69% have not got dressed because they didn’t get this help.”

It quotes one individual:

“I don’t eat. I don’t change clothes, nothing except maybe get a drink of water and go to the bathroom when I can’t hold it anymore. Don’t take my meds either. I can lose entire days and nights that way.”

That is what is at stake. In the regulations, the definition used for determining whether an adult with autism gets support is “to be unable”. Those familiar with autism consider that that should be extended to include guidance and prompting. Someone with autism might be physically capable of carrying out a basic act of personal care, but often they need to be prompted, reminded or guided to do it. Prompting, in that case, means reminding, encouraging and explaining, by another person verbally or through the use of visual aids.

My last point is that adults with autism should receive community care assessments from people with specific expertise in autism, because someone who is not aware of the varied and hidden aspects of autistic behaviour could fail to understand that adult or could make the wrong decision as a result of being primarily influenced by the physical appearance of the individual. That has happened, and is happening, with disability examinations when mental health problems and their debilitating effects are not given due and vital attention by medical examiners who lack detailed mental health knowledge and tend to concentrate on the claimant’s physical aspects.

It is very important that I raise this issue in the debate, because the regulations are being formed now and will probably come to the House immediately after the recess. If that is the case, they will be secondary legislation, which is not amendable, so the current consultations and discussions with bodies such as the National Autistic Society have to be sympathetic and take on board those points. Otherwise, people who are already damaged will be damaged further, because we will not be able to change the regulations.

I will end on that note and wish you, Mr Deputy Speaker, the staff—particularly Betty, and Noeleen, Mary and Margaret in the Tea Room—and other Members a short but happy recess.