Mrs.
Gillan: I understand the Minister’s difficulty.
Following the statement he has just made, anybody looking at the
Committee proceedings, or interpreting the Bill when it is enacted,
will see that it was the clear intention of Parliament that the
foundation trusts should also be included in it. I hope that that
satisfies the hon. Member for South
Thanet. 4.15
pm
Phil
Hope: My hon. Friend the Member for South Thanet brings
great experience to the Committee, having served as a Health Minister
himself in the past. He made an important point about young people in
transition. I cannot pre-empt what the guidance will say about out of
area placements. Clearly, that possibility exists, because the issues
he raised are covered by the guidance in subsections (b), (c) and (d).
As we go through the process of delivering guidance on those issues, he
will be able to find a way of ensuring that his concerns about out of
area placements are covered.
My hon.
Friend the Member for South Thanet made an important point about
definitions of autism. We all know that there is a debate about which
conditions should be included under the umbrella of the autistic
spectrum. We know, too, that there is professional disagreement on
matters of diagnosis and the classification of conditions, which is why
we think it would be inappropriate for Secretaries of State—in
effect, lay people—to include the definitions in primary
legislation. We want to include those in the strategy—the range
of symptoms, the spectrum that the strategy embraces and the needs for
which support and services must apply. We can keep the strategy under
review, and as developments
and new thinking occur, and as conditions become
identified, we have the flexibility to revise the strategy, as we
debated earlier, to embrace the matters that my hon. Friend
raised. Dr.
Ladyman: My amendments were only ever intended to be
probing. I never expected the Minister to put the definition in the
Bill. Governments never do that, whether it is a good or a bad idea.
However, I want the definition to be included in the guidance and be
part of the process of review, so that there is clear guidance for the
people who make decisions about whether a person is on the spectrum of
disorders. I particularly want the Minister to use the words and state
that it is his intention that the Bill will include people who are
symptomatically autistic rather than what a future scientist might
define as autistic.
Phil
Hope: In the good practice guidance, “Autistic
Spectrum Disorders”, which the Department for Education and
Skills and the Department of Health published in 2002—my hon.
Friend might even have been the Minister at the time, I am not
sure—we listed the conditions that might be considered to be on
the autistic spectrum: Asperger’s syndrome, atypical autism,
Kanner’s autism, childhood disintegrative disorder or
Heller’s syndrome, high-functioning autism, pervasive
developmental disorder not otherwise specified, and semantic pragmatic
disorder. We made it clear in that guidance, and I hope that that gives
the hon. Gentleman the assurance that he needs. In future guidance, we
can address the approach that he described. We made it clear that it
was a tentative list. We stated exactly which disorders should be
included in the spectrum. How broadly the spectrum extends is
controversial and still debated. The importance of revising guidance to
take into account the approaches that he argues for gives us that
opportunity. I know that he wants me to use particular words now in
Committee. I fear that I will not be able to satisfy him in that
regard, but I can say that he has made his point eloquently. When we
publish the strategy and the following guidance, he will be able to
press his
points.
Dr.
Ladyman: I want to reiterate my point. The Minister has
given the list of disorders that we currently consider to be on the
spectrum. I will have a little bet with him—some time in future,
scientists will identify a genetic link to some of those disorders.
Equally, one or more of those conditions may not have that genetic
link. I do not want people with those disorders to fall outside the
scope of the Bill, simply because we discover a genetic link to three
quarters of the disorders.
Phil
Hope: I understand my hon. Friend’s point. I think
that we both want to land in the same place—this is about how we
get there. We do not want to risk excluding particular people by being
too definitive in the Bill. However, through the strategy, which can be
regularly revised, we may be able to embrace and include people who, as
yet, are not identified. We want to arrive at the same place, but we
want to get there in a slightly different
way.
Angela
Browning: I want to support what the hon. Member for South
Thanet said. Even if the first research shows specific genetic links,
which I hope will happen within our lifetime, none the less, there may
be many
variables. I have to live with the fact that I have
autism in my family. We spend a lot of time looking at our relatives
and the people we know, thinking, “Well, they all seem autistic
to me.” I sometimes feel that I am probably more autistic than
the rest of them, but, seriously, we could say that, given the genetic
basis—if that is what is proved, and I personally think that it
will be—when two people come together there may be variations in
their genetic make-up that produce an autistic child, but we do not
know that yet. I suspect that the hon. Member for South Thanet is
saying that the first research will not be the end, and it would be
wrong for it to be taken as, “This is
autism.”
Phil
Hope: The hon. Lady reinforces the point that I made to
the hon. Member for Daventry about the value of reviewing the guidance
and the strategy on a continual basis to respond swiftly to changes of
that kind when we need to develop new approaches. The hon. Member for
Tiverton and Honiton raised the issue of mental health services, which
I think I covered earlier. Mental health trusts will be listed in the
Bill, as new clause 4(1) states:
“‘NHS
body’ means...a National Health Service
Trust”. That
includes mental health trusts, and I made a point about foundation
hospital trusts earlier. The hon. Lady made a point about misdiagnosis
and individuals with complex needs or a variety of needs. I hope the
guidance that will flow from the Bill, and which will specifically
include issues arising from diagnosis, will cover that point when the
time comes.
I want to put
on record our thanks to my hon. Friend the Member for Burton, who is no
longer in the Room. She is at a meeting about complex needs—I
think that I was supposed to be there too, but never mind. She has been
a great champion for autism in her role as chair of the all-party
group. We have other former chairs here, and we all know that all-party
groups in this House play a highly significant role. They allow hon.
Members from both sides of the House to have a shared purpose across
party lines and to join organisations representing particular groups in
which they have an interest to introduce proposals. I want to
congratulate the all-party group on the work that it has done. I think
that I have covered all the points made in our debate.
Question
put and agreed to.
New clause
1 accordingly read a Second time, and added to the
Bill.
New
Clause
2Guidance
by the Secretary of
State ‘(1) For the purpose of
securing the implementation of the autism strategy, the Secretary of
State must issue guidance—
(a) to local authorities about the exercise of
their social services functions within the meaning of the Local
Authority Social Services Act 1970 (c. 42) (see section 1A of that
Act), and (b) to NHS bodies and
NHS foundation trusts about the exercise of their functions concerned
with the provision of relevant
services. (2) Guidance must be
issued under this section no later than 31 December
2010. (3) The Secretary of
State— (a) must keep the
guidance under review, and (b)
may revise it.
(4) In keeping the guidance under review the
Secretary of State must in particular consider the extent to which the
guidance has been effective in securing the implementation of the
autism strategy. (5) Guidance
issued under this section must in particular include guidance
about— (a) the provision
of relevant services for the purpose of diagnosing autistic spectrum
conditions in adults; (b) the
identification of adults with such
conditions; (c) the assessment
of the needs of adults with such conditions for relevant
services; (d) planning in
relation to the provision of relevant services to persons with autistic
spectrum conditions as they move from being children to
adults; (e) other planning in
relation to the provision of relevant services to adults with autistic
spectrum conditions; (f) the
training of staff who provide relevant services to adults with such
conditions; (g) local
arrangements for leadership in relation to the provision of relevant
services to adults with such
conditions. (6) The Secretary
of State must consult and seek the participation of local authorities,
NHS bodies and NHS foundation trusts
before— (a) issuing
guidance under this section,
or (b) revising it in a way
which would, in the opinion of the Secretary of State, result in a
substantial change to the
guidance. (7) Consultation and
steps to seek participation undertaken by the Secretary of State before
this section comes into force are as effective for the purposes of this
section as consultation and steps to seek participation undertaken
after that time.’.—(Phil
Hope.) Brought
up, read the First and Second time, and added to the
Bill.
New Clause
3Local
authorities and NHS bodies: duty to act under
guidance ‘(1) This section
applies to guidance or revised guidance issued under section
[Guidance by the Secretary of State] to a local authority or an
NHS body. (2) Guidance or
revised guidance is to be treated as if it were general guidance of the
Secretary of State under section 7 of the Local Authority Social
Services Act 1970 (c. 42) (local authorities to exercise social
services functions under guidance of Secretary of
State). (3) For the purposes of
guidance or revised
guidance— (a) an NHS
body is to be treated as if it were a local authority within the
meaning of the 1970 Act (see section 1 of that Act),
and (b) the functions of an NHS
body mentioned in section [Guidance by the Secretary of
State](1)(b) are to be treated as if they were its social services
functions within the meaning of that Act (see section 1A of that
Act).’.—(Phil
Hope.) Brought
up, read the First and Second time, and added to the
Bill.
New
Clause
4Interpretation ‘(1)
In this
Act— “adult”
means a person who is aged 18 or over (and, accordingly,
“child” means a person who is under the age of
18);
“local authority”
means— (a) a county
council in England; (b) a
metropolitan district
council; (c) a non-metropolitan
district council for an area for which there is no county
council; (d) a London borough
council; (e) the Common Council
of the City of London; (f) the
Council of the Isles of
Scilly; “NHS
body” means— (g)
a Strategic Health
Authority; (h) a Primary Care
Trust; (i) a National Health
Service trust all or most of whose hospitals, establishments and
facilities are in England; (j)
a Special Health Authority performing functions only
or mainly in respect of
England; “relevant
services”— (k)
in relation to an NHS body, means health services provided for the
purposes of the health service continued under section 1(1) of the
National Health Service Act 2006 (c.
41); (l) in relation to a local
authority, means services provided in the exercise of the
authority’s social services functions within the meaning of the
Local Authority Social Services Act 1970 (c. 42) (see section 1A
of that Act). (2) In this Act
references to the provision of services include references to arranging
for the provision of services (and references to services provided are
to be construed accordingly).’.—(Phil
Hope.) Brought
up, read the First and Second time, and added to the
Bill.
New
Clause
5Extent,
commencement and short
title ‘(1) This Act extends
to England and Wales only. (2)
This Act comes into force at the end of the period of 2 months
beginning with the day on which it is
passed. (3) This Act may be
cited as the Autism Act 2009.’. —(Phil
Hope.) Brought
up, read the First and Second time, and added to the
Bill.
The
Chairman: We shall now work through the original clauses,
which, as I understand it, the Committee will need to negative. The
clauses may be debated. I shall put the clause stand part in each case.
If any hon. Member wishes to speak to any of the clauses, they may do
so. I shall put the clause stand part question at the end, when it will
be up to the Committee, but to make sure that we get it right, I shall
endeavour to indicate what the Committee wishes to
do.
Clause
1Duty
to record and provide information on the number of children with
autism Question
proposed, That the clause stand part of the
Bill.
Mrs.
Gillan: In the course of negotiations, the Government and
the Ministers involved, who are present, have given the reassurances
that we need and, indeed, made some great steps forward. I do not
intend to speak at length or at all on clauses 1 to 3, if that is any
help to the Committee.
The
Chairman: That is clearly helpful to the Committee. If the
hon. Lady wishes to make any all-embracing remarks in relation to
clauses 1 to 3, I am perfectly happy to allow her to do
so.
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