Autism and ADHD Assessments

Justin Madders Excerpts

Monday 6th February 2023 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair this afternoon, Ms Fovargue. I congratulate the hon. Member for Carshalton and Wallington (Elliot Colburn) on introducing this debate and on the many important points he made. I will certainly not repeat all the statistics that have been stated, as it is clear from what Members have said that there is a very serious issue here.

Instead, I want to focus on one particular statistic, quoted by the chief executive of the ADHD Foundation, which suggests that there has been a 400% increase in the number of adults seeking a diagnosis nationally. Between July and September alone, an estimated 170,000 people were prescribed at least one drug for ADHD, a 20% increase on the figure for the previous year. That is a huge increase in one year, and services have clearly been unable to cope with that increase. We have heard of some horrendous waiting times—I know that a recent FOI request by The Guardian showed that some people were waiting up to three years for an ADHD diagnosis.

However, I am afraid that in my part of the world it is even worse than that. My local adult ADHD service, provided by the Cheshire and Wirral Partnership NHS Foundation Trust, has been closed to new referrals since April 2019. Despite the trust saying that it would be taking new referrals from last year, we are yet to see any notification of that happening. It is really letting down people who need help. I have been informed that part of the reason why the trust closed its doors to new referrals was that the funding it was allocated between April 2018 and March 2019 was enough to provide capacity for 79 assessments, so when it received 362 referrals in that period it was clear that it would not be able to manage. However, to close altogether to new referrals is completely unacceptable.

The fact that the trust was telling people that they might wait up to five years for an assessment is also completely unacceptable. We would not accept a five-year wait for a physical condition, so we should not accept it for ADHD. We certainly would not close our doors altogether to new referrals in that case. Could the Minister indicate whether action will be taken to ensure that my constituents can be seen in a timely manner, and actually seen at all, when GPs are referring them for an assessment? Surely refusing to see patients or assess them for specific conditions is discrimination. It is certainly against the founding principles of the NHS.

Once we realised that that was a problem, we noticed that it was not only a problem with adults. As we have heard, there is a huge issue in education. The fact that more adults are now seeking diagnosis points to past failings in the education system. There is certainly increased awareness in our school system now, but that begs the question of what opportunities have been lost because people were not diagnosed or identified as needing assistance at an earlier stage.

However, as hon. Members have said, not everything is rosy in the education system now. Every Member of Parliament will be able to tell us about how parents feel they have to fight every step of the way just to get a referral. Then they have to fight to get adjustments in the school and seem to have a constant battle to ensure those provisions are maintained.

When the umpteenth constituent came to see me this year about delays in receiving an EHCP, I looked into why that was the case and found there is a huge shortage of educational psychologists. When one constituent was recently informed that their child could not have the assessment within the legal timeframe required because there were no educational psychologists available, I decided to look into the numbers. I discovered that the ratio of educational psychologists covering the Cheshire West and Chester area was one for every 5,822 children and young people.

That is a stark comparison to figures from 2017 to 2019, when a report from the Department for Education found that the average number for the whole country was one for every 3,500 young people, and in the north-west it was one for every 3,900. I would be interested to see whether those national and regional figures have changed in the last two or three years; I suspect they have gone in the wrong direction. I know the Government have spent around £32 million on more support and on training for educational psychologists, but if we do not have the people able to undertake the assessments, we will never get the backlog sorted.

I want to say a little about some of the impacts that is having on constituents. An individual who has a child with ADHD came to see me. They have just begun the EHCP process, which they understand will take a number of months, but in the meantime they are struggling to find a school that will take their child. The child has already been removed from one school because of challenging behaviour, and now they are being kept off school for their own and other children’s safety. My constituent has had to give up work, meaning both she and her child are losing out. From talking to parents, it seems that more and more children are dropping out of the school system altogether for a whole range of mental health issues. The number of pupils who are no longer on any school roll is a national scandal on which we need far more concerted action.

To end on a more positive note, I have heard from people with ADHD how transformative a diagnosis can be—the difference it can make to their lives and the sense it brings to some of the issues they have been struggling with, possibly for many years. That shows the importance of putting investment into diagnosis, to ensure that everyone gets opportunities to fulfil their potential. The waiting times we are talking about—five years, in some cases—are cruel and inhumane.