Autism Diagnosis Waiting Times

Debate between Jim Shannon and Jo Cox

Tuesday 8th March 2016 Westminster Hall

[Jo Cox]

I agree entirely, and one of the worrying things that became apparent to me in my research for this speech is the growing regional disparity in autism diagnosis waiting times, as well as in the service someone gets once they have a diagnosis. Let us hope that the Minister addresses that point.

My constituent from Batley has given up his job so that his son can attend school every day. As I have said, the problem exists not just in my constituency, but up and down the country, and stories from the NAS highlight that. There is Mel from Watford, whose son waited nine years. Noah, who is four, waited two years for his diagnosis—that is half his life. Meanwhile, data from Public Health England from the latest adult autism strategy show huge regional variation in adult services, with waiting times between referral and first appointment —not even the whole diagnosis journey—in the south-west reaching 95 weeks. In my region of Yorkshire and the Humber, it is 84 weeks. The NICE quality standard on autism is clear: once referred, people should wait no longer than three months before having their first diagnostic appointment. For this to happen, the Government, local authorities and NHS England need to act.

In my own local authority, Kirklees, despite strong leadership and a clear commitment to protect and safeguard vulnerable children and adults, there is an acknowledged crisis in children’s mental health and autism services. Some families have been waiting more than two years for a diagnosis, often longer. I have been encouraging Kirklees and its clinical commissioning groups to clear the backlog and redesign their services, and I am pleased to announce that, starting last Friday, a plan to clear the backlog within 12 months is now being rolled out regionally. This will quadruple the number of diagnoses that can take place in my constituency.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate. Autism diagnosis across the whole of the United Kingdom of Great Britain and Northern Ireland is a big issue. In Northern Ireland, some 2,000 young people are waiting for a diagnosis, although the Minister has set some money aside. There is a need not only for early diagnosis, but for further stages of the education programme as well. Does the hon. Lady agree that the Minister should consider what has been done regionally—in Northern Ireland, Scotland and Wales—because there are lessons to be learnt that would benefit all of us?

[Jo Cox]

I agree entirely. It is time for the Government to bring a wider discussion about autism services to the Floor of the House.

My local authority’s announcement last Friday now means that we will quadruple the number of diagnoses that can take place in my constituency. It still needs to redesign the service in a way that prevents future backlogs, but this is good news for Batley and Spen and for people across Kirklees. However, it should not go unacknowledged that local authorities such as mine are working hard to reform services in an environment of severe and disproportionate budget constraint, imposed on them by Government. Of course, this is just one local authority; what about the hundreds of others and the desperate families in their care?

We also now have to accept that this failure to diagnose autism early ends up costing taxpayers much more. When developing its guidance for health services, NICE stated:

“Investment in local autism services also contributes to: a reduction in GP appointments, fewer emergency admissions and less use of mental health services in times of crisis, including the use of inpatient psychiatric services.”

Civilians in Syria

Debate between Jim Shannon and Jo Cox

Monday 12th October 2015 Commons Chamber

[Jo Cox (Batley and Spen) (Lab)]

Every decade or so, the world is tested by a crisis so grave that it breaks the mould: one so horrific and inhumane that the response of politicians to it becomes emblematic of their generation —their moral leadership or cowardice, their resolution or incompetence. It is how history judges us. We have been tested by the second world war, the genocide in Rwanda and the slaughter in Bosnia, and I believe that Syria is our generation’s test. Will we step up to play our part in stopping the abject horror of the Syrian civil war and the spread of the modern-day fascism of ISIS, or will we step to one side, say that it is too complicated, and leave Iran, Russia, Assad and ISIS to turn the country into a graveyard? Whatever we decide will stay with us for ever, and I ask that each of us take that responsibility personally.

To date, neither side of the House has a record to be proud of. Let me start with my party. One of the reasons it is such an honour to be standing on this side of the House is the deep, deep pride that I have in Labour’s internationalist past. It is pride in the thousands of people from our movement who volunteered to fight tyranny alongside their fellow socialists and trade unionists in the Spanish civil war; pride in the leaders of our party—and Robin Cook in particular—who demanded action to stop the slaughter of Bosnian Muslims in Srebrenica and elsewhere, in the face of outrageous intransigence from the then Conservative Government; and pride in the action we led in government to save countless lives in Kosovo and Sierra Leone. In recent years, however, that internationalism has first been distorted, and now risks being jettisoned altogether.

My heart sank as I watched in 2013 when, following President Assad’s use of chemical weapons against civilians, we first voted against a military response and then supported taking military options off the table. Responsibility for the mishandling of that critical vote, which had such far-reaching international implications, falls principally on the Government, but we on these Benches carry some culpability for letting Assad ride roughshod and unchallenged across what should have been a sacrosanct red line. As a result, the international community lost all credibility in our subsequent efforts to stem the spread of, and the suffering in, this horrific civil war. Indeed, our failure to intervene to protect civilians left Assad at liberty to escalate both the scale and the ferocity of his attacks on innocent Syrians in a desperate attempt to cling to power.

I understand, of course, where our reticence comes from. It comes from perhaps the darkest chapter in Labour’s history, when we led this country to war in Iraq. Many Members in all parts of the House have been scarred by that experience, and understandably so; but let us all be clear about the fact that Syria is not Iraq. I opposed the war in Iraq from the beginning because I believed that the risk to civilian lives was too high, and their protection was never the central objective. I knew, as we all knew, that President George Bush was motivated not by the need to protect civilians, but by supposed weapons of mass destruction and a misguided view of the United States’ strategic interest.

I marched against that war, and have marched against many others in my time. Indeed, before I joined the House I was an aid worker for a decade with Oxfam. I have seen at first hand the horror of war and its brutal impact on civilian populations. I have met 10-year-old former child soldiers with memories that no child should have to live with. I have sat down with Afghan elders with battle-weary eyes. I have held the hands of Darfuri women, gang-raped because no one was there to protect them. From that experience, alongside a horror of conflict, I have the knowledge that there are times when the only way to protect civilians requires military force. I might wish that it were not so, but it is. That is why I firmly believe that the Labour Government were right to champion the adoption, in 2005, of a landmark global commitment to the best and most fundamental of our human ideals: the responsibility to protect civilians. I still firmly believe that a legitimate case can be made for intervention on humanitarian grounds when a Government are manifestly unwilling or unable to protect their own civilians. Sovereignty must not constitute a licence to kill with impunity.

The history of Iraq hangs over us all, and it should, but its legacy is awful enough without supplementing it with a new one of ignoring the slaughter in Syria. We must not let it cloud our judgment or allow us to lose sight of our moral compass.

The war in Iraq led to the deaths of thousands upon thousands of civilians. Its legacy must be to make us all put the protection of civilians at the centre of our foreign policy, not to make us sit on the sidelines while hundreds of thousands more are killed and millions flee for their lives.

[Jim Shannon (Strangford) (DUP)]

I am greatly concerned about the persecution of Christians in Syria. Some 600,000 Christians have been displaced from Syria. They have been given the ultimatum of “convert or die”. Does the hon. Lady feel our Government could do more to put pressure on Assad and parts of ISIS to make sure the persecution of Christians stops?

[Jo Cox]

I thank the hon. Gentleman for his intervention and I will come on to that subject later in the speech.

I shall now turn to the Conservative party’s record. For four years the Government have categorically failed on Syria, and it is not just the UK that should be judged so harshly. The failure to develop and then implement an effective strategy on Syria left this conflict free to create a horrendous European refugee crisis and provide a haven for the barbarism of ISIS to take root, allowed chemical weapons to be used unchallenged and even emboldened Russia. In particular, since the Prime Minister’s mishandling of the 2013 Syria vote, the Government have let this crisis fester on the “too difficult to deal with” pile. There has been no credible strategy, nor courage, nor leadership; instead we have had chaos and incoherence interspersed with the occasional gesture. Indeed, it has been a masterclass in how not to do foreign policy and a stark lesson on what happens when we ignore a crisis of this magnitude. Britain—with our proud tradition in international affairs, our seat on the UN Security Council and one of the best diplomatic, humanitarian and military services in the world—has been a political pygmy in this crisis.

None of us has a proud history in this affair. If we are to put this right, we must put that behind us; we must put party politics to one side and focus on what really matters—the protection of Syrian civilians.

Let me first turn to two of the arguments that do most disservice to a serious discussion of this crisis. First, please let us stop casting the humanitarian, diplomatic and military responses as mutually exclusive alternatives. They are not. If we are serious about addressing this crisis, we need to stop pretending that any one of them offers a panacea and instead weave these strands into a coherent strategy. Secondly, let us not be duped into believing that we need to make a choice between dealing with either Assad or ISIS. On the surface, this may seem appealing, but it is not an option. There is no choice.

We can, and must, address both Assad and ISIS for two principal reasons. First, a sole focus on ISIS will not end the conflict and the threats to our interests. The Assad regime ignited, and continues to drive, the violence in Syria. This year alone, it has killed seven times more civilians than ISIS, so a strategy that only focuses on ISIS will not end the fighting or the threat to regional stability. It will not stem the tide of desperate refugees pouring into Lebanon, Turkey and Jordan, or trying to get into Europe.

Secondly, and crucially, a myopic focus on ISIS will not lead to its defeat. It will not work. Assad is ISIS’s biggest recruiting sergeant, and as long as his tyranny continues, so too will ISIS’s terror. Indeed, a sole focus on ISIS while ignoring the regime’s ongoing bombardment of civilians risks inadvertently strengthening the jihadis’ narrative, which is fuelled by the idea that the west is colluding with Shi’a forces in Tehran and Damascus in a crusade to subjugate Sunni Arabs. That is why, to make good on our past failures, to protect our interests and to live up to our proudest traditions, we need urgently to develop a comprehensive and coherent strategy.

I believe that there are three core elements to such a strategy, none of which is easy and all of which are critical. First, I shall talk about the humanitarian aspect. Four years on from the start of the conflict, there are now 240,000 dead—some credible estimates put the figure at over 330,000—and more than 12 million people are in need of humanitarian assistance. The scale of the human disaster is breathtaking. One area in which the UK Government have shown considerable and commendable leadership is in the regional humanitarian response to the refugee crisis, where we have led the way with the US and our European partners. I now urge the Government to go further.

As the Minister will be aware, the vast majority of Syrian refugees are in the region and those countries are buckling under the strain. The G20 summit in Turkey in November should be marked by the launch of an ambitious plan to meet refugees’ urgent needs, to invest in their education and livelihoods and to support Syria’s neighbours in reconstruction and development. Equally important is the UK’s response to the refugee crisis, which has, to date, been woefully inadequate. Taking 20,000 refugees over five years is simply not good enough; it sends an awful message about how seriously we take civilian protection. Whether it is the response to the drownings in the Mediterranean or our offer to take Syrian refugees, the Prime Minister has been pushed into climbdown after climbdown, embarrassed into action by the humanity of the British public. It is time for him to lead, not follow.

But let us be clear that, no matter what our humanitarian response is to this crisis, it will never be enough. It cannot end the conflict. That is why we also need to invest far more in diplomatic efforts to find a political solution. There are clearly no easy answers, but we can at least be clear on the principles. First, this needs to be a much higher-level conversation. We saw some improvement in that respect at the UN General Assembly last month and in the reopening of the UK’s embassy in Tehran. However, the Foreign Secretary and Prime Minister need to make it clear that ending the conflict in Syria is their No.1 international priority, and to challenge other world leaders to match their commitment.

Secondly, we must not let the urgent need to find a political solution cloud our judgment about what a credible one looks like. If four years of continuous vicious conflict have taught us anything, it is that the current regime is no longer capable of bringing peace and stability to Syria. Whatever its exact complexion and character, and whatever the complex negotiations and compromises needed to get there, a credible political solution has to involve a transition to a new Government that represent all Syrians and that enjoy sufficient trust and legitimacy that all but the delusional fanatics of ISIS will be willing to lower their guns and work together to rebuild their country. Russia’s recent intervention makes the route to a political settlement more complicated but it does not change the necessity for one. A political solution is the only way to end the conflict between the regime and the opposition in Syria. Only when that conflict has ended can ISIS and the handful of other extremists allied to al-Qaeda be defeated.

The third element of the strategy has to be military. While I do not believe that there is a purely military solution to this conflict, I do believe that there will be a military component to any viable solution.

The threat from ISIS—to the region, to the west and to Syrian and Iraqi civilians—is real and growing. I do not believe it to be ethical to watch from the sidelines as Syrian villages are overrun by ISIS fighters who make sex slaves of children, terrorise minority groups and slaughter fellow Muslims. In addition, their call for individual sympathisers to attack westerners anywhere and anytime requires a robust response.

The estimated 20,000 foreign fighters in Syria and Iraq, many of whom hold western passports and can therefore travel freely in Europe, present a real and serious threat to us here in the UK. In addition, ISIS’s spread to new havens in Libya, the Sinai peninsula, Afghanistan, Yemen, Nigeria and elsewhere convinces me of the need for active UK involvement—but only if that is part of a comprehensive strategy to protect civilians and end the conflict.