Autism

Paula Sherriff Excerpts

Thursday 29th March 2018 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

I congratulate the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) on securing this debate and thank the Backbench Business Committee for providing the time for it. It is an important debate because, as we have heard, there are several hundred thousand people with autism, and of course millions of people will be in a family with one of those autistic people. It is important to thank Autistica, the National Autistic Society, Ambitious about Autism and all the other charities and organisations in the sector for the work that they do and the support that they give to those with autism. I also wish to recognise the Whole Autism Family in my constituency, which is run by Anne-Marie and Martin Kilgallon. They have two sons with autism and provide amazing support to other families in the area.

It is important to say that, although I am the shadow Mental Health Minister, as we have heard this afternoon autism is not a mental health condition. It is entirely possible for people with autism to have good mental health, but, sadly, for too many that is not always the case. As we heard from the hon. Member for North Ayrshire and Arran (Patricia Gibson), it is estimated that between 70% and 80% of autistic people develop mental health problems such as anxiety and depression, and four out of 10 children with autism have at least two mental health challenges. Indeed, Autistica highlighted mental health as the top concern facing people with autism and their families.

It is clear that more needs to be done to support the mental health needs of people living with autism. The reduction of the health inequalities experienced by people living with autism is a priority for the NHS mandate for 2017-18. That is of course welcome, but to tackle the disparities it is necessary to ensure access to appropriate mental health care.

The motion rightly highlights diagnosis—the vital first step towards getting support for people with autism. As we heard in the excellent contributions from the right hon. Member for Harlow (Robert Halfon) and my hon. Friend the Member for Alyn and Deeside (Mark Tami), getting a diagnosis is the first hurdle that children with autism and their parents need to get over to secure the support and education to which they are entitled. The NICE quality standard on autism recommends a maximum wait of three months from referral to first diagnostic appointment. It is clear that currently that standard is too often breached, and that the waiting time can be gamed by delaying later appointments. Some children have quite literally been left waiting to wait.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

My constituent Patrick Samuel had to wait nine years before he was diagnosed with autism. It was only when he was diagnosed that he got the drugs and support that he needed. He is now a flourishing, successful artist. Does my hon. Friend agree that it is totally unacceptable for someone to have to wait for nine years?

[Paula Sherriff]

I think all Members would concur that waiting nine years is absolutely unacceptable. To be fair, that is at one end of the waiting-time limit, but it is clear that there are many delays in many areas, often running to years. One local authority has recently admitted that it has delays of 125 weeks. Collectively, Members from all parties need to work together to try to bring down delays of that length, because they mean that support and intervention may be less effective when it arrives, and lead to parents losing confidence in the system. As with many other conditions, illnesses or whatever we call them—it is difficult to find a suitable noun that actually describes autism—early intervention is absolutely the key.

There is clear evidence that a positive experience in the diagnostic process is associated with lower levels of stress and more effective coping strategies for families. We have heard in previous debates about the lack of data on waiting times. This April is meant to see the start of new standards on the collation and publication of such data. I hope the Minister will update the House on where we are with that. There is a need for better data on the number of diagnoses and who is being diagnosed with autism, so that we can identify where there are gaps. The National Autistic Society has reported that more than three quarters of people who use its adult services are male, but there is a concern that that may be related to a lack of recognition for women and girls with autism. Similarly, there is a generation of people for whom autism was not a recognised condition when they were younger.

[Bob Stewart]

I rise in support of the hon. Lady’s point. I bet there are a heck of a lot of people who have autism, and no one can really understand that they have it—they probably do not understand it—but a lot of people are like that and they are adults.

[Paula Sherriff]

I thank the hon. Gentleman for his intervention.

NICE recently recommended the creation of an autism register so that areas where autism may be under-diagnosed can be identified. Following that, the Government committed to including autism in the primary care register. Will the Minister update the House on the implementation plans for this scheme?

We must also ensure that post-diagnosis support is in place. We know that parents have raised concerns about being left with no support during and after the diagnostic process, not being signposted to other advice and help, and not even getting a written report of the diagnosis. Too often, there are significant barriers to accessing the right treatment. In a previous debate, we heard the shocking case of a young boy who was having suicidal thoughts, but was rejected four times for treatment because he had not yet made an attempt to take his own life. The Children’s Commissioner for England confirmed concerns about that issue when she stated to the Health Committee that this type of situation was now “the norm” within children’s mental health services. That is worrying for children’s wellbeing generally, but particularly so for those living with autism.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Does my hon. Friend agree that we need increased support in schools? Nearly 77% of parents say that their child has to wait more than six months for support at school. It is just as important that a child gets support at school as in the health system.

[Paula Sherriff]

Once again, I absolutely agree with my hon. Friend. I will go on to talk about that matter in a moment.

GPs may also need to tailor the way in which they communicate with patients. For instance, they may need to use clear language, or to find ways to communicate with somebody who does not speak. To do that, GPs must be able to access detailed and accurate records about their patients’ needs. Currently, GPs often do not record much information about their autistic patients, and may not even record at all that a patient is autistic. The five year forward view for mental health recommended that NHS England should develop autism-specific mental health care pathways. If the Minister could give us any more information on that I would be very grateful indeed.

As I alluded to earlier, early intervention is key for communication and language skills, which are closely linked to life chances for people with autism. Perhaps the Minister could address the new communication therapies that are being trialled, such as pre-school autism communication therapy, and the pilot studies in Plymouth and Bangor to test new post-diagnosis support programmes. If these programmes are successful, what steps will the Government take to ensure that they are rolled out?

In education, children with autism and other special needs are all too often paying the price for cuts. The first real-terms cuts in school budgets for a generation have put enormous pressure on schools. The vast majority of school budgets are spent on staff costs, and that makes it hard for schools to keep their current staff and maintain the necessary level of pastoral provision. As a constituency MP, I know how the cuts have hit my own borough of Kirklees. The Government’s new funding formula leaves councils needing to take money for central high-needs funding from the amount allocated to schools. That means that schools may now face a cut of up to 1.5% in per-pupil funding.

More than 4,000 children in England with approved education, health and care plans still receive no provision. There was an increase from 1,710 in 2016 to 4,050 in 2017, which was five times the number in 2010. The impact on children with autism was laid bare by the recent inquiry by the all-party group. More than four in 10 families have been turned away when asking for the extra help that their child needs, and 70% of parents said that their child waited more than six months for support at school, with 50% waiting more than a year. I could go on with yet more shocking statistics, but I think the reality is evident. Does the Minister have any response to the all-party group’s recommendations?

If we let down children with autism in education, the impact is felt when they become adults seeking employment, as we have heard from a number of Members this afternoon. In 2015, the Government pledged to halve the disability employment gap, but they watered that down in their 2017 manifesto. Analysis from the TUC found that the Government were years behind schedule on their 2015 manifesto commitment to halve the disability employment gap, and at current rates of progress that would take until 2030 to achieve.

There is an urgent need for improved in-work support for people with disabilities. The Government must act to strengthen and enforce workplace rights, and to improve support for employers to help their employees to stay in work. That would be good for everyone, because a 10% rise in the rate of disability employment would represent a £12 billion gain to the Exchequer.

The autism employment gap is even wider than the disability employment gap. Over the past 10 years, there has been no real change in the numbers of autistic people in full-time work, with the percentage rising from 15% to just 16%. The National Autistic Society found that less than a third of autistic adults were in some kind of paid work, even though more than three quarters wanted to work. There are concerns that this is not even monitored, so perhaps the Minister will address that point. The NAS has also called for an autism employment pathway, an awareness programme for employers and targets for getting people with autism into work. I hope that the Minister can tell us how the Government intend to respond.

Finally, there is the simple question of awareness, which we have touched on a number of times this afternoon, with contributions from my hon. Friends the Members for Bristol West (Thangam Debbonaire), for Cardiff West (Kevin Brennan) and for Coventry South (Mr Cunningham), my right hon. Friend the Member for Knowsley (Mr Howarth), the hon. Members for Luton North (Kelvin Hopkins), for Berwick-upon-Tweed (Mrs Trevelyan) and for Cleethorpes (Martin Vickers), and my hon. Friend and neighbour the Member for Huddersfield (Mr Sheerman). The research shows that only a small minority of people with autism feel that the condition is widely understood. The work of the charities and other organisations in this area is commendable, and hon. Members who have spoken today have done their bit to raise awareness. Will the Minister tell us how the Government will do the same?

The testimonies that we have heard from Members this afternoon starkly show just how crucial it is that more is done on the issue. The power to make meaningful change is in the Government’s hands. I hope that they have listened and will act accordingly.