Autism and Neurodiversity Research Funding

– in the House of Commons at 4:51 pm on 16th November 2021.

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

Photo of Robert Buckland Robert Buckland Conservative, South Swindon 5:29 pm, 16th November 2021

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 spoken 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.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

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?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

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.

Photo of Steve Brine Steve Brine Conservative, Winchester

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?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

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.

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

I will let my hon. Friend Simon Hoare in first before my hon. Friend Sir Robert Neill.

Photo of Simon Hoare Simon Hoare Chair, Northern Ireland Affairs Committee, Chair, Northern Ireland Affairs Committee

I echo what our hon. Friend 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 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?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

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.

Photo of Bob Neill Bob Neill Chair, Justice Committee, Chair, Justice Committee

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?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

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 of 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.

The wider debate is all about replicating the best practice we see across Government and local government, and across private enterprise and business as well, because I do not want this debate to be just about what the Government can do—me with my metaphorical hand out, saying, “More money please.” This is about society realising that if we are going to crack the issue and make a difference, we need carefully targeted research into what works.

Photo of Nickie Aiken Nickie Aiken Conservative, Cities of London and Westminster

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.

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

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.

School exclusion—I see Sarah Jones in her place—is the most obvious consequence. That is a particular issue, and the disengagement with the system that it can lead to all too often leads to a descent into criminality, which, frankly, then brings us back to the criminal justice outcomes that I have been wrestling with all my professional life and in my ministerial incarnation. In devising the right type of support, we need to try to put the process in its proper context. We must remember that this is about the person and centre something on the individual and their needs.

I am delighted after many years to renew my association with Autistica, our country’s leading autism research organisation. Today, by happy coincidence, it published an excellent support plan on autism. Having read it very carefully, I think it is groundbreaking. It is targeted, and it tries to move the debate in a direction in which I think all of us, including the families and those who have autism, would like to see it go. That contribution follows from the Government’s own commitment, in the revised autism strategy published at the end of July, to improve autism research, to improve innovation and to look for examples of best practice.

As we near a very important moment in the life of our country, with the Department’s publication later this year of the long-awaited White Paper on social care, Autistica has identified a gap in research—and guess where the gap is, Madam Deputy Speaker. It is in social care. We have learned so much about genetics and about the causes or the reasons for autism. That has been incredibly important in understanding that this is a condition, not an illness or a disease, and that there is no cure, and in moving away from all that redundant language and understanding the condition for what it is—and celebrating it too, by the way. We do not do enough of that. We tend to view it as some sort of wicked problem. For many people, it is actually their life; it is who they want to be and how they want to be recognised. We must never forget that.

Photo of Greg Clark Greg Clark Chair, Science and Technology Committee, Chair, Science and Technology Committee

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?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

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.

Photo of Greg Clark Greg Clark Chair, Science and Technology Committee, Chair, Science and Technology Committee

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

Photo of Eleanor Laing Eleanor Laing Deputy Speaker and Chairman of Ways and Means, Chair, Standing Orders (Private Bills) Committee (Commons), Chair, Standing Orders (Private Bills) Committee (Commons)

Order. I did not correct the right hon. Gentleman the first time, but it is essential that he faces the Chair rather than Robert Buckland, because he cannot be heard if he is speaking to the back of the Chamber. I never understand why, when there is all this space, people want to sit where the occupant of the Chair cannot see them. There must be a reason for it.

Photo of Greg Clark Greg Clark Chair, Science and Technology Committee, Chair, Science and Technology Committee

I will address you directly, Madam Deputy Speaker. I accept your ruling on that.

One problem people with autism sometimes face is that, when they come to an age where they are looking for jobs, work experience is increasingly important and some employers are reluctant, based on lack of familiarity and nervousness, to give work experience opportunities to young people with autism and other conditions. Work experience is an essential gateway to employment. Will my right hon. and learned Friend join me in encouraging employers to open up and give work experience opportunities to a wider range of young people?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

My right hon. Friend is absolutely right. We have seen that in other areas, for example mental health, where there has been concerted work, including by excellent organisations such as the Mindful Employer Network in my area, to demystify the issue and remove the stigma. Such work allows employers to understand autistic people, some of whom see the world in ways that you and I could not dream of. Going back to my celebratory point, it is all about the potential of people with neurodiverse conditions and what they have to offer.

Photo of Sarah Jones Sarah Jones Shadow Minister (Home Office)

I congratulate the right hon. and learned Gentleman on the debate and on his cause. It is incredibly exciting that he has chosen this subject to focus on after his ministerial career—not that it is the end of his ministerial career; I am sure it will carry on—and I just want to stress how important it is that we talk about autism and educate people about it. In my constituency, we had a five-year-old boy who was excluded from school. He was on the path to being diagnosed, but had not quite been diagnosed. His classroom was moved around over half-term and when he came back, he did not understand where anything was. He kicked off and was excluded. The language used in the letter to his mother included strange adjectives—it said that he was being “manipulative”—and other language one would not use about a five-year-old, because his teachers did not understand his condition. Now he is in a good school that does understand and he is thriving. He will have a lot to contribute to society. I just wanted to congratulate the right hon. and learned Gentleman and say that I am very happy to support what he is doing.

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

I am very grateful to the hon. Lady. I think we formed a pact on Sunday night that we would work together cross-party on these issues. There are plenty of others on the Labour Benches—Jonathan Reynolds has a similar experience and knowledge of autism—who I know will put their shoulder to the wheel, and that will be incredibly powerful. She has done work on the issue of knife crime. All too often, there is a sad correlation between the isolation of people who might be suffering from anxiety driven by an undiagnosed condition and what I call a cycle of isolation that can often lead to the decision to arm themselves for their own protection. That is an aspect of knife crime—we always think and talk about gangs—that we misunderstand at our peril, so I am grateful to her for taking part in the debate.

I was talking about the golden opportunity we have. We are between the autism strategy as published and the White Paper, which I am waiting for with relish. The Prime Minister knows that that is another issue I will be pressing him and the Government on in the next few months. Many of us identify social care as an issue not just for older people, important though that this, but for adults with disabilities who need lifelong support. They must be part of the mix. More than half of local government expenditure is on adults with disabilities. If we do not pay regard to that in the plan, we are failing. Although I supported and am happy to support difficult decisions on national insurance and on funding issues, we have to make sure that the system that we are funding is well evidenced, produces the outcomes that we all want to see and has an element of accountability that, at the moment, is lacking. People talk about the black hole of health and social care funding. With respect to everybody concerned with that, that is what it feels like to us on the outside, and we have to change. That is why research on care will be so important.

Photo of Steve Brine Steve Brine Conservative, Winchester

I am so pleased that my right hon. and learned Friend made the point that social care is not just about older people. That is so important. What he is actually talking about—who knew that the Back Benchers and Front Benchers were so joined up?—is levelling up. He is talking about realising the potential of everybody in our country. It is not that autism is therefore a condition to be managed and kept in its box, as we seek to minimise the damage, but that we want people to achieve their potential, and if everybody can achieve their potential, that is just levelling up really, is it not?

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

I could not have put it better myself. Levelling up is about people and communities, not things. Things are important and they deliver us levelling up, but levelling up is about people. That is why the Government have to show seriousness of purpose. I am with the Government on these things—I helped to author a lot of the documents on which they will be held to account. This matters, but if we do not focus on people, we are not going to level up. That is the point that my hon. Friend made so well.

I commend the Autistica report to hon. Members, but if I may crave the indulgence of the House for a little longer, I want to outline what Autistica suggests the key stages of support should be that will make a real difference. First, the report made the important point that support for autistic families around and shortly after the time that they receive a diagnosis has to be improved, because it is big news for families. It is a big moment when they get that diagnosis. I remember now the mixture between relief that the system is listening and deep sadness, grief and anger, and all the emotions that someone goes through as a result. These are big moments for families. It sounds axiomatic, but this does not happen, because we do not empower all families of people with autism to understand the diagnosis and to come to terms with what it means for them. This is a moment when services have an opportunity to get to know these families better and to ensure that their personal profile, which should be done, is really understood.

Photo of Simon Hoare Simon Hoare Chair, Northern Ireland Affairs Committee, Chair, Northern Ireland Affairs Committee

Does my right hon. and learned Friend share my concern that, very often, as with so many of these things, the children of the—let me use this phrase—“sharp-elbowed middle classes” seem to get a disproportionate amount of attention, care and support and those who are often least comfortable with officialdom and challenging professionals and asking questions usually get the smaller section of the pie? Quite a lot of work needs to be done on that to ensure that we have that uniformity of levelling up.

Photo of Robert Buckland Robert Buckland Conservative, South Swindon

Again, that is a really important point. I do not make any criticism of the sharp-elbowed middle classes; these people are doing what they think is right for their children. I have been there and I make no apology for it, but among all those dedicated, wonderful, loving parents and carers, there are many families who do not have that wherewithal, and they often come to our surgeries and offices for help. We are the last port of call and, very often, we can make a difference. Looking back on the plethora of cases that I have dealt with, I am probably most proud—I know that hon. Members will share this feeling—of bumping into families years later and being told, “You helped our son. He has just finished his education and is going to go off and pursue a skill. If you hadn’t intervened six years ago, I don’t know where we’d be.” That is wonderful, but it should not be necessary: that is the big message that I want to convey today.

Rather than just stand here and make a general cri de coeur, my aim is to look at the bigger picture. Individual cases such as the one that the hon. Member for Croydon Central mentioned are symptoms of the problem, but it is all about dealing with the challenge itself. Documents such as the Autistica plan really help to tie the threads together and give us a blueprint that the Government, working with the private and charitable sectors, can run with.

I mentioned support around diagnosis. The document has some very interesting proposals for pilots and initiatives relating to how we can improve what is referred to as the diagnostic pathway. At the moment, there is a lot of ambiguity about precisely what is offered and what works, but the time of diagnosis is not a time for ambiguity. It is no good making educated guesses at that point; we want to know with certainty what pathways work. Families embarking on this new journey need that certainty, so I strongly commend to the Minister the document’s recommendations, particularly in relation to the work of the National Institute for Health Research.

As stage one, we need a framework that can be applied nationally, rather than relying on purely local initiative. Stage two, as the document describes it, is preparing for the future: after diagnosis, what systems do we have to match the needs of people with autism and brain conditions with the right therapies and services? We need to make those connections better; we need to connect people to safe practical advice, particularly from people who have been through the system. Peer-to-peer support works in so many contexts, and particularly in this one.

What we and Autistica are asking for is not a finger in the air, but evidence-led systems. It is no good just saying that the needs of autistic people are diverse. They are diverse, believe me: when you have met one person with autism, you have met one person with autism. They are all wonderfully unique, in my experience, but that should not be an excuse to say, “We’ll let a million flowers bloom and see complete diversity.” We need less of an unguided mêlée and much more of a framework—a mechanism by which, with evidence, we can ensure better support for people as they prepare for life and work out the pathway.

Finally, the third element of the report is meeting in a realistic and feasible way—we are not trying to create something totally out of this world—the evolving, ever-changing needs of people with autism. That is particularly important at the transitions, be they from primary to secondary, from secondary to tertiary, or from tertiary out of education. Age 25 is a big time for people who have an education and healthcare plan, because it is the moment when it stops—and what’s next? All such transitions can feed anxieties that if left unchecked can develop into a co-morbid mental health problem, with the concomitant waste that I spoke about at the beginning of my speech.

The truth is that the needs of people with autism and their families fluctuate and change. Instead of inviting crisis, let us plan for it and avert it. The support that the report envisages is all about services that will be there if things start to get a bit heavy, but that can be light-touch in other circumstances. The suggestions about nurturing expertise in the NHS and social care with hubs of expertise to deliver specialised services seem the most sensible way of developing those service models.

This is going to take investment, but, as I have said, I do not believe that it should begin and end with Government, which, hopefully, is good news for my hon. Friend the Minister. If she has had a chance to see the report that I mentioned—it was published only today, but I know that her officials will be familiar with it, because Autistica works very well with the Department, and I commend those officials for working with it so constructively—she will know that it sets out a costed programme, in which Autistica itself declares it will invest, or partner, to the tune of nearly £16 million. That is money from the third sector, but we ask the Government to step up, because the total cost of the projects that Autistica envisages in its list is just over £65 million. All those projects are designed to improve the evidence base and hence to improve the way in which we can deal with each of those three stages, and I warmly commend them to my hon. Friend.

What, finally, is the context in which we should work? I have talked—at the risk of stating the bleeding obvious—about the need for Government Departments to come together: the Department for Work and Pensions on employment, the Department for Education on exclusions, the Minister’s own Department on diagnostics and care, and my former Department on criminal justice. As I have said, however, this will require an effort from all sections of society, and the private sector must step up as well.

It is in businesses’ interest to get this right, if they are to unleash the talent of autistic people not just because it is good, but because it is damn sensible. It is to that sort of enlightened self-interest in the wider community that I want, through the House, to appeal tonight. I think that the offer of finance from Autistica is significant, although I want to see it scaled up. I think that the work we need to do outside this place to harness philanthropy and the support of the private sector could start to bring us much closer to the levels of research investment that we see in, for example, the United States, which, although it does not enjoy the wonderful national health service that we have in our country, is very far ahead of what we are doing here in terms of research investment.

If we are to succeed, that partnership between the third sector, the private sector and the public sector will be essential. The quid pro quo for Government is that our wonderful officials must remember that they do not have a monopoly on wisdom. I have sat in the Minister’s seat and worked with officials and worked well with them, but sometimes there is an institutional reluctance to go outside the tent because of fears about control, whatever form it may take, and, inevitably, about accountability. We must overcome that, because Government alone will not be able to crack this.

The last two years have, in many ways, opened our eyes to the potential that Government can offer. Government-led support and declarations of Government funding meant that we were able to create a vaccine manufacturing capacity virtually from scratch. I am about to see 250 jobs come to Swindon—jobs that would not have existed a few years ago, without the terrible crisis that we have all had to live through. The Government rose to the challenge, and I was proud to see them do so, underwriting, in effect, many of these initiatives.

We heard words such as “moonshot”, did we not? We heard about the Government’s big ambition to deal with the threat posed by the pandemic, and rightly so. Let us remember that. Let us bottle it and use it here. Let us have our autism moonshot; let us have our neurodiversity moonshot. Let use the power of Government—its convening power—to kick-start this research, and to lead our society in the improvement of research. Through the gathering of that evidence and Autistica’s work, we can reach some of Autistica’s 2030 goals. Its realisable ambitions for 2030 include: halving the employment gap for people with autism; services truly centred around the person with autism; proven support from day one; public spaces being more accessible for neurodivergent people; tailored health checks for people with neurodivergence; and, yes, screening at an early age, whether in the health system or the education system. That is a wider application of the principle that I wanted to see in our criminal justice system.

This could be a decade of achievement. It is up to all of us and the Government to make it happen.

Photo of Gillian Keegan Gillian Keegan Minister of State (Department of Health and Social Care) 6:15 pm, 16th November 2021

I thank my right hon. and learned Friend Robert Buckland for securing this important debate on funding for autism and neurodiversity research and for such a wonderful, heartfelt speech. It is truly my honour to respond. I commend him on the incredible work that he has done throughout his career to improve the lives of the nearly 560,000 autistic people and about 5 million neurodivergent people across the country. In his previous roles as Lord Chancellor and chair of the all-party parliamentary group on autism, he has been instrumental in driving improved awareness and understanding of autism across Government.

We know that too many autistic people and neurodivergent people more generally are ending up in the criminal justice system and that much more needs to be done to improve people’s experiences. The review that my right hon. and learned Friend commissioned as Lord Chancellor in 2020 looked at this important issue and, as a direct result of his contribution, I expect our newly published national autism strategy will make a big difference to the lives of autistic and neurodivergent people who come into contact with the criminal and youth justice systems. We know that the strategy needs to improve autistic people’s lives. It was informed by a national call for evidence and incorporated the views of more than 2,700 autistic people, their families and carers. It is underpinned by an implementation plan for year one—that is 2021-22—and backed by over £74 million for the first year alone. It sets out our vision for what we want autistic people’s lives to be like by 2026. Over the next five years, we will improve understanding in society, reduce diagnosis waiting times and improve access to high quality health and social care for autistic people.

My right hon. and learned Friend mentioned social care, and that will be a key part of the White Paper along with the social care needs of working-age adults. We will also publish further implementation plans for year two and beyond that will build on our actions this year. They will set out how we will drive improvements across health and care, employment, education and the criminal justice system.

We have made important strides across England in the last decade since the introduction of the landmark Autism Act 2009. I pay tribute to our friend Dame Cheryl Gillan for all her work in this area. The Act includes improvements in public awareness of autism and the availability of diagnostic services. To date, we remain one of the only countries in the world to have such legislation—I know that we are proud of that—but we know that we still need to do more to ensure that autistic people have equal access to services across their lives.

One of the biggest challenges that we face is, as my right hon. and learned Friend outlined, gaps in our evidence about what services and support work best for autistic people. I saw the real-life impact of that recently when I was interviewed by an impressive young woman called Immie. She told me about her struggle and how long it took her to get diagnosed with autism as well as the struggles faced by women and girls in getting the right support due to under-diagnosis. While we know that that is an issue and are taking action to address it, we need better evidence about the effects of masking and under-diagnosis of autism for women and girls.

When I was the Apprenticeships and Skills Minister, I met many young autistic people who told me they struggled to find and get into work. Recently, at the start of UK Parliament Week, I visited Littlegreen Academy in my constituency, which specialises in providing education to boys aged seven to 16 with autism. Pretty much every single one of them asked whether I would help them to get some work experience, to help them get on the ladder towards employment. Like my right hon. Friend Greg Clark, I took that as my action from the meeting.

Through our new autism strategy we are strengthening and promoting pathways to employment, such as supported internships, traineeships and apprenticeships, but to make further headway on closing the unacceptable autism employment gap we need to better understand the barriers to employment and the other barriers faced by people with autism.

We know that we have not reduced fast enough the number of people with an autism diagnosis in in-patient care, which is important, as my right hon. and learned Friend the Member for South Swindon said. There are many reasons for that number, but a main reason is that people are being diagnosed as autistic after they are admitted. We need to make sure the number of autistic people in such settings is reduced, as in many cases they are not the right settings. We set up a delivery board across Government and across system partners to make sure we monitor progress, identify blockers and propose actions so that people are better supported in their community, not in inappropriate in-patient care.

Many hon. Members mentioned the lack of understanding, and it is so important that we have more general understanding. I am sure many hon. Members remember the autism training that MPs and their offices received, again at the behest of Dame Cheryl Gillan, who pushed and encouraged us all to do that. I certainly learned a lot.

As set out in the “Right to be heard” publication in 2019, we are also trialling the Oliver McGowan mandatory training in learning disability and autism for all health and social care staff, backed by £1.4 million of funding. The trials are under way, and three providers are currently delivering the training. Hundreds of staff have already been trained. There will be a final evaluation report, which is due in the spring, and the outcomes will inform the wider roll-out of the Oliver McGowan mandatory training. We are working with his parents, Paula and Tom, to introduce the training.

As part of our new autism strategy, we will publish a cross-Government research action plan that lays out the steps we will take to improve and embed a culture of autism research by 2026. We know that we need a strategic approach to ensure that areas currently receiving less research investment, such as care and support—my right hon. and learned Friend mentioned the postcode lottery—are prioritised in future. We also need to make sure we are prioritising the right areas for research and that the research delivers the right change.

We will work with autistic people and their families, the research and voluntary sectors and NHS England to carry out this research action plan, which will ensure that we are building on the important work already happening in autism research. For example, we have already provided £81 million for autism and neurodiversity research in the past five years, which includes funding for a study on the impact of covid-19 on autistic people, a project to improve the accuracy of adult autism assessments and a systematic review to understand what mental health support works for autistic people.

In addition, we were delighted to announce this year a three-year partnership between the National Institute for Health Research and the UK’s leading autism research charity Autistica—which my right hon. and learned Friend mentioned—to fund research into the social care that works for autistic people. The partnership will encourage and support more research applications in this important subject area and we encourage many people to make such applications. I am glad we have had the opportunity today to hear about Autistica’s fantastic work and to welcome its new support plan. I am due to meet Autistica next week—that gives me some time to read the report—and I look forward to working with it on the development of our research action plan to transform the autism research funding landscape over the next few years.

I again thank my right hon. and learned Friend for securing this important debate and all Members for their contributions. I recognise that we must ensure that the actions we take to support and improve the lives of autistic people and their families are grounded in evidence. Through our new autism strategy and research action plan, we will level up support for autistic people throughout the country. I look forward to working with my right hon. and learned Friend and other Members to make that happen.

Question put and agreed to.

House adjourned.