Autism and Neurodiversity Research Funding

Motion made, and Question proposed, That this House do now adjourn.—(Rebecca Harris.)

It is with great pleasure that I rise in my first end-of-day Adjournment debate in the better part of eight years, but it is a topic that I am very happy to return to from this position. It is one that I championed in Government and one that I worked very hard on when I was a Back Bencher prior to my ministerial office. I am hugely grateful to Mr Speaker for granting me today’s debate.

Many hon. and right hon. Members will know that this issue has been close to my heart for many years: autism and the range of brain conditions that can be summarised by the word neurodiversity. From my own direct family experiences, which I spoke about in this Chamber when we held the first Chamber debate on autism back in 2013, and from the plethora of constituency casework that I have worked on over the years helping families of children and young people with autism and associated conditions, I have developed a certain knowledge and experience of these issues. As a Minister and a Secretary of State, I was glad to be able to push the agenda even further.

One of the privileges of being a Back Bencher is that I can put on record my thanks to local organisations in my constituency which do so much to support and work with people with autism, whether it is officers of the local authorities, volunteers in local carers’ groups such as the Swindon Carers Centre, or organisations such as the Uplands Enterprise Trust, which is pioneering and developing more post-19 support for young people with autism and other disabilities in my area, working with the excellent special schools network and the Brunel multi-academy trust in Swindon. It is really innovative work.

My debate today is the beginning of a process that was made clear in my exchange of letters with my right hon. Friend the Prime Minister on my departure from Cabinet two months ago: to bring about a sea change in how autism and other brain conditions are not only diagnosed, but supported and treated throughout the lives of those people. Our country is one of the most advanced in the world when it comes to these issues, but there is still a huge amount to do.

My successor as chair of the all-party parliamentary group on autism, the late, great Dame Cheryl Gillan, will always be remembered as the author of the groundbreaking Autism Act 2009, which was a new departure for health, in that a specific condition was delineated in legislation, much against the initial resistance of the then Government, but the strength of feeling in this place and outside was such that Dame Cheryl thankfully got her way. The autism strategy, which was revised in its latest iteration only in July this year, is the direct result of that important legislation. Twelve years on, I think we can safely say that awareness and diagnosis levels have risen dramatically, but the situation remains stark.

About 1 million people in the United Kingdom are autistic, but they still have some of the worst outcomes in our society. First, the death rates mean that they die on average decades before the rest of us. Secondly, with two in 10 in employment, they have the lowest employment rates of all disability groups. Importantly, and deeply worryingly, disproportionate numbers of autistic people and people with brain conditions end up in mental health detention or, even worse, in our criminal and youth justice systems. They are being locked up by a system that represents barbaric practices from a generation ago. I have certainly found, from my professional and ministerial experience, far too many in our prison system, our young offenders’ institutions and our criminal justice system generally with those conditions.

I know the right hon. and learned Gentleman has had a particular interest in the issue for a number of years, for both personal and other reasons, so I congratulate him on securing this debate. I give an example from Northern Ireland, which to be fair is not the Minister’s responsibility, but shows what is happening: an increase of 148% in the number of children waiting for an assessment for autism and a 687% increase in the number waiting more than a year for an assessment. This is a system where the capacity is nowhere near meeting demand, as I think the right hon. and learned Gentleman has also said. Does he agree that a corresponding increase in funding to get to the root of autism and how best to treat and live with it must be a priority for the Government?

I am grateful to the hon. Gentleman, who rightly outlines some of the pressures on the system—the increase in diagnosis, which in many ways is a good thing, and the personnel and capacity issues that cause many of the delays in diagnosis, which are all too familiar a pattern for many families, including those in England, Wales and Scotland.

It is interesting to note that research by, I think, the Northern Ireland Assembly calculated the estimated cost to the country of the failure to deal with autism at a staggering £32 billion. Let us just think about that. What a cost to our country: resources wasted, lives wasted and lives lost as a result of these omissions. It does not have to be like this.

It is such a shame to see my right hon. and learned Friend not in Government, but such a pleasure to have him on the Back Benches and to be here for his first speech from the Back Benches in what I suspect is a number of years. Seeing that we have a lot of time in tonight’s Adjournment debate, does he, as a former Lord Chancellor, agree that the way we look at people on the autistic spectrum within the secure estate, and the way he is proposing we might look afresh at that, might affect the way we look at the secure estate as a whole—to understand a lot more, and condemn a lot less? We have such a high prison population, many of whom, especially women, should not be in the secure estate. Could this be the issue that causes us to look afresh at our prison system?

I am grateful to my hon. Friend. In 2020, he and I visited his local prison in Winchester, a prison with many challenges and, there is no doubt about it, a share of the population with a brain condition, sometimes undiagnosed and often an acquired brain injury. Many people who are in for offences of violence have themselves been the subject of violence. Those issues are frankly endemic within the criminal justice system.

That is why, when I was Lord Chancellor, in last year’s sentencing White Paper, I announced a call for evidence on neurodiversity in the system. I was hugely grateful to Charlie Taylor, Her Majesty’s Chief Inspector of Prisons, and Justin Russell, Her Majesty’s Chief Inspector of Probation, for leading that independent call for evidence. Charlie Taylor was a public servant who came from the education sector, specifically the special needs sector, had real frontline knowledge and experience of autism and brain conditions and previously ran the Youth Justice Board for England and Wales.

The good news is that, thanks to the published results of the call for evidence, the Government committed—I am pleased to say I committed—to training for frontline staff and the upskilling of those staff right across the criminal and youth justice system, as part of a new custody and detention apprenticeship that is being offered and that will be completed by all prison officers. Her Majesty’s Prison and Probation Service is developing a revised policy framework and guidance all about those issues, but in particular about children in custody with those conditions. This work is carrying on. I will develop those points a little further. I know people are anxious to come in.

I will let my hon. Friend the Member for North Dorset (Simon Hoare) in first before my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill).

I echo what our hon. Friend the Member for Winchester (Steve Brine) said in that it is a travesty that my right hon. and learned Friend is not speaking still from the Front Bench, but it is a delight to hear him speak this evening.

To go back to the point made by the hon. Member for Strangford (Jim Shannon), what is my right hon. and learned Friend’s assessment of the impact of covid on diagnosis, assessment, the provision of support and the crucial need to link up the Ministry of Justice, the Department of Health and Social Care, the Department for Education and the Department for Work and Pensions?

I am very grateful to my hon. Friend. There is no doubt that covid has had an impact on backlogs in all parts of the health system, including diagnosis. Having said that, there are significant advantages in the use of remote technology for people with autism and brain conditions. For them, very often the journey to a clinic, hospital or health centre is in itself traumatic and anxiety-forming. I see remote technology as a real liberator for many people with autism, so the potential there is immense.

Sadly, the point my hon. Friend makes about the impact of covid is one that, without increased capacity and increased staffing, we will have to wrestle with for a number of years. On the point he makes about joined-up government, I well remember saying on many occasions to anybody in Government who wished to listen that Justice could not do this on its own. As a downstream Department, it needed Education, Health, the DWP, the Ministry of Housing, Communities and Local Government and, frankly, all arms of Government to work together to identify some of these problems at the root to prevent them from becoming part of criminal justice, but I will speak more about that in a while.

My right hon. and learned Friend is making the case most powerfully and demonstrating, as other hon. Members have said, why it is a tragedy that he is not still on the Front Bench.

I welcome the very significant initiative that my right hon. and learned Friend made in relation to this when he was the Secretary of State—something that, as he will know, the Justice Committee warmly welcomed. Does he agree that it is very important now that we maintain the momentum for this, and in particular that the moneys available to the Ministry of Justice in the spending review are put into important areas of this system that for too long, until his work, were overlooked?

I am very grateful to my hon. Friend the Chair of the Select Committee. It was encouraging to see that the revenue settlement for the Ministry of Justice over the next three years was a pretty good one, with a just over 4% increase year on year. Obviously, it is now going to be for Ministers, in their allocation process, to work out precisely what they want to spend within that envelope. I very much hope that the announcements we made as a result of the call for evidence—published as part of the autism strategy document in late July, which I cleared together with my right hon. Friend the Secretary of State for Health—will be followed through on.

More than that, it became increasingly clear to me, as I read the response to the call for evidence and as I followed the debate, that screening people coming into the criminal justice system and the prison system is an essential prerequisite for understanding the best way to handle them. I think a screening process for brain condition would reveal acquired brain injuries. It might reveal an undiagnosed condition—maybe attention deficit hyperactivity disorder, attention deficit disorder, dyslexia even. Let us do that at this stage and work out what is going on in people’s minds, so that we can not just better manage them, but actually help them along the path of rehabilitation.

Do you know, Madam Deputy Speaker, that my worry is that, time and again—not just in the prison system, but in the probation service—regimes are set up and orders are made with the best of intentions, and the people with these conditions are set up to fail, because they are not able actually to access, understand or compute that in a way that perhaps neurotypical people can? That is not their fault; it is a fact of who they are and what they are. That is why we need to change the approach that we take. I do not want to see people set up to fail. I certainly do not want excuses for criminal behaviour, but I do want smart answers on ways in which we can meaningfully rehabilitate people. I have seen it happening. In Parc prison—a private prison, I have to say to those on the Labour Benches—in south Wales I was awestruck by the work being done on the neurodiversity wing. Prison officers trained in the right skills were working with some of the most difficult and complex prisoners in that estate and achieving results that might not to the naked eye look terribly remarkable but which, by the measure of the people they were dealing with, were extraordinary. We need to replicate that sort of work, which is being done in one corner of the estate, across the entire prison estate.

I welcome my right hon. and learned Friend back to the Back Benches. I am sure we will be hearing more from him over the coming weeks and months. Does he agree that as well as research, on which I agree entirely, societal support is needed? Organisations such as the Caxton Youth Organisation, a brilliant youth club in my constituency for children and young people with autism and learning difficulties, can play their part in supporting young people with autism. Society and Government also have a part to play because this is about us all working together to support these young people.

My hon. Friend is right. Drawing on her local government experience and having been directly responsible for many of these services, she encapsulates the best practice we see in many local areas. The trouble is that we do not see it everywhere and there is, to use the dreaded phrase, a postcode lottery, which is just not good enough for so many families across our country.

I see where we are now as a moment to make a choice. There is a golden opportunity for Government and indeed for society, and I deliberately wanted to include neurodiversity in this debate because I believe it is hugely important. Diagnostic descriptions are vital for many families. Speaking from my own experience, they open a door to statutory services and obligations—statements, as we used to call them, or education, health and care plans as they became under the Children and Families Act 2014. However, the system is in danger of becoming a prisoner of that process. In the natural concern that public authorities have to conserve resources there is a danger that we start to become overly obsessed with labels and then find that if somebody is not labelled there is, to mix my metaphors, a cliff edge and nothing for the person who does not happen to get through the door marked “autism”.

Let us think about that for a moment—think about how wrong that is in terms of the lives we are dealing with. No one person just presents as autistic; they might have a range of conditions and challenges including, for example, epilepsy, which, sadly, is a very common comorbid condition with autism. There are also other conditions that might fall short of autism but if undiagnosed the consequences can be baleful, such as attention deficit hyperactivity disorder, attention deficit disorder, dyslexia and other types of impairment that mean that people cannot access education, for example, in the way that neurotypical people can. These conditions might not be seen as acute compared with some other conditions that are diagnosed but can lead to disaster for the individual if they are not diagnosed.

My right hon. and learned Friend is making a powerful speech, and it is good to have him free to contribute in this way. Does he agree that, in so far as there are problems, they can be in people’s responses to those with autism, and that if people were to respond in a better informed and more generous way, then such problems as exist today may not be there in the future?

My right hon. Friend is absolutely right. There is no doubt that an inappropriate response, or a response, however well intentioned, that results from a lack of evidence or a lack of understanding, can make a bad position much worse for somebody with a condition such as this. Therefore, for me, research is not a luxury or an optional extra; it is essential. If we, as public services, as private enterprise, as business—as an economy that needs a supply of new talent, bearing in mind the announcement today that there are 1.2 million job vacancies in our country—are to really release the potential of people with brain conditions, then this is, to use the phrase, a no-brainer.

I am grateful for my right hon. and learned Friend’s indulgence—