Michelle O’Neill MLA, Deputy Chairperson
Committee for Health, Social Services and Public Safety
Room 412
Parliament Buildings
BELFAST
BT4 3XX
E-mail: committee.hssps@niassembly.gov.uk
Tel: 028 9052 1360
Fax: 028 9052 1667
15 December 2008
Mr Michael McGimpsey MLA
Minister for Health, Social Services & Public Safety
Castle Buildings
Stormont Estate
BELFAST
BT4 3SQ
Dear
The Committee welcomes the opportunity to comment on the Autism Spectrum Disorder (ASD) Strategic Action Plan 2008/09 – 2010/11 consultation document.
In the foreword to the document you point out that the Draft Action Plan has been informed by the Independent Review of Autism Services carried out by Lord Maginnis and you will be aware that the Committee was briefed by Lord Maginnis on 3 July 2008. The Committee took evidence about the draft Action Plan on 13 November from Autism NI (PAPA), Autism Initiatives, NI Union of Supported Employment and the National Autistic Society Northern Ireland. The Committee also paid a fact finding visit to Wales on 19 – 20 November 2008 to learn from the experience there.
The Committee’s primary concern in relation to the Draft Action Plan is that it seeks to address services for people with ASD solely from a health and social care perspective. The Committee is also conscious that the terms of reference of the Independent Review of Autism Services chaired by Lord Maginnis were similarly restricted to health and social care needs. In his evidence to the Committee on 3 July Lord Maginnis noted “that the one constraint on our inquiry was that we did not have authority – or any great welcome in some areas – when we tried to step outside the parameters that were dictated by the Department of Health, Social Services and Public Safety…there appears to be no desire for other departments to co-operate…unless that can be overcome difficulties will emerge in the future”.
This issue was also stressed by the autism organisations when they gave evidence to the Committee. Autism NI, for example, stated “The action plan is public health and medically driven, without the awareness that, beyond assessment and diagnosis, the paramount issues are social care, education and employment and learning. …… … I regret the fact that the autism action plan was produced only by the Department of Health but, next year, the Department of Education will also produce one. As a strategic organisation, we feel that that is sufficient evidence of the need for a cross- department al regional autism strategy ”.
The National Autistic Society said “A strategy to address the needs of people with autism must cut across Departments. In the case of young children, it is essential that health and social care services work in conjunction with the Department of Education. As children progress to adulthood, there is a need to work with the Department for Employment and Learning. Subsequently, the Department for Social Development should be involved when the individual wants to access housing and explore independent living, for instance.”
The visit to Wales brought home to the Committee in a very striking way that the issue of providing services for people with autism benefits greatly from being addressed on a cross- department al basis. During the visit we were briefed jointly by senior officials in both health and education and by the Welsh Strategy Implementation Manager. Three years ago the Welsh Assembly Government adopted a social care model of developing services for people of all ages with autism involving health, education and other aspects of Government. In a foreword to the Strategic Action Plan for Wales, published in April 2008 and jointly signed by the Minister for Health and Social Services and the Minister for Children, Education, Lifelong Learning and Skills, partnership working both within Government and with the voluntary sector was stressed as the key to success.
The Committee believes that, while autism may be primarily a health issue, other Departments, including education, employment and learning, social development and the justice system have a crucial role to play. The development of this Autism Action Plan offers an opportunity to broaden the approach to developing comprehensive services for people of all ages with autism and strongly recommends that you take this issue to the Executive seeking the establishment of a Ministerial sub-group to develop a joined-up approach to the issue.
The remaining comments relate to the detail of the draft Action Plan which has been generally welcomed by the autism organisations.
The Committee has some concerns that the Action Plan relates to the next three years only rather than developing a strategic approach for the next ten years and beyond. The autism groups also raised concerns that the Action Plan is targeted at the early years of autism and the groups highlighted the problems faced at various transition stages, particularly when moving on from formal education. It was stressed that people with autism are now looking for opportunities in further education or training and employment rather than depending on day facilities.
The difficulties around support for those who are diagnosed with autism in adulthood were also raised. The Committee notes that the introduction refers to the ‘urgent need to develop and improve services for people of all ages who are affected by ASD’. However, the National Autistic Association argued that by focusing solely on diagnosis, assessment and intervention for very young children it “will fail the majority of people in Northern Ireland who have autistic spectrum disorder”.
The Committee shares the concerns of the autism groups that the Action Plan does not give a complete picture of the prevalence of autism. It refers to 200 children who are born with autism each year but both organisations claim there are around 4,000 school age children and 17,000 adults with autism.
The Committee welcomes the extra funding to be provided over the period of the Action Plan but shares the concerns about the level of this funding and notes that it is lower than that recommended in the Independent Review.
The Committee learned that full-time autism co-ordinators have been appointed in each local authority in Wales and that three regional co-ordinators are in the process of being appointed. The Committee notes the concerns raised by the autism groups that within Trusts here mangers will be asked to take on a co-ordinating role on autism in addition their existing duties.
Finally, while the draft Action Plan acknowledges that partnership working with the voluntary and community groups is required, the groups expressed disappointment that the voluntary sector has not been given a more active role in delivering the plan.
I hope these comments are helpful.