Autism

Lord Hunt of Kings Heath Excerpts

Tuesday 22nd March 2016 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, it is a great pleasure to comment for the Opposition in this very important debate, on which I congratulate the noble Baroness, Lady Browning. She made a very persuasive case for the early diagnosis of autism. She made the point that currently, although we have seen an improvement, there is a huge variation in practice in many parts of the country. I come back to my noble friend Lord Wigley’s comment that it is good to have a strategy but you need to have an implementation programme to ensure that there is consistency across the country. The debate has shown that at the moment there is a postcode lottery and widespread inconsistency in the availability of diagnosis and access to treatment. The principal question for the Minister is what action she can take to ensure that clinical commissioning groups are kept up to the mark and monitored over the issue of diagnosis. The issue of transparency, and the availability of comparative information so that individual CCGs can be monitored and held to account, is crucial in this area.

My noble friend Lord Touhig suggested that a difficulty in getting diagnosis may in essence be a rationing tool, in that if you do not get a diagnosis you do not get access to treatment. If that is the case, that is entirely unacceptable. The same issue applies to access to treatment. If we are to understand the challenges that we face, we have to have local and comparative information about the difficulties of access. I hope that at the very least the Minister will take this away and consider with her colleagues how that might be brought about.

The noble Baroness, Lady Browning, said that we ought to have one single national clinical director to focus solely on autism. I very much agree with that. However, the current set-up of national clinical directors is wholly unsatisfactory. They are given very little time and virtually no support, and it is not fair to ask them to do what they have been asked to. The noble Baroness, Lady Hollins, mentioned her membership of expert groups. She may well know that NHS England has a consultation, which I think has now finished, on the membership of clinical reference groups, which are crucial groups that advise NHS England on policy development. My understanding is that the proposals that were sent out on 9 February proposed reducing the numbers of those CRGs and their clinical members. That is a matter of great regret and I hope the Minister will be able to comment on it.

Resources have been mentioned. The noble Lord, Lord Prior, said recently in response to an Oral Question about the excellent Mental Health Task Force report that £1 billion per annum will be spent by 2020. The problem is that that is not ring-fenced; it is part of the overall allocation to the NHS. As we know, the NHS is facing very severe financial pressures, and I know no one who believes there is any chance whatever that that £1 billion will actually be spent on mental health services.

I end by referring to the excellent Autistica report that came out last week. It shows that people with autism are more likely to die at a younger age compared with the general population. It makes a strong argument that we need to build the research and knowledge base; that the learning disability mortality review should include a new national autism mortality review; that standardised mortality data about all autistic people should be collected nationally and locally; and that the Department of Health should include preventing premature mortality of autistic people as a key outcome in the 2017-18 deliverables. Will the Minister’s department take very careful note of the Autistica report and perhaps in due course let noble Lords who have taken part in this debate know what the outcome of those considerations might be?