3. Statement by the Cabinet Secretary for Health and Social Services: The Autistic Spectrum Disorder Strategic Action Plan

– in the Senedd at 2:58 pm on 19 June 2018.

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Photo of Elin Jones Elin Jones Plaid Cymru 2:58, 19 June 2018

(Translated)

We'll move on, therefore, to the statement by the Cabinet Secretary for Health and Social Services on the autistic spectrum disorder strategic action plan. I call on the Cabinet Secretary to make his statement—Vaughan Gething.

Photo of Vaughan Gething Vaughan Gething Labour 2:59, 19 June 2018

Diolch, Llywydd. The Welsh Government re-affirmed our commitment to improve the lives of autistic people in November 2016 when we published the new autistic spectrum disorder action plan, backed by £13 million of investment in new services. Today, we published the first annual report on the delivery of the action plan. I am pleased to reflect the achievements of all those involved in responding to the challenges we have set. The real progress made this year reflects on our vision for delivery. Innovation and collaboration have helped to establish a strong basis for future success.

The most significant achievement this year has been to establish a national integrated autism service, creating consistent support for people with autism. It has been a time of great energy as new ways of working are established between agencies working in partnership in what is a complex environment. There is great pride in the achievement that the integrated autism service is open in Cardiff and Vale, Cwm Taf, Gwent and Powys. It will be launched next week in north Wales and will open later in this financial year in Western Bay and west Wales. I am very pleased to see that we are receiving very positive feedback. This includes participants reporting that this is the first time that they have felt listened to.

(Translated)

The Deputy Presiding Officer (Ann Jones) took the Chair.

Photo of Vaughan Gething Vaughan Gething Labour 3:00, 19 June 2018

The progress we are making would not be possible without the support of the ASD national development team that is hosted by the Welsh Local Government Association. It published its annual report today also, and I understand that a statement highlighting that has gone around to Members from the WLGA. The team is working with regions to develop the integrated service and to promote engagement and good practice across Wales. The team has a long-established role in raising awareness of autism, publishing a wide range of resources and information, which is freely available on their ASDinfoWales website. 

Just two of the team’s notable achievements over the last year include the extension of the Learning with Autism programme. In addition to the primary school scheme, the secondary school and early years schemes have been launched and are being rolled out. Eighty schools have now completed the primary school programme, with nearly 13,000 children becoming autism superheroes. The Can You See Me? campaign is also being delivered, aimed at improving awareness of autism in local communities. The campaign film and resources are being rolled out in partnership with local parents, carers and businesses across Wales. Successes so far include awards achieved by Merthyr Tydfil shopping centre and McArthurGlen Bridgend shopping outlet, and training has been provided to Swansea City Association Football Club.

Although we are making good progress, we know that there is still much more to do. We continue to look carefully at the issues that autistic people say matter most to them to inform future action. Waiting times for assessment is a priority for many, and since 2015, we have invested an additional £2 million a year in children’s neurodevelopmental services, introducing a new 26-week waiting time standard from referral to first-assessment appointment, which we are now piloting. We want to make further progress, and this year, we are looking at good practice in some areas that is already achieving results in reducing waiting times, with the aim of replicating that success and good practice across Wales.

I understand that for parents of autistic children, the most pressing issue is often to ensure that their child is receiving the right educational support to help them achieve their full potential. Earlier this year, the Additional Learning Needs and Education Tribunal (Wales) Act 2018 was passed. That will pave the way for the transformation of support for children with additional needs up to the age of 25, creating a unified legal framework that will put learners and their parents at the centre of how to plan and meet their needs. The reforms will also focus on skills development in the workforce to deliver effective support for learners, and there will be easier access to specialist support, information and advice. The new system will be rolled out in a phased approach from September 2020. 

Over this Assembly term, we want to focus all our efforts on delivering the ASD strategic action plan, embedding the new integrated service, and delivering on all our other commitments. I have considered carefully the calls for autism legislation and the proposals contained in the draft Assembly Member-led Autism (Wales) Bill. It is clear that we are all focused on ensuring that we invest in autism services in the longer term. The difference between us is in how we seek to achieve those aims.

I do understand that the prospect of autism legislation that is specific is attractive to many. It's clear that the intention of the draft legislation, as we have seen it, is to underpin existing duties and expectations on public bodies to provide services and support for autistic people. Public bodies are, of course, already required to provide needs-based services for people who require care and support—autistic people and their carers already have the same entitlement to access to services, just as every other citizen in Wales. 

We are already delivering some much-needed improvements in autism services. I don't believe that costly and resource-intensive legislation will bring additional benefits for autistic people beyond the practical commitments to improve services that we are already completely committed to. In my view, it would be better to invest time and money in ensuring that we deliver on our firm commitments and to ensure that there is a focus on continuous improvement as the new services that we are putting in place become established.

To further support service improvement, I intend to highlight the needs of autistic people and the requirement to meet those needs across statutory services by introducing a code of practice on the delivery of autism services. This is already being developed in partnership with autistic people. It will provide clarity on the support that people with autism can expect to receive and provide guidance on how services can adapt their practice to meet the individual needs of people with autism. We will be consulting on our plans later this year, and I encourage everyone to engage with that consultation to make sure we focus on the issues that really matter. We will also update our delivery plan and reflect the feedback we receive on service delivery.

The calls for improvement in autism services are not falling on deaf ears. We are taking action to achieve the improved outcomes that everyone wants to see. We are raising awareness of autism across services, improving access to assessment and diagnosis and putting in place additional specialist support in every region of Wales. We will continue to listen, and I will keep an open mind on the potential need for autism-specific legislation in the future, if it becomes clear through evaluation that the improvements that we all want to see can only be delivered by taking this route.

Photo of Mark Isherwood Mark Isherwood Conservative 3:06, 19 June 2018

Thank you for your statement. I have to say the vast amount of autism-related casework my office is handling and the personal stories from outside of north Wales we're receiving indicate that huge sums of money continue to be spent getting it, sadly, very, very and sometimes tragically wrong. How do you respond to concerns raised with me that one of the four integrated autism service, or IAS, areas where the service has been launched are now saying they just want to become a diagnostic service and lose their support worker function? Another area is already making representations that, despite already receiving an extra £150,000 to £170,000 annually from local authorities and health boards on top of their IAS funding, they can't cope with the level of referrals they're receiving, and these are medical, not social referrals, not focused on prevention and intervention. Concern has been expressed to me that the majority of people accessing current non-IAS services will disappear or present in crisis. There is a concern about the lack of numbers being picked up by the IAS and the lack of services from IAS to pick up the slack from third sector bodies that, progressively, are losing local support, despite being supported sometimes by hundreds of local members of the autism community.

You referred to the 26-week waiting time standard from referral to first-assessment appointment. What measures have the Welsh Government put in place to take action when health boards aren't meeting that target? Is the waiting-time data being updated quarterly, and if not, what action is the Welsh Government taking?

How many autistic people have benefited from employment as a result of the Getting Ahead 2 programme? Did the Welsh Government achieve accreditation in the 'positive about working with autism' charter last year, and how is it maintaining its accreditation this year and beyond?

How many people have accessed the integrated service in each of the four health boards where the service was launched, which professionals have received awareness training, and what are the priority areas, as we look forward, on that? Of course, in addition to awareness training, which is often led by non-autistic people who are professionals in the medical or caring professions, which have a medical focus, what action are you taking or will you take to address the massive deficit in autism acceptance and equality training led by trainers who are autistic people or members of the autism community, focused on autistic and non-autistic people working together to overcome the disabling barriers in society?

Has the advisory group agreed a work plan? Will the Welsh Government publish that work plan if it has? How is the Welsh Government responding to the recommendations contained in the interim independent evaluation of its autism strategy and integrated autism service, which found weaknesses and inconsistencies in both assessment and diagnostic services for adults with autism and in support services for adults and children with autism? It said

'Success requires a co-productive approach involving staff, service users and carers in the design, implementation and evaluation of the IAS.'

But there are concerns about the top-down approach, which they said had 'stifled this'. 

With the service being launched in north Wales on 27 June, as you said, what action will you be taking when you learn of stories that I raised last week, such as those of the judicial review proceedings settled recently, prior to a full hearing, when Flintshire council agreed to provide a formal apology and make a damages award after failing to assess and meet the needs of an autistic young person with additional needs, and to take full account of her parent carers' needs? That's just one case. I have I don't know how many similar cases—primarily but not exclusively in Flintshire—at the moment. How would you respond to the Flintshire parent who e-mailed me yesterday regarding the response to her Flintshire CAMHS complaint, which said, 'Your daughter doesn't have an ongoing anxiety condition', and was simply an apology for poor communication, but they'd been forced to a private psychiatrist because of lack of care, who has diagnosed the daughter with severe PTSD, depression and anxiety? She says, 'We're now glad we're getting treatment and a recommendation for home tutoring, thanks to our private psychiatrist, but my daughter should have received this when she asked Flintshire CAMHS for help six months ago.'

I've nearly finished, but a key issue is the genderised issue. I've raised this many times, but I'm still almost daily receiving casework where girls clearly requiring autism diagnoses are being told they couldn't possibly have a diagnosis. A letter, for instance, from the health board here:

'It's difficult to marry the description of difficulties given by some families with the information from teaching staff who report no or minimal issues in the school environment. This is not indicative of children with ASD', when a wealth of national and international research and evidence directly contradicts that, in relation to the masking and coping strategies that many children, and particularly girls, adopt.

You say that calls for autism legislation—

Photo of Ann Jones Ann Jones Labour 3:11, 19 June 2018

No, I'm sorry. [Interruption.] Well, you've had several questions and you're well into six minutes, nearly, so if you can say it within the next 30 seconds, you can get your last question in.

Photo of Mark Isherwood Mark Isherwood Conservative

How can you possibly say that unless you bring in statutory duties to provide the support from statutory services that these people and countless others need, that you're going to be able to meet their needs with this service? Until and without enforcement of your existing legislation, such as the social services and well-being Act, how can you possibly tell how well you're doing currently?

Photo of Ann Jones Ann Jones Labour 3:12, 19 June 2018

Minister, and you don't have to answer all that set of questions, or we'll be here till tomorrow.

Photo of Vaughan Gething Vaughan Gething Labour

Regrettably, I recognise your point, Deputy Presiding Officer. I won't be able to answer the more than a dozen different points put, with respect to the Member and others who wish to respond. But, to be fair, a number of those, the points raised, are individual ones, and there are some more general ones. If the Member wants to write to me with the detail that he has set out, then I'll happily ensure that the appropriate person responds to him. And, of course, I will also be at the cross-party group tomorrow to answer questions and have a conversation with people there.

I think there are a couple of points that I'd make in response to what the Member said. Thinking about his final point about the need for legislation or otherwise, actually, part of the answer is what you were saying about the enforcement of existing duties that are already set out, and the challenge in making those rights real. Part of what we are seeking to do in investing in the integrated service is to make that real. It's also what the code of practice is aimed at trying to highlight and to try and make real for families. So, this isn't a way of trying to say that we think that you are wrong and the examples you are raising are not true. I recognise that, for lots of families, this is a real and significant challenge for children and adults with autism too. This is about how we actually make sure they really do get to achieve their potential. I have some personal insight into this as well, from my own family, so I do understand that this is not an easy challenge that should be glibly dismissed or glossed over. That's why, even in these most difficult financial times, we've invested £13 million into the service. It's why we should all take some pride in the roll-out of the integrated service, and the feedback that we're talking about is direct feedback from families themselves about the difference that the service has already made, and that is a real difference—it is not simply something concocted or a work of fiction to try and get through a challenge here.

Our challenge, though, of course, is not just about understanding what has been successful when the service has been rolled out, but to understand how we try and adapt and apply that learning to the areas where the service has not yet been rolled out. It is also, in accepting that there really is positive feedback to the integrated service, to recognise that it isn't perfect—no human service ever is—but to understand how, in those examples where the service has not met the needs of those individuals and their families, we learn from that to inform improvement, because that is the point: there will not be a standstill time. I will have more to say on waiting times after the pilot has been completed, and I will of course make sure that that is publicly available. My hope is that they become official statistics, in which case, they'll be readily available on a month-to-month basis for all Members to scrutinise. But, no doubt, we'll continue to discuss these general themes, not just today but for a significant period of time to come, in particular as I expect that the Member will be producing his Bill before we go into summer recess.

Photo of Rhun ap Iorwerth Rhun ap Iorwerth Plaid Cymru 3:15, 19 June 2018

(Translated)

I'll try and keep my comments brief. I think that I have about four questions here. In terms of the statistics that are gathered, a target has been set of 26 weeks in terms of waiting for the first assessment—and the data is being gathered. When are we going to have this data being published, because I think that any data that's available has to be published?

In terms of passing the Additional Learning Needs and Education Tribunal (Wales) Bill, the concerns about the lack of resources to support that Bill have been very evident. Could the Cabinet Secretary explain which resources the Government intends to provide to support local authorities in implementing that Bill?

There is a piece of legislation that's starting its journey through the Assembly. The statement has rejected the idea of legislating, and cost is one of the main arguments against that legislation. Will the Cabinet Secretary accept that the legislation itself won't cost anything? That is, the cost will stem from any financial implications stemming from the content of the legislation that will mainly deal with embedding the right to services in law. If you intend to meet those objectives by improving services, there will be no real additional cost, but at least having legal guarantees—and this is where legislation is useful—will give some certainty to a minority group that their services won't be the first to go every time local authorities face financial challenges.

I think that's the third one; so the fourth one is that the statement doesn't mention employment. Just 16 per cent of adults with autism are in full-time employed work, and only 32 per cent are in any kind of employment. Could the Cabinet Secretary provide more details about how you intend to reverse this situation, because years of partnerships and encouragement aren't working, obviously?

Photo of Vaughan Gething Vaughan Gething Labour 3:17, 19 June 2018

Thank you for the questions. On your final point, there's a recognition that we seek to achieve a cultural change. This isn't simply about families with people with autism, but actually about the support they receive in the workplace and the attitudes of different employers. Within the report published today, you see direct examples of people who have been helped by the service to remain in employment if they are in employment, or to seek employment as well. The challenge is how we don't set up a service to fail, but how this is part of wanting to change our national conversation and trying to change the amount of practical support that is available to businesses and to their employees. But I recognise that there is a significant road to travel here, just as there are in a number of other areas, but that is part of the commitment that was set out in the integrated service.

I'll deal with your point about waiting times now. The 26-week target: there will be more information available internally, within the Government, this autumn as we look again at the roll-out of the waiting time standards. We need to be certain, before we roll out the target and we start publishing information, that it is robust and reliable. All of us have had experience in the past of trying to roll out waiting time standards with them not been available, and then—where they've not been ready in the robust way that they should be, rather—that then causes a lack of confidence in what the figures are. I'm not trying to hide the figures; I’m not trying to make sure that they only come out when they look good for me. I'm really interested in making sure that they're actually genuinely reliable, because I expect there will be a variation in learning between different parts of Wales. But I want to make sure that they are robust, that they can be relied upon, and that they help to drive some improvement in measures that actually matter and have real impact on families.

On your point about the cost to legislation, there is always a cost to legislation, not just a cost to this place in the mechanics of running, but there's a challenge here in terms of the cost and in terms of the time and resource that is available to practitioners, to the policy team here centrally, and what that then means in terms of diverting that attention to go into a legislative process as opposed to being focused on improvement. Legislation won't produce more money. We will still have the sum of money that we have available to the Government, and we'll still have to make choices about that, together with our partners in other services. I'm most interested in understanding for the people delivering the service and taking part in it the difference it's made, and what our real prospects are for delivering the sort of improvement that, as I say, each of us in this room would want to see.

Your point about statutory services—we already have statutory requirements for ourselves, the health service, local government and partners to achieve and to deliver on. We need to make sure those are made real, and that's part of the reason why I'm moving forward with the code of practice, because I do recognise that there will be people who will understand and who will tell their own story about what has happened, and about where their needs have not been met in the way in which we envisaged the legislation would do. I think we have to get that legislation right and make those rights real, and that would, could and should make a real difference to those families as well.

Photo of Caroline Jones Caroline Jones UKIP 3:20, 19 June 2018

Thank you for your statement, Cabinet Secretary, and for providing an advance copy of the 'Autism Spectrum Disorder Strategic Action Plan: Annual report 2017/18'. I'm pleased that the Welsh Government are investing in services and that progress is being made. However, the evaluation of the integrated autism service and the autistic spectrum disorder strategic action plan interim reports, by Dr Holtom and Dr Lloyd Jones from People and Work, make it clear that there has been a failure to drive systemic change that has helped create a postcode lottery of support for adults on the autism spectrum.

This is not news to any of us who have been campaigning for an autism Act. The Welsh Government might have good intentions, but people living on the spectrum are not seeing delivery on the ground. Despite the roll-out of the integrated autism service, many parts of Wales still have no clear pathways to diagnosis. The interim report highlighted the fact that, although funding has not been an issue when it comes to establishing the new integrated service, the regional partnership boards had little capacity for developing the service.

The fact that the first integrated autism service was established appears to be down to the hard work and dedication of the national ASD lead, but as the interim report highlights, this is a lot of strain to place one person under. Success or failure shouldn't rest upon the actions of a single individual. Cabinet Secretary, what actions are you taking to ensure that future roll-out plans are not reliant on a single individual, no matter how talented?

I recognise that one of the key achievements of the strategic action plan was the introduction of the 26-week waiting-time target for neurodevelopmental assessment. Cabinet Secretary, can you confirm that this target is being met by all health boards? If not, do you have a timescale in place for when you expect all health boards to meet their targets?

Finally, Cabinet Secretary, while I remain unconvinced that Wales does not need an autism Act, I am prepared to work with you in order to deliver improved services for people in Wales on the autism spectrum, and hopefully in 12 months' time you will have convinced me that legislation was indeed unnecessary. I look forward to seeing what progress can be made in the coming year. Diolch.

Photo of Vaughan Gething Vaughan Gething Labour 3:23, 19 June 2018

Thank you for the comments. I think I've dealt with the challenges and the points about waiting times already. I recognise what you say about your current view on legislation, but being open to the possibility that if we may be able to make sufficient improvement, the prospect of more legislation may not be something you would support. I think there is a challenge here about the practical purpose of the legislation that Paul Davies is minded to introduce. I would say it's about a shared objective, about improving services, about making sure there is greater certainty for families about the support that they can expect, and to make sure that the needs of people with autism are properly met.

That is why the integrated service that operates in four regions is important to us, because if you think about the practical services we will need to deliver, the experiences of those families in those areas interacting with the service, their awareness of the service, and equally the front-line staff that we will need to deliver that service—to be fair, you made points about staff as well, and in particular not relying on a single individual to deliver the whole service, and I recognise that a service wholly reliant on an individual is not a sustainable model to roll out across the country. We can, though, say that the integrated service is seeing a welcome increase in autism expertise as more clinicians are being recruited. The model that we've provided is actually more attractive to staff who want to come in to work in a way that is joined up with other health and care professionals. Crucially, we're seeing families respond to that and recognising that they are having their needs listened to and met. As I said earlier, that will not always be perfect, but it is a real improvement that we are delivering. 

You mentioned the interim evaluation report. Again, it honestly reflects that there were differing visions and priorities at the start, but those are largely resolved, and each region where the service is rolled out is proud of their achievements and recognise they've made a real difference. That's the point. We want a service that won't just be something that a politician can stand up and celebrate and wave around an annual report, but a service that people would recognise—the people who work in that service, the people who interact with that service and take part in the services that are provided would recognise—as making a real difference, the difference that all of us wish to see for these families. 

Photo of Jenny Rathbone Jenny Rathbone Labour 3:26, 19 June 2018

Thank you very much for your report. It's very heartwarming to know that there's good work going on with our schools to ensure that they are as inclusive as possible. Where possible, we need to be including young people with autism into mainstream schools, but where it's not possible we obviously need to ensure that we have excellent services for those with the greatest disabilities. So, I think that's definitely to be welcomed. 

I just wanted to ask you about the services available for adults on the autistic spectrum. One of the voluntary organisations that works with people with autism is Autism Spectrum Connections Cymru, which is based in the city centre of Cardiff in my constituency. They mainly support people with Asperger's. They've had hundreds of referrals, mainly from Cardiff and the Vale, but also from other south-east Wales local authorities. I think, whilst assessment is important, support services are also important. One of the examples that was given in the ASD development team's annual report was support to ensure that employers and employees, where the employee has autism, understand the needs of each other. There was a case study there that was very good that was done by Cardiff and the Vale and I'm sure there's a lot more work needed to be done there.

But, I think my main question really is: how integrated is the national integrated autism service in relation to prudent healthcare and operating both with people who have autism as well as the voluntary organisations who support them? What role does the voluntary sector play in delivering the autism strategic action plan? How does the autistic spectrum development team decide which voluntary groups they work with and which ones they fund? Because Autism Spectrum Connections Cymru doesn't receive any funding at all, even though they're obviously supporting hundreds of people.

Photo of Vaughan Gething Vaughan Gething Labour

You raise an interesting point. I think the real examples in the national ASD development team report will see a range of different age ranges in there, from children to teenagers to adults and older adults as well. It's about how they've been helped at various different points through their life stage, and actually lots of people go through life without having a diagnosis and the potential support that can mean. Lots of people manage to cope, but it's about what coping looks like that's actually still allowing someone to achieve their potential. There's a challenge there about having a diagnosis that they will find difficult later in life as well. The challenge about how integrated the service is, though, is still about understanding the needs of the population and understanding how those needs are met.

I'm sure there will be a variety of third sector groups that will be providing services and support and, as ever, there is a challenge about how those services are run, funded and then signposted between different people. Lots of people in the third sector don't look for money, they look for acknowledgement of what they do and that they're part of being the answer. I couldn't comment on the particular organisation referred to and the fact they aren't funded through the service. If you want to have a specific conversation about that, I'd be happy to do so, but I don't want to get into a more general point, because what I don't want is that there's somehow—sometimes, when you announce money around a service, it's as if people want to bid into that service as opposed to how do we make the whole service work to meet the needs of the population. That's what I'm most interested in. If you think the particular group that you referred to could be part of that answer, then I'm happy to have a conversation with you about that. 

Photo of Paul Davies Paul Davies Conservative 3:30, 19 June 2018

As the Cabinet Secretary has said today, he is, of course, aware of my intention to bring forward primary legislation to help improve the lives of people living with autism in Wales, and I'm very disappointed that the Cabinet Secretary in his statement today is currently ruling out the need for primary legislation. I would urge him to reconsider his position, because it's clear from the two consultations I've held that there is overwhelming support for a Bill, and I hope, therefore, that he and the Welsh Government will reconsider their position and engage through the legislative process and help deliver an autism Bill that this institution and the autism community can be proud of.

Now, I accept that the Welsh Government has made some progress in some areas, although I think it's clear that the Welsh Government's introduction of a code confirms the fact that the current strategy clearly isn't meeting the needs of the autism community. The autism community has overwhelmingly made it clear that they favour legislation, given their responses to my consultation. Therefore, does the Cabinet Secretary at the very least agree that the views of service users in Wales must be at the heart of any direction of travel for autism services in the future?

The Cabinet Secretary has today made it clear that he intends to introduce a code, and, of course, the problem with introducing a code is that it can always be revoked and it cannot be changed or amended by this Parliament once it is presented to this place. However, my proposed autism Bill will enable Members to amend the legislation through the legislative process, and an Act will ensure a level of permanence to the delivery of services, as well as giving autism a statutory identity. And so perhaps the Cabinet Secretary can tell us how he believes a code will address these concerns and how a code will deliver the improvements in services that the autism community wants to see.

And, finally, Deputy Presiding Officer, given that the Government does not believe in currently introducing legislation, can he confirm that the Government will therefore be giving its backbenchers a free vote when my Bill travels through the legislative process, given that some of his colleagues have been supportive of placing services on a statutory footing?

Photo of Vaughan Gething Vaughan Gething Labour 3:32, 19 June 2018

On the final point, any legislation that comes through this place, the Government won't, at this early stage, be negotiating or outlining how we'll look to work with members of our own group, with members who support the Government. We'd need to see the detail of any legislation and to take a view on it, Paul, and it's important that we do that. I don't think people would agree with the fiction that there's somehow not a view on it, and I'm being honest about this. We've had an honest disagreement about the right way forward to improve the lives of people with autism, and we can continue to disagree, but I don't want to set out that level of disagreement or the nature of it in a way that isn't honest. I don't want to try to say something here that you and I know that I wouldn't really agree to do and support. 

Part of our challenge is that, the legislation in England, I can't see any real evidence that it's led to a significant and sustainable improvement in services. And so I'm looking for whether legislation will really deliver and deliver the sort of improvements you and I both want to see, and be a better way to do that than the path we've set out with the resources we have already made available. I think lots of people have a lack of faith that politicians will deliver on their promises and sometimes that leads to people saying, 'Change the law and that will make sure that services happen.' Actually, it still requires a variety of different decisions to be made, and that includes the budget choices we made, and it includes the work we've already done with different partners to deliver the four integrated services that are making a real and positive difference to families in those four parts of the country, and that we are committed to rolling out. 

And, in terms of a code and the point and the purpose, well, you know as well as I, because we've had these conversations in the past, that the code is about trying to make sure that we deliver on the responsibilities that actually exist already within statute, to make sure that they're real rather than illusory or simply talked about and pointed to in a piece of legislation but not made real for people. And I know from my previous life—I'm a lawyer in recovery as opposed to a lawyer who's been dragged back into it, looking at my poor, misfortunate colleague Jeremy Miles. I used to be a lawyer, and so I'm well aware that, in dealing with the law, the rights that people have are only real if you can enforce them. And what does that mean? And it's always better to help to give people advice so they can actually deal with their rights and responsibilities in a way that doesn't require the involvement of lawyers. There's a challenge there about making sure that it's a real way of working, and the culture change that we talk about—that's what we're trying to deliver and make sure that that leads to an improvement in service.

And on your point about whether people should be at the centre of our direction of travel, yes, that's absolutely right—you see that in a range of different areas across the Government, a range of different activities. That's why, in my initial statement, I made it clear that people with autism are part of helping us to draft the code that we're looking to. So, we'll continue to involve people with autism, we'll continue to listen to them, their real lived experience, to make sure that the shared objectives we have are being delivered upon. That's the aim and objective of this Government, and that will continue to guide us in our approach to services and any future debate about legislation.

Photo of Neil McEvoy Neil McEvoy Independent 3:35, 19 June 2018

There have been so many good questions raised today, some good points made. I want to focus on two things, really. Generally, this Government makes policies sound good—the lovely buzz words—but the reality at the sharp end and the front line is somewhat different. I wanted to focus firstly on integrated autism services and referrals. Because, in Rhondda Cynon Taf, there have been none; in Powys, there have been none; in Cardiff, 10; and, in Gwent, 130. So, the first thing is: how do you explain the disparity in that, and what can be done to improve matters? Secondly, the autism-aware businesses, which sounds really good on paper—it sounds good listening to it in the Chamber, but I wondered if you'd outline to everybody in the Chamber, and the public, exactly what you have to do to become an autism-aware business.

Photo of Vaughan Gething Vaughan Gething Labour 3:36, 19 June 2018

There's training and support provided to businesses to become autism aware. I'll happily send a note from the annual report about those businesses that have done it, the ones that I've mentioned in my statement, and the sort of training that they've undertaken to become autism-aware businesses. And, again, it will depend on the nature of the business, about those people and what they're doing in their interaction. So, I'll happily send a note on—

Photo of Ann Jones Ann Jones Labour

No. There's no giving way on a statement.

Photo of Vaughan Gething Vaughan Gething Labour

I'll happily send a note—[Interruption.]

Photo of Ann Jones Ann Jones Labour

No, there's no giving way on a statement.

Photo of Vaughan Gething Vaughan Gething Labour

I'll happily send a note on what that looks like, rather than getting into a row on an important issue across the Chamber. And I don't quite recognise the figures that you've quoted on the activity of the integrated autism services. In the report that's been published today you can see the nature and the range of different activity that's undertaken by each of those integrated services. And so, in each area, you'll find people coming in to the service, being supported, and achieving different outcomes. I am a little puzzled about the figures that he's provided. If he wants to write to me, setting out where he's got those from, I'll happily respond to him and make sure that there is a level of priority about that too.

Photo of Ann Jones Ann Jones Labour

Thank you very much, Cabinet Secretary.