Autism Bill

I thank the hon. Member for Guildford (Anne Milton) for her warm words and encouragement and hope that, through my speech, I can address all her points. I am so pleased and indeed proud to speak to this Bill. I sincerely apologise on behalf of the Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope), the care services Minister, who has played such a key role in its progress. He is very disappointed and sorry that other business prevents him from being here today, but I shall be sure to pass on to him the very kind remarks about his commitment that were made in all parts of the House and, in particular, by the hon. Member for Chesham and Amersham (Mrs. Gillan). I pay tribute to the hon. Lady. She should be proud of her achievement in introducing the Bill. Her determination to drive it forward, while recognising the need for a realistic and collaborative approach in Committee in order to obtain the ends that she seeks, greatly impressed my hon. Friend the care services Minister. In addition, I recognise the efforts of the hon. Member for Tiverton and Honiton (Angela Browning) in her tireless work to promote the needs of people with autism before the Bill was introduced and since, including her active participation in Committee. I have the highest regard for the hon. Member for Tiverton and Honiton, because prior to entering Parliament we both had a health background, and we both know how we have struggled to bring our knowledge to the forefront in this place when it has not always wanted to listen. I suppose that we now have to put Devon county council on warning, as this debate has managed to do; the way in which the hon. Lady managed to put across the reality of the misdiagnosis of mental health problems will never leave my mind. I hope that that goes not only for people in the House today but for health professionals outside. She gave an example in which she asked, "If this were a cardiac condition, how would it be managed if it were misdiagnosed?" That was absolutely accurate and to the point. I know that many Members from all parts of the House have the highest respect for her, and after the debate I look forward to perhaps chatting to her about how we can continue to work together. The Government, like the hon. Members for Chesham and Amersham and for Tiverton and Honiton, are committed to taking action to improve services for people with autism. We are determined to see true, transformational change and a real improvement in their quality of life. Our means for achieving that is the development and publication of an adult autism strategy. The full publication of a consultation on the content of that strategy began in April, and that in itself indicates our commitment. As Members present know well, my hon. Friend the care services Minister made it clear on Second Reading that, although we shared the principles set out in the Bill, we could not support it in the form it took at that time. That is why in Committee, my hon. Friend tabled the amendments that have made the Bill what it is today. The hon. Member for Chesham and Amersham has eloquently made the case for this Bill, and the figures that she quoted are a powerful testament for the need for action in this area. I have no ministerial responsibility for this area of care, but since knowing that I would be present today and having been privileged to be a part of taking the Bill forward, I have learned a great deal. Even though I am a former health professional with more than 28 years' experience, I know that we can still learn a great deal and it has been a pleasure and privilege to learn more on this subject. The National Audit Office's recent report on services for people with autism provides further evidence of the needs of people with high-functioning autism and Asperger's syndrome, and of the types of service and good practice that already occur in some areas. Senior officials from the Department of Health, the Department for Work and Pensions and the Department for Children, Schools and Families appeared before the Public Accounts Committee earlier this week, as has been mentioned, to give evidence on the NAO's findings. The hon. Member for Tiverton and Honiton took that opportunity to press for continued action to improve services, especially on the diagnosis, assessment and understanding of autistic spectrum conditions, and I trust that she and other members of that Committee were reassured that we take the issue seriously not just in the Department of Health, but throughout the Government. My hon. Friend the Member for Erewash (Liz Blackman), who spoke with her usual honesty and passionate feelings on the subject, raised the issue of how important local leadership will be to the implementation of services, and I am pleased to say that there will be representatives of the Association of Directors of Adult Social Services on the external strategy reference group. Clause 1 places a duty on the Secretary of State to prepare and publish by April 2010 a document setting out a strategy for meeting the needs of adults in England with autistic spectrum conditions. By improving the provision of relevant services by local authorities and the NHS, the Secretary of State will be required to keep the autism strategy under review and will be able to revise it. He will have a duty to consult and seek the participation of such persons as he considers appropriate in preparing and revising the autism strategy. That consultation process has already begun, so clause 1 also contains provisions to ensure that the consultation will fulfil the Secretary of State's duty, even though it will have not only begun but ended by the time the Bill comes into effect. Similarly, my hon. Friend the care services Minister has made it clear that our intention is to publish the autism strategy by the end of this year. Therefore, the clause also contains provisions to ensure that doing so fulfils the Secretary of State's duty to publish a strategy even if the Bill has not come into force at the time of publication. Of course, publishing an autism strategy is only the beginning of the story. The hon. Member for Mid-Dorset and North Poole (Annette Brooke) ended her contribution by saying: although we have packed and got the journey, how will it end? I hope that, with her knowledge of young people and children, on whom she so often speaks, we will be able to complete the journey together. To that end, clause 2 places a duty on the Secretary of State to issue guidance by 31 December 2010 to local authorities, NHS bodies and NHS foundation trusts for the purpose of securing the implementation of the autism strategy. Some Members may ask why there is apparently such a gap between the deadlines for the strategy's publication and for issuing the guidance on its implementation, and I shall return to that point later. Clause 2 also sets out some issues that guidance should cover as a minimum. It requires the Secretary of State to keep the guidance under review and to consult the NHS and local authorities on preparing it and, if the Secretary of State proposes, on revising it. On the strategy itself, there are also provisions to cover the possibility that the consultation on the guidance may begin before the Bill comes into effect, and to ensure that such a consultation fulfils the Secretary of State's duty under the clause. Clause 3 is of particular interest. On Second Reading and, indeed, elsewhere, my hon. Friend the care services Minister gave clear commitments that the guidance on the implementation of the autism strategy will have the necessary bite to drive real transformational change. The clause puts that commitment into action. It specifies that the guidance is to be treated as section 7 guidance under the Local Authority Social Services Act 1970, meaning that local authorities will be required to exercise their social service functions in accordance with the guidance. Case law has established that that means more than just taking account of the guidance. A local authority that failed to comply with section 7 guidance without a really compelling reason for doing so would be acting unlawfully. For NHS bodies, there is no existing provision equivalent to section 7 of the LASS Act. In order to create the same obligation on NHS bodies to act in accordance with guidance issued under clause 2, clause 3 also specifies that, for the purposes of that guidance, NHS bodies are to be treated as local authorities. That means that their functions in relation to the provision of relevant services are social services functions under the provisions of the LASS Act. That means that NHS bodies will be bound by the guidance to the same extent as local authorities, which also means that the case law that has established the status of section 7 guidance as being more than just advice to be taken into account will apply equally in relation to NHS bodies. I should add that these provisions will not apply to NHS foundation trusts. Although the Secretary of State is required by clause 2 to issue guidance to NHS foundation trusts, they are not covered by clause 3 because the definition of NHS bodies set out in clause 4 does not include NHS foundation trusts. That means that foundation trusts will be expected to take the guidance into account in planning and providing services for adults with autistic spectrum conditions, but they will not have the same duty to act under it as local authorities and NHS bodies. This reflects the greater autonomy of NHS foundation trusts.