Autism and ADHD Assessments

Laura Farris Excerpts

Monday 6th February 2023 Westminster Hall

[Laura Farris (Newbury) (Con)]

I thank the Petitions Committee for agreeing to the debate. This is a bittersweet moment for me: I brought a debate on this issue to this Chamber exactly one year ago. You were in the Chair, Ms Fovargue, and the same Minister was in her place. The kernel of my argument was that children in West Berkshire were waiting far too long for diagnoses of autism and ADHD, with sometimes devastating implications for their educational and social development.

I have been campaigning since then for no child ever to have wait more than one year for an initial diagnosis. That may sound as if it lacks ambition, but the reality for many children in West Berkshire is that the wait is more like three years. I would like to be able to say that there has been some progress. I had West Berkshire CAMHS in the dock last year, but I pay tribute to the service. I have spoken to the service a number of times this year and have relayed the impact of waiting times. The service has assured me that by March 2023, which is next month, it will have capped waiting times at two years, and by March 2024—in 13 months—it will have capped waiting times at 12 months, so my campaign will have eventually got there. But I regret to say that, of the many parents who wrote to me in advance of the debate, far too many still say that they have been waiting for much longer than that.

I will give a couple of examples; I could not possibly fit everybody in, which says something in itself. One lady, Kathleen, who looks after her two grandsons, told me about the 12-year-old boy, who is now approaching three years on the CAMHS waiting list:

“He is no longer in education. If I don’t get help soon I feel he is in danger of being criminalised due to his anger and behaviour being out of control”.

Another lady, Vanessa, told me about her eight-year-old son. She was initially told to expect a three-year wait, but says her GP pushed to get that reduced. She described filling in endless forms, and ended by saying:

“We are crying out for help he is 8 years old and seeing him so angry, upset and hating life is breaking our hearts.”

I know that the Government understand the impact of this issue, because they wrote about it, sensitively and with real understanding, in their SEND review, which was published last year. I look forward to hearing what they have to say about that, because I know there is more coming soon.

One of the petitions calls for an emergency fund. I can talk only about my local service. West Berkshire CAMHS received an extra £1.6 million in April 2021 to reduce waiting times. At the time, the service told me that it hoped that that would enable the recruitment of an extra 27 members of staff to help with diagnoses, and it has now recruited those people. None the less, it does not disagree that families continue to face long waits. The service has had an awful lot of extra money. I wonder whether there are other issues; I will touch on them today and invite the Minister to respond.

First, I wonder whether the system for diagnosis is too complicated. I know that the system falls between the Department of Health and Social Care and the Department for Education, and that there has been a surge in demand for diagnostic services of this kind. However, I find it surprising that the experience of every single parent seems to be the same, irrespective of whether the child is still in mainstream school. I would be grateful if the Minister could confirm whether there could be a flagging system at the initial point of triage, so that a child who is failing to access the curriculum or at risk of exclusion could be prioritised for diagnosis.

Another route I wanted to ask about stems from something that West Berkshire CAMHS said to me. I do not know whether this is true, but I will repeat what the service told me verbatim, which is that schools erroneously say that they cannot help until there is a diagnosis, although in fact they can on the presentation of need. If a school is confronted with a child who is presenting with typical ADHD-type symptoms, could there be an online tool, perhaps run by CAMHS, that would allow for a preliminary “We think it’s ADHD”? The child could then progress down that pathway while they wait. I do not know whether that is possible.

I also invite the Minister to comment on whether there could be better joined-up work between health and education services. In preparing for this debate, I refreshed my memory as to what she said when she responded to my debate last year. In that debate, the Minister talked about a £600,000 autism early diagnosis pilot taking place in Bradford that was creating testing facilities in

“at least 100 schools over the next three years to assess whether new approaches to…faster diagnosis can be rolled out across the country.”—[Official Report, 9 February 2022; Vol. 708, c. 382WH.]

That is a commendable pilot. By now, it must be at least a year in. After the debate, I went to see Ministers at the Departments of Health and for Education to see whether West Berkshire schools could join the pilot. Unfortunately, I did not get anywhere with that, and I have not had much of an update on the pilot either. I would be interested to know whether on-site testing in schools is now ready for roll-out, or at least how the pilot is going.

My final point about CAMHS is something that other Members have touched on. When I visited the Downs School—a secondary school in Compton—last Friday, a pupil told me that one of the limitations of CAMHS is that mental health issues such as anxiety and depression are bundled together with neurodiversity diagnoses. While there is sometimes an overlap between the two, they are, in fact, distinct areas. Could the Minister comment on whether she thinks the neurodiversity aspect of CAMHS would work better if it was completely separated from the mental health element?

I know there is no magic bullet for any of these issues, but the solutions and ideas I have presented, some of which come from CAMHS professionals and teachers, suggest a simplified, more streamlined and accountable approach to ADHD and autism diagnoses. I would like to hope that this time next year, we will not need to have this debate again.