The following amendments have been selected: amendment 1 in the name of Rhun ap Iorwerth, and amendments 2 and 3 in the name of Rebecca Evans.

We move on to item 9, which is the Welsh Conservatives debate. Before I call the mover of the motion, can I say I have—there's an awful lot of people who want to speak and therefore I have reduced the speaking time for supporting Members who wish to speak to three minutes and I'd be grateful if you could adhere to three minutes rather than the usual five, or for some of you, five plus, because you think I don't look at the clock. And that's so that we allow everybody to have their contribution. So, it does not affect the mover or the closing of the debate or the mover of the amendments. I call on Mark Isherwood to move the motion.

Motion NDM7124 Darren Millar

To propose that the National Assembly for Wales:

1. Notes the publication of the Evaluation of the Integrated Autism Service and the Autism Spectrum Disorder Strategic Action Plan final report on the 1 April 2019.

2. Further notes the written statement made by the Minister for Health and Social Services published on the 3 April 2019.

3. Regrets that the Welsh Government voted against the implementation of the Autism (Wales) Bill.

4. Acknowledges that, whilst the Autistic Spectrum Disorder Strategic Action Plan Annual Report 2018-2019 outlines the Welsh Government’s approach to developing autism services in Wales, there are a lack of outcome measures within the report on the delivery of the Autistic Spectrum Disorder Strategic Action Plan 2016.

5. Recognises that whilst some progress has been made to improve autism services in Wales, there are inconsistencies in the service and support offered which impacts on outcomes for autistic people and their families.

6. Calls on the Welsh Government to ensure the long-term sustainability of the integrated autism service and to deliver high quality autism support services by:

a) providing sufficient support and services to autistic people and their families that reflects the wide range of needs that they may have; ensuring that the service meets the expectations of users and strengthens the autistic voice by moving beyond autism awareness to autism empowerment;

b) developing a clear and consistent monitoring system to allow for more effective reporting of outcomes for autistic people;

c) clarifying the future funding arrangements for the integrated autism service beyond the initial funding period of March 2021 to provide certainty for service users;

d) placing the integrated autism service within a broader approach to support autistic people and to deliver the ‘priorities of action’ outlined in the Refreshed Autistic Spectrum Disorder Strategic Action Plan, including increasing education and employment opportunities;

e) working to implement the recommendations of the Evaluation of the Integrated Autism Service and the Autism Spectrum Disorder Strategic Action Plan as soon as practical.

Motion moved.

Diolch. People are born with lifelong autism spectrum conditions and autistic people see, hear and feel the world differently to other people. If you are autistic, you are autistic for life. Autism is not an illness or disease and cannot be cured. Often, people feel being autistic is a fundamental aspect of their own identity. Our motion recognises that, while some progress has been made to improve autism services in Wales, there are inconsistencies in the service and support offered, which impacts on outcomes for autistic people and their families.

It notes the publication of both the evaluation of the integrated autism service—or IAS—and the autism spectrum disorder strategic action plan final report in April, published at the end of March, and this month's Welsh Government autistic spectrum disorder strategic action plan annual report 2018-19, whilst acknowledging the lack of outcome measures within this report on the delivery of the 2016 autistic spectrum disorder strategic action plan. It therefore calls on the Welsh Government to deliver long-term sustainable, high-quality autism support services by implementing the recommendations of April's evaluation and ensuring that services strengthen the autistic voice by moving beyond autism awareness to autism empowerment, by developing a clear and consistent monitoring system, by clarifying future funding arrangements, and by delivering the priorities of action outlined in the refreshed autistic spectrum disorder strategic action plan, including education and employment opportunities.

As the Trades Union Congress's recently published toolkit, 'Autism awareness in the workplace' highlights, autistic employees can bring huge benefits to the workplace. Although Welsh Government documents continue to refer to ASDs—autism spectrum disorders—autistic people generally prefer the term 'autism spectrum conditions', ASCs, whereas the term 'disorder' is felt to be inaccurate, stigmatising and disparaging—please stop doing it.

As our motion also states, we regret that the Welsh Government voted against the implementation of the Autism (Wales) Bill. In so doing, we reflect the regret expressed to us by the autistic and autism communities across Wales. As I stated when proposing the Autism (Wales) Bill in the Chamber in October 2016, the autism community will not receive the support they know they need until there is statutory underpinning and accountability and we move beyond consultation to a direct role for professional and third sector bodies and the autism community in design, delivery and monitoring.

My staff and I have to repeatedly emphasise to public bodies that, when an autistic person is not given enough time to process information, it can lead to them feeling anxious and, in the worst-case scenario, they can have a meltdown, that, because autistic people may be oversensitive to some senses, under-sensitive to others, and often a combination of both, this can cause them pain and sensory overload, leading to a meltdown, and that a change to routine and structure can be very distressing for autistic people. It is therefore incumbent on public services to establish and adjust to an autistic person's social and communication needs, recognise the causes of an autistic person's heightened anxiety or meltdown, and therefore avoid treating the autistic person as the problem.

As the Special Educational Needs Tribunal for Wales recently ruled regarding the exclusion from school of a young autistic pupil I've worked with, the exclusion itself was discriminatory. As the parents of an autistic student recently told me, their daughter had been issued with a final written warning for unacceptable behaviour after returning to a further education college and finding that she'd been given the wrong instructions on which room to attend, despite the college knowing that she found it difficult to manage changes in routine or organisation. As the mother of an autistic student at the same college, who committed suicide last year, told me, 'He appeared just a quiet, bright young man; they don't see the struggle these kids go through every day to survive in a neurotypical world'.

The April evaluation recognises a number of improvements in the delivery of autism support services in Wales following the introduction of the IAS. However, the National Autistic Society Cymru commented that, whilst the evaluation is a positive step forward to see such a comprehensive outline of where we are in Wales, it also provides a clear picture of where improvements now need to happen. These include that there is no clear reporting on monitoring mechanisms developed for the IAS; autistic people, their families and professionals don't seem to have faith that there are sufficient services and support available to meet the wide range of needs that autistic people may have; that the focus on the IAS has been at the expense of other commitments, such as improving employment outcomes of autistic people; and that a lack of clarity on the future sustainability and funding of the IAS needs to be addressed.

The evaluation found inconsistencies across geographical areas that impact upon the effectiveness of the IAS, concerns that the IAS does not meet the service users' expectations due to delays in establishing the service, and that users want the IAS to do more, including working directly with children, which is not part of its remit. Service users, they said, are often unclear as to what support the IAS can provide and are often left frustrated when they cannot access the support services they require. It found that, although the IAS was intended to complement and strengthen but not replace existing services, this view was not shared by some stakeholders, and that long waiting times for adult assessment and diagnosis have increased sharply, with the new service uncovering a large, previously unmet demand.

Worryingly, the Welsh Government's 2018-19 ASD strategic action plan annual report provides little information on how it will implement the recommendations of April's independent evaluation, instead suggesting that most of the recommendations will be, quote, 'considered'. This report is vague in its proposals to financially support the development of the IAS beyond the current deadline, despite wide concern from service users, stakeholders and the integrated autism services themselves. And, whilst noting that good quality data is essential to understand the impact of service reforms and to plan future autism services, the Welsh Government report fails to provide sufficient information on how the Welsh Government and autism service stakeholders such as the IAS, the national autism team, regional partnership boards and local health boards undertake data collection and on how data is then used to inform the planning of services.

Well, the Welsh Conservative 2021 manifesto will include concrete funding proposals for sufficient, sustainable autism services in Wales, services that have been designed with the autistic and autism communities, and we encourage other parties to do the same. Although we must provide certainty to autistic people and their families, the lack of information provided by the Welsh Government is causing concern. An autistic IAS volunteer in north Wales has asked me to share his concern that, although the service could be a power for good, it could end up creating more gaps, that more people are being assessed but there is then nowhere for them to go, that his social worker has caused a huge issue by saying things but not keeping to them, that we need to get it right first time, not cause aggravation, which increases pressure on services, and that we need autistic people actively involved everyday.

Another autistic person involved in the IAS in north Wales told me that, overall, there are positives and negatives regarding the service. Some of the negatives, he said, can be fixed easily with better communication and training. However, he added, 'I believe the service is not meeting the need for most autistic individuals, including practical support, support around finances, organisations, skills, et cetera.' And that, he said, 'To be successful, I believe IAS needs to develop services that are bespoke to the autism community, including "what matters" assessments, conversations that are individually focused on client empowerment and choices.'

An autism professional told me the IAS roll-out has put extra strain on voluntary sector services to support people before and after diagnosis, with advocacy services at breaking point, and that the training materials she was given from ASDinfoWales had no depth and she had to create her own to promote better understanding of the condition and prevent exclusion. As well as being a professional, she has years of lived experience.

Autism community members in north Wales told me that the IAS appears surprised and confused that women and girls do not fit the criteria generally used for boys and men, and that many autistic parents of autistic children are seriously disadvantaged when dealing with education, social services and child and adolescent mental health services, because the IAS does not provide direct work with children. And, as a charity supporting children and young people on the spectrum told me, funding is not focused on the most important areas and gaps in service provision, including autism school training for all staff, resources at schools, autism-specific activities and clubs, parent support in times of crisis, respite services for families, and family outreach support. That's where the £13 million should be going.

We will support the Plaid Cymru amendment, although autism is already covered by the Equality Act 2010, as are other neurodiverse conditions, such as dyslexia. Worryingly, the Welsh Government's amendments dodge the calls in the independent evaluation they commissioned to address the weaknesses of the IAS as a matter of urgency, including, they said, a lack of published data and a lack of clarity over the long-term funding model. Please listen to the evaluation you commissioned and the evidenced recommendations they made.

Thank you. I have selected the three amendments to the motion, and I call on Helen Mary Jones to move amendment 1, tabled in the name of Rhun ap Iorwerth.

Amendment 1—Rhun ap Iorwerth

Insert new point at beginning of motion and renumber accordingly:

Believes that in order for people with autism to receive the best services possible, neurodiversity needs to be considered as an equalities issue in its own right, with having a non-neurotypical brain becoming a protected characteristic under equalities legislation, and public services responding accordingly.

Amendment 1 moved.

Diolch, Dirprwy Lywydd. I'm very grateful, and we are all on these benches very grateful, to the Conservative group for choosing this very important topic for their debate. I'd associate myself with much of what Mark Isherwood has said, and I won't trouble the Chamber or take the time to repeat it, but I think it is crucial that we do understand that, whatever changes and services are provided, the voices of people who are neurodiverse, including autistic people, have to be at the centre of that. We have to be sure that we are providing the services that people want and need to use, and not simply providing the services that are easy and convenient for those who are providing the services, and that is always the risk.

We share the regret that the legislation proposed by Paul Davies did not proceed. I think we all acknowledged, in that process, that the legislation wasn't perfect—it wasn't a done deal—but the Member had made it very clear that he was interested in looking at improvements and amendments, had the legislation been allowed to progress. And coming back to my point about listening to the voices of autistic people and their families, it's very, very clear to us that they felt that they needed their protections put on a statutory basis, that they needed to know what they could expect from services, and they needed enforceable rights. Now, of course that wasn't necessarily a universal view, but it was certainly the overwhelming response that I received as a member of the health committee and from my own region.

I'll speak briefly, if I may, Dirpwy Lywydd, to amendment 1. We do believe that neurodiversity needs to be a protected characteristic in its own right. I'll touch briefly on why, and my colleague Leanne Wood will say more in a moment. Because it isn't quite accurate to say that these conditions are fully covered by the Act, because in order to be fully covered by the Act as it stands, people have to demonstrate that in some way they are disabled by their condition, and there are many people, of course, in the community, who do not perceive themselves as being disabled in that sense, but they do know that they are discriminated against for being who they are. Some neurodiverse people are protected under the disability strand, but many, of course, also choose not to disclose their neurodiversity in the workplace, because they are afraid of being stereotyped in some way as odd and being discriminated against. So, we believe that a specific neurodiversity category in the legislation would help to address those issues, and would also help to raise awareness amongst employers, because this, of course, is a challenge that people face in their lives and in their communication—that it isn't always possible to see clearly. So, we believe that neurodiversity does need to be included as a separate and specific protected characteristic under the equality Act, though of course we would prefer that equality powers came to this, our Senedd, so that we could legislate here on this and all other equality matters.

I want to end what I'm going to say, Dirprwy Lywydd, with a few comments about the Government's amendments. I find it frustrating that they, as all too often, suggest that things are either fine as they are, or they very soon will be, which they clearly aren't, as anybody's constituency postbag can tell you. They replace the clear calls to action in the original motion with more consideration. Now, nobody wants people to rush and make the wrong decisions, but as Mark Isherwood has pointed out, this information has been with the Minister for three or four months now, since April. How much longer do we need to consider, and when can people see action?

And then of course we have the usual shifting of responsibility to the UK Government for part of the problem. Now, nobody on these benches, and me least of all, is going to be wanting to say nice things about this particular Conservative Government, and I am sure that it is very frustrating for the Welsh Government that they don't yet know what their budget is, but I feel that it's not exactly dignified to be putting that responsibility somewhere else. In the end, autistic people want to know what we are going to do. They don't want to see blame being placed elsewhere—however deservedly that blame may deserve to be placed. This is a pattern that I see in too much, frankly, of Government amendments from some quarters to opposition motions. If you don't agree, vote against it—that's fine. But to amend it so much that you make it meaningless, I challenge the purpose of that.

To return to this vital agenda, if we are to make progress on this vital agenda, we would benefit from some shared frankness about the challenges. That is much, much needed. We cannot ensure that every autistic and other neurodiverse person in our country is enabled and supported to live their fullest lives if we pretend that everything is okay now. I commend amendment 1, and we will support the motion unamended by the Government amendments.

Thank you. Can I ask the Minister for Health and Social Services to move formally amendments 2 and 3, tabled in the name of Rebecca Evans?

Amendment 2—Rebecca Evans

Delete point 3 and renumber accordingly.

Amendment 3—Rebecca Evans

In point 6, delete all after sub-point a and replace with:

building on the monitoring that exists within services to allow for more effective reporting of outcomes for autistic people;

clarifying the future funding arrangements for the integrated autism service beyond the initial funding period of March 2021 once we have the much awaited clarity from the UK Government of our settlement for 2020 – 21 and beyond;

placing the integrated autism service within a broader approach to support autistic people and to deliver the ‘priorities of action’ outlined in the Refreshed Autistic Spectrum Disorder Strategic Action Plan, including increasing education and employment opportunities;

working with partners and stakeholders to consider the recommendations of the Evaluation of the Integrated Autism Service and the Autism Spectrum Disorder Strategic Action Plan.

Amendments 2 and 3 moved.

Formally.

Thank you. Mohammad Asghar.

Thank you, Deputy Presiding Officer. Two years ago, I spoke in this Assembly in support of a Welsh Conservative motion seeking permission to introduce an autism Bill. Our proposed autism Bill would have made provision for meeting the needs of children and adults with autism spectrum condition. Its aim was to protect and promote the rights of some 34,000 people living with autism in Wales. The fact is that many autism sufferers do not receive the support that they need to help them to get on with their lives. They face challenges when trying to access employment, education, health and housing services. This makes it increasingly difficult for them to lead an independent life. The decision of the Welsh Government to vote down our motion was met with widespread dismay.

To be fair, the provision of services for people with autism in Wales has recently been improved, but these irregularities bring into question the effective—. Sorry. However, the evaluation of the integrated autism service and the refreshed autism action plan—. A recently published independent report says that there are a number of inconsistencies in support provided at the moment. These inconsistencies bring into question the effectiveness of the integrated autism service in delivering adequate support for service users and enabling autism empowerment as well as autism awareness.

These days, service users are often unclear as to what support the integrated autism service can provide. They are often left frustrated when they cannot access the support service they require. Deputy Presiding Officer, the Welsh Government must clarify what services people with autism can expect, and it must assess whether services need to be expanded to ensure that service users receive the support that they need in order to deliver on a stated commitment to take action to address any gaps or weaknesses in provision. We need a commitment to regularly review the progress of services that people with autism can expect, so a consistent level of care is delivered by service providers.

There are also irregularities in the support that each regional integrated autism service provides. This has created a postcode lottery in services. Many regional autism services do not comply with all the national standards. Presiding Officer, I still believe that we need statutory backing to protect the rights of autistic people and raise awareness of a complex condition. The Welsh Government must implement the recommendation contained in the plan as soon as it is practical. I support the motion.  

I asked Members of the National Autistic Society group in Blaenau Gwent to discuss this debate this afternoon, and to ask them what they thought about some of the services that they were receiving. I have to say that their conversation, which I heard over lunchtime, should make us all stop and think about the reality of services that too many people are receiving.

We spend a considerable amount of time talking about the pressures that exist on education and social services budgets, but quite often, we say that in the abstract. This morning, we had a very clear impact of how that affects people and children. In Blaenau Gwent, there's clearly a real lack of communication from the local authority. The local authority makes mistakes frequently with the information provided. E-mails are ignored. There's no feedback during processes, and little feedback or response to e-mails. People feel like they don't matter and the authority doesn't care. That's an appalling reflection on our local authority.

Too often—and I've seen this in my own caseload—to get into the local school in Pen-y-Cwm, it takes simply too long, and people and children are waiting much, much longer than they should do to have the education they need and deserve. When I stood in front of this place as a Minister responsible for additional learning needs, I gave all Members an undertaking that we would provide the greatest possible educational opportunity for all children and all young people. We have to deliver on that in ensuring that the resources and the structures that deliver that resource are available to people. That is not something that we can wish away.

All too often, GPs seem unsure of the appropriate routes for help, and GPs don't understand what should be provided for children or young people that are being presented to them. People are being told that they could try antipsychotic drugs to see whether that will work, and then come back in a few weeks if it doesn't. All too often, to get help and to access services from public bodies, the whole process is confusing. People feel lost in the system. People don't understand where they turn to for help and assistance. All too often we hear stories, usually from mothers who talk about what they go through in trying to deliver the services and the love and the support for their children. One individual woman this morning felt that parents had to reach a real crisis point to be able to access any help. Her son was self-harming and attempting suicide, and she had to call the police on a number of occasions. The services simply weren't there.

Transition from child to adult services is also a difficult and sometimes traumatic time—

Will you take an intervention?

I won't take an intervention because time is against me on this, but I hope that all other Members will have an opportunity to speak.

What I hope we can do this afternoon, Minister, is to shine a light on the reality of these stories. I voted with the Government in January on the issue of an autism Bill, and intellectually I'm not convinced by the argument for it. But I have to say to the Government that we have given very serious undertakings to the people of this country, and if we are unable to deliver on those undertakings, and provide them with the services they require, I will be supporting legislation to ensure that all public services work together to deliver those services in the future.

It's estimated that around 1 in 7 people, more than 15 per cent of the population of the UK, are neurodivergent, which means that the brain functions, learns and processes information differently. Different people experience neurodiversity differently. It's therefore important that people are not stereotyped according to the better-known characteristics. Not all autistic people, for example, will be good at maths or have some kind of hidden superpower. Neurodiversity is a form of human diversity. There's no such thing as a 'normal' or 'healthy' type of brain, just as there can be no normal or healthy gender or race or culture. I'm sure that most Assembly Members will be aware from their inboxes of the types of discrimination that autistic people can face. It's that discrimination that we are seeking to tackle with our amendment this afternoon.

Plaid Cymru wants to see neurodivergence as a separate protected characteristic. You could argue that, to some extent, the equality Act has already offered some limited protection for neurodivergence, as it could fall under a more general category of disability, but that's problematic, and I'd like to explain why. To get protection under this Act, a person would need a diagnosis, which we all know can be time consuming, and they would need proof that the condition significantly impairs day-to-day activities. This question shouldn't be looked at through the lens of disability. Neurodivergence doesn't necessarily impair somebody. With the right support, people can thrive. The issue is about understanding and adjustment, not necessarily disability.

The equality Act requires proof that a behaviour or circumstance would discriminate against a typical person with that condition, and that's difficult to enforce for neurodiversity as each condition affects an individual in a unique way. Labelling something as learning difficulties, as often happens, is not helpful. For many people, that term is associated with children, and many neurodivergent workers, for example, do not struggle to acquire new skills or under new concepts. Furthermore, there is no duty to make reasonable adjustments if the employer did not know or could not have reasonably been expected to know that a person was disabled within the meaning of the Act. However, almost three quarters of neurodivergent workers do not disclose their condition for fear of discrimination, and half of all workers who do disclose later regret doing so. And that is exactly why this discrimination should be outlawed. Every speaker here this afternoon accepts that the status quo cannot continue. We all acknowledge how people are being let down by our public services and by our entire society. Carrying on just saying that has to stop now. You on the Government side all voted down the legislation that was previously available to us on this. We now need deeds, not words. When will we see them?

Thank you, Deputy Presiding Officer, and I was honoured to have had the opportunity to bring forward proposals for autism legislation. And whilst the outcome wasn't what many of us had hoped for, the autism community and I can take some consolation from the fact that autism was at the top of the Assembly’s agenda for so long. Now, I'm not saying for one moment since my proposed Bill that there isn't some good work being done across Wales, because in some areas there has been some good progress. However, the problem remains that whilst there’s good practice in some parts of the country, in others, services are poor and there are unacceptably high waiting times for a diagnosis. That for me was the real crux of why autism legislation needed to be introduced in Wales, and the optimist in me sincerely hopes that the Welsh Government will still consider legislation if it’s been shown that their current strategies aren't successful.

I accept that the Welsh Government has introduced the integrated autism service, and the recent independent review highlighted some of the improvements that have been made, and I'm particularly pleased to see that the established services are working in person-centred ways, developing and adapting their services to meet the needs of individuals and groups. However, that same report later stated that the established services are still facing challenges in managing demand for assessment and diagnosis, therefore, it’s clear that much more work needs to take place to address these particular challenges. Let us also remember that those people living with autism in west Wales are only now seeing a service developed in their area, and it will be interesting to see how the new integrated autism service in my area will be developed, and the effect this will have on my constituents being able to access services.

One of the other concerns that I've received from talking to charities and third sector organisations who deliver support services for people with autism is the fact that people are referred to them from statutory bodies without receiving any financial support themselves. This is the message I received only very recently when I visited AP Cymru. Now this, in my view, needs to change. So I would urge the Minister to look at this very seriously and to change the funding infrastructure to make sure these organisations, who do a fantastic job in supporting autistic people, actually receive the financial support that they deserve. 

One of the key benefits of the proposed autism Bill was the very fact that it put a legal requirement on the Welsh Government to publish an autism strategy. The rationale behind this was to secure a measure of permanence and sustainability in providing services for people living with autism in Wales. Beyond the period of the revised autism strategic action plan 2016-20, there is simply no certainty of continued prioritisation of autism services in Wales. Furthermore, we know from autism legislation in other parts of the UK that legislation is needed to ensure that the momentum for improvement is not lost. Therefore, I hope that the Welsh Government will give serious consideration to this proposal and look at ways it can safeguard the prioritisation of autism services in the future.

Dirprwy Lywydd, whilst my attempt to see the proposed autism Bill passed in this Chamber may not have been successful, there is no reason why the Welsh Government can't take its aspects and incorporate them where applicable into its own programme and, indeed, into its own legislation in the future. I know the Welsh Government has brought forward a code of practice, and whilst it doesn't go far enough in my opinion, it at least shows a commitment from the Welsh Government. Therefore, in closing, Deputy Presiding Officer, I urge Members to support our motion this afternoon and send a statement to the autism community that we are listening and doing everything we can to address the challenges that people living with autism in Wales face.

I think that there’s a danger of us constantly having a glass-half-empty approach rather than acknowledging the progress that has been made as a result of the discussion that we've had in the Chamber and elsewhere. I've visited the integrated autism service for Cardiff and the Vale, which is based in Penarth, and I really admire the collaborative, prudent healthcare approach that they have. They're very careful not to spend too much time on simply diagnosing autism, in order to ensure that staff have enough time to provide support and guidance for people with autism. Because diagnosing autism doesn't actually change the problem; it's the support that's absolutely crucial.

So, I think there's been a lot of progress made, and I think we need to acknowledge that, but we do need to look at the staffing and funding model and whether it promotes partnership with the voluntary sector, which for me is a key issue to ensure that, instead of developing a medical model of provision, we strengthen the social model, where it's society that has to change, rather than adding to lists of equality issues. So, that's why I would oppose the Plaid amendment 1.

I'm very pleased to read that Estyn reports that person-centred planning has improved schools' and colleges' understanding of learners' needs and improved the relationships with family members and carers. Clearly, the learning with autism programme has improved the understanding of teachers who are teaching people with autism, but the take-up remains patchy. So, it's something that we definitely have to work on. But, as we increasingly move away from setting standards, which foster teaching to the test, and increasingly focus on how schools and colleges are adding value to each pupil's needs, I'm sure that there will be much more attention given to learning with autism and making sure that they are delivering for those children.

I just wanted to, in the short time I've got available, talk about two things. One is that I want to flag up a more child-friendly test for autism that's being developed in Canada, where they're using photographs of faces to be able to identify neurotypical children, as opposed to other children who are part of the study. These children spend a lot more time studying the mouth and significantly less time looking at the eyes of these pictures, and it's proving to be a much more accurate test of autism. So, that's something that is very important when we're dealing with children, because having psychologists and questionnaires assessing them isn't something that children will find useful—it's, indeed, intimidating.

The second thing is, in developing the social model, I'd like to applaud the GAME store in St David's shopping centre, which is working with people with autism, giving them awareness training and then hosting bi-monthly autism friendly nights, at times when the shopping centre and the store are quiet, making people with autism feel much more comfortable about going to the store and taking part in their games. This is one of only four areas in the UK that have been selected for this trial. So, I congratulate the GAME store in St David's. Thank you.

Autism is a range of conditions, as we know, that doesn't get discussed or debated sufficiently—one of the reasons why there remains a lack of understanding about its impact, so it's always good to have an opportunity like this to discuss this condition. There's still a stigma attached to it and we've all got a responsibility to address that. The lack of understanding can, as we know, result in fear of a diagnosis of autism or perhaps people not offering support because they perhaps don't know what support might be required. It was interesting what Jenny Rathbone just had to say about that test for autism where potential sufferers are shown the faces and look at the mouths, I think you said, more than the eyes. Fascinating research is being done into that area. 

General ignorance about autism is strange when you consider how prevalent autism is amongst the UK population. As we've heard, people with autism require additional help, not solely because of their condition, but because of the failings in the way that society responds to people with that condition. What a tragedy, and an avoidable one, and one that we can do a lot to addresses. According to the National Autistic Society, 70 per cent of autistic children have been suspended from school at one point or another, around half of those have been suspended persistently on three or more occasions, and only 16 per cent of autistic adults are in full-time paid employment, and a similar proportion are in some other kind of paid work. Should autism itself necessarily be a barrier to work? Well of course it shouldn't. We've really got to move beyond some of the old-fashioned ideas about autism. 

More than one in three adults with autism experience severe mental health challenges, but, again, this isn't necessarily directly related to autism, but the support, or lack of support, we as a society offer to those people. At this point I would like to mention the invaluable work of groups such as Mencap Cymru in my area, in Chepstow, an organisation that's been running for 40 years and has had great success in dealing with young people with a range of difficulties, of learning difficulties, and also a number of people with severe autism. There are many other groups out there that are working equally hard in all of our constituencies and they really are making a real difference on the ground, where it matters.

There's a lot more that we can do to support people with autism, so let's look at some of the things that we can do. As Helen Mary Jones and others rightly said, I, like many people across Wales, remain disappointed and frustrated that we missed an opportunity to embed the rights of autistic people through a bespoke autism Act. I know the Welsh Government had its reasons for saying there was another route to take instead of an Act, but I am one of those who believe that an Act would help to embed those rights in the statute book. And I hope Members will, perhaps, have an opportunity in future to revive plans for a dedicated autism Bill for Wales.

But there are other things that we can do to support people with autism, as Paul Davies said. We need progress on the Government's action plan for people with ASD. We need to have the introduction of some clearer outcome measures and more effective monitoring.

In closing, Dirprwy Lywydd, in the run-up to 2021, I do hope that all parties here would commit to protecting funding for this vital service. I think if we all come together on this issue, we really can make the progress we need to see. 

When I spoke in the debate on the Bill in January, I mentioned the fact that my daughter was awaiting a diagnosis for autism, and she received that diagnosis in February. Tomorrow is her fourth birthday, and some of the things I said at the time were: will she be able to remain in school; how can I help her overcome her frustration at not being able to tell me what she wants; will we ever be able to hold a conversation; how can we approach toilet training if she doesn't understand the concept; who can teach me to help her; and will she ever be able to tell me that she loves me? And I have to say that the support we've received has been incredible. We've received brilliant support. We've been to toileting workshops as parents and she has speech and language support at school. I would say that there is a delay and a wait for EarlyBird training. We are still waiting for that, and I think we'll be waiting for six months after the diagnosis. So there remain problems. 

I voted against the Bill, but let me say that I would not have voted with the whip. I voted on a decision, having taken advice from many different sources in my constituency. I took advice from the health board, I took advice from Trinity Fields School, and the acclaimed autistic spectrum service that operates there. And the Minister came to visit. And I think an awful lot of this—and I have to say, and I'm speaking now as a parent, I feel an awful lot of this has been the politicisation of autism by parties in this Chamber. I have to say I feel that way and I feel that it has been fed—[Interruption.] Janet Finch-Saunders is shaking her head; you shouted 'Shame' at me when I said I wasn't going to support the Bill last time. 

The National Autistic Society is complicit in this. When I read the National Autistic Society's Facebook page, I read some of the comments immediately after the debate, and here are some of the comments that are still on that page today. This is what they said about us as Assembly Members who voted against the Bill: 'Give them an autistic child or a child with special needs and see how they vote then.' 'Welsh Labour are a sack of—expletive. They really couldn't give a toss about autism and individuals and families affected by it.' Someone else said: 'Name and shame the heartless—expletive—who voted against this Bill.' And there was another one who said, 'Maybe MPs who voted to block this Bill should spend a week with families caring for children and adults with ASD.' The National Autistic Society have made no attempt whatsoever to address the inaccuracies—[Interruption.] 

Mark Isherwood rose—

I'm not taking an intervention.

The National Autistic Society have made no attempt whatsoever to address the inaccuracies in these comments. I've written to the National Autistic Society, and they said, 'We don't monitor our feed 24 hours a day. We will remove any profanities and posts that are inappropriate.' The inappropriate posts are still there and the profanities are still there. They are not educating parents as to why a Bill would or would not be appropriate. They are part of the political game with this. 

I am pleased, and I have a lot of common ground with Members of all parties who've said that we have made progress and have also raised the issue of the condition, rather than a disorder; I fully agree with that. But I would say to Leanne Wood, who raised a concern, the status quo isn't continuing. Change is happening; I've seen it. But I have concerns and I think that the wording of the motion today is better, and this debate has been better than the debate on the original Bill, but please, if we are going to make progress, let's make progress on a cross-party basis.

I'd like to thank the Welsh Conservatives for tabling this debate. The Welsh Government rejected Paul’s autism Bill, telling us that we didn't need an autism Act because the Welsh Government is delivering real change in services for those on the autism spectrum. But that's not always so, is it? Because Welsh Government assertions do not match delivery on the front line.

We are failing on diagnostic waiting times, and Welsh Government introduced a waiting time for referral to neurodevelopmental assessment that is twice the waiting time suggested by NICE guidelines. There is no Wales-wide data for this waiting time, but anecdotal evidence from some patients suggests that the 26-week target is not being met. Demand for services is far outstripping supply in many areas. Many adults are unable to receive a diagnosis, and are therefore left without support. This was one of the key reasons for the creation of the integrated autism service. The lack of data collection and reporting makes it difficult to assess whether the Welsh Government’s assertion that the services simply need time to bed in is accurate. For the past two years, we were supposed to receive data on waiting times for diagnostics, and to date this information has not been published for children, young people or adults.

The 'Evaluation of the Integrated Autism Service and the Autism Spectrum Disorder Strategic Action Plan' report by doctors Holtom and Lloyd-Jones from People and Work makes it clear that while there has been progress, there is a lack of resources and a postcode lottery of support for adults on the autism spectrum. The report clearly highlights our failure to support adults on the spectrum, and it is telling that most of the adults who contributed to the report were not diagnosed before they experienced a crisis. This is not good enough. And I still maintain that Wales needs an autism Act, and until we get our act together, people of all ages on the spectrum will suffer as a consequence. As doctors Holtom and Lloyd-Jones point out, access to social care remains difficult despite the existence of the Social Services and Well-being (Wales) Act 2014.

If the Welsh Government will not support an autism Act, then they must fully implement the recommendations of the 'Evaluation of the Integrated Autism Service and the Autism Spectrum Disorder Strategic Action Plan' report. The committees, following their pre-legislative scrutiny of Paul Davies’s autism Bill—. We have made progress, but this progress is not fast enough, and change is not happening quickly enough. We have been discussing improvements to autism services for many years, yet we are still letting down autistic people and their families. It is time for the Welsh Government to act or to introduce the Act that we have all been calling for. We can’t afford more wasted years, and those on the spectrum can’t wait much longer. Diolch yn fawr.

I'm standing this afternoon and I'm agreeing with a lot of what's been said by Members across the Chamber. We all have experience among constituents, and we actually have a father who has identified here experiencing his own situation. If you know Hefin David, you will know that he is telling it from the heart, and telling it as it is. 

We need to ensure that the services are right. Let's not hide from the fact that services are not working fully totally. I keep getting constituents coming to see me explaining the difficulties they're facing. They're facing challenges and barriers. They are exhausted, they are shattered and tired. They're going to deal with their children. They're going into the school to try and fight for their children. They're going into the education system to fight for their children, and some of those children are now adults as well. Employment issues are still to be addressed. 

But we are moving forward; the autism report highlights there is progress. Now, regarding the inconsistencies, I fully understand why there are inconsistencies because when that was produced in April, the service in my area wasn't even up and running. It's only been up and running since April, and I've met with the lead. When we talk about the Bill, because it's in there, I voted against it; Paul Davies knows my views very heavily. But I looked at the expert advice, I looked at the opinions from various doctors and royal colleges and, actually, having spoken to the lead of the autism services in my area, who is a parent of autistic children herself, she said that the Bill was wrong. It wouldn't have worked. So, in a sense, you can do emotional arguments, but people don't want emotional arguments—they want results and they want support. And that's where we're failing, I think, in one sense: how do we ensure the support is there on a timely basis? And that's what this really is about. We shouldn't be trying to put it—I don't want to criticise it, but we should be ensuring that, when we have our constituents coming in, when they're coming to us with anyone who has an autistic member of their family, whether it be a child or a sibling, we should be able to ensure that they are getting the support they need. And they shouldn't have to fight for it. That's the battle we've got to fight here. Sometimes, that's addressing the public bodies and making sure the public bodies are delivering those services. One parent this week came to see me, and the child was diagnosed as autistic—so the diagnosis is there—and has a statement, but the local authority is still not delivering on the needs of that child, who is going into full-time education in September, and really they need one-to-one support because that's what's been said both by the assessment and the school he's currently in. That's the mechanism, that's the area we need to focus on. Let's deliver the services that these people need, make sure that they're getting it. And that means we have to make sure we deliver the right criteria—[Interruption.]—yes, funding, I totally agree, you can't deliver some of those services without funding, but we need to focus on what they need to ensure that their families and those individuals with autism can get the life they should have.

Diolch, Dirprwy Lywydd. As with Hefin David, I have to declare an interest in that my near-five-year-old granddaughter is autistic. Whilst her autism was diagnosed very early on, I believe this was by chance rather than by local agency intervention. A teacher at the nursery that she attended had an autistic child herself and so alerted us to the fact that she was showing autistic traits. Her parents immediately sought advice, and it must be said that the support they are receiving post recognition has been excellent and the support from the teaching staff at her nursery has been exemplary.

However, it remains a fact that many autistic children are not diagnosed at an early stage, and so much-needed interventions do not occur. In many instances, parents have faced a long and difficult fight to have their child diagnosed, leading to great stress and a prolonged wait for help and advice. Perhaps the Minister could comment on progress made in this critical area. We must, of course, acknowledge here the setting up of the national development team and the excellent progress they are making, particularly in the area of autism awareness training, which they are rolling out across both the public and private sectors. We also accept that this is very much still work in progress, but results so far are very encouraging, and we congratulate the team on their achievements since its inception.

Could the Minister indicate where he feels the next priorities lie for the development team? We should also acknowledge that local autistic groups do an excellent job in bringing parents of autistic children together, and they give help and support to those who are in touch. There's no better intervention for the parents of autistic children than that of parents of an autistic child. However, if a child is not diagnosed as autistic, parents of such children are often not aware of such groups and so lose out on the much-needed support. Will the Minister outline his support for such groups?

Although there has been substantial progress over recent years, it does appear that the support services are still piecemeal, where some areas give excellent support post diagnosis, while others fall short of providing the support needed. We would hope that a development board will alleviate this problem in the future by providing the basis for a more joined-up provision, thus facilitating a more consistent service across all local authorities and health boards.

Finally, Minister, as a grandparent of an autistic child, I thank the Government for their positive interventions thus far but urge you to make sure that adequate funding is made available so that these services may be maintained in future years. And will the Minister outline how the Government will commit to this future funding?

Thank you. Can I now call the Minister for Health and Social Services, Vaughan Gething?

Thank you, Deputy Presiding Officer. I welcome this opportunity to update Members on the work being done to improve support with and for autistic people. I'm pleased that the motion recognises that there has been genuine improvement, but there is, of course, more to do. And I do want to say at the outset that I do recognise the genuine commitment of Members right across this Chamber who have spoken—and equally those who have not—to deliver practical help and support across Wales to improve the lives of autistic people and their families. In particular, I do recognise the impact on families where improvement is not being made. I see that both as a Minister with my own engagement but equally in my own role as a constituency Assembly Member.

So, it is important not just for Members but also for autistic people, their families and carers that the Welsh Government is transparent about the extent and quality of current service provision. That's why I published the second annual report about the Welsh Government's autism strategy. It provides clear information on the delivery of our commitments in the autism delivery plan. That report summarises the progress that we are making against each of the objectives in the delivery plan, and alongside that, the national autism team has also published an annual report demonstrating the range of their success in delivering on their annual work plan, and the report clearly shows the support for the roll-out of the integrated autism service. There are now strong partnerships in place, additional awareness raising and training is taking place, and there is a real emphasis on the involvement of autistic people in their work. That involvement was evidenced at the recent national autism conference for adults, which was co-produced by autistic people. I am very pleased to say there was positive feedback for autistic people who participated, though I'd recognise this is a group in our society who have regularly told me that they can feel invisible and that their needs can be overlooked.

The work of the national team does, however, demonstrate that better really is possible. To continue the national team's work, I've agreed funding of over £145,000 to support the delivery of their work plan for this year, and I agree with the sentiments behind the motion that the reforms we're making must meet autistic people's needs and improve their individual outcomes.

Since 2015, we've taken targeted action through the children and young people programme. Its neurodevelopmental work stream now has dedicated neurodevelopmental teams in each area and we've established national service standards and referral pathways. As we near the end of this programme, we're working to establish proper legacy arrangements to ensure that the progress made in neurodevelopmental services continues in future years and to ensure transparency in the state of our progress, Public Health Wales will publish over the summer a report that reflects the service's position against each of their agreed service standards. It will make recommendations on where future developments should focus.

We must also ensure that services are supported to achieve the 26-week waiting time standard for assessment. Health boards have begun reporting data to the Welsh Government and we're working with them to make sure that data quality returns are up to a standard to enable us to publish them as part of a national data set. And so I'm happy to remake the commitment to do so. The neurodevelopmental services are also working to develop richer and outcome-based monitoring arrangements. Those will reflect improvements in individual outcomes.

And for the integrated autism service, all seven regions are now open and we're implementing an outcome-focused data monitoring system supported by Data Cymru. This data will provide information on how each service is delivering on the agreed service standards and include returns of parent, carer and autistic adults' feedback.

Each service is also using the outcomes star approach to measure the distance travelled by each individual supported through the service. In this way, we will have a clear picture on how the integrated autism service is benefiting people seeking support. The data collector has been piloted to test quality and consistency and we will make it publicly available as soon as is possible.

Earlier this year, we published the independent evaluation of the delivery of the integrated autism service. It recognises the commitment by health boards and local authorities to work together to launch the service in each area of Wales. I'm supporting further evaluation of the service and the autism strategy this year.

The integrated autism service is funded to at least 2021. I've made that decision with a risk against future budgets, and during that time we'll continue to support and monitor its development. I will be in a position to consider future funding once we do have some clarity from the UK Government on our settlement for 2021 and beyond.

So, we are making real progress, but I know from speaking with and listening to autistic people that there is still a distance to travel and I have never tried to claim otherwise. We'll continue to seek feedback on our reforms and to address real barriers to improvement. So, we're listening to stakeholder concerns gathered through evaluation and through the scrutiny of the autism Bill and the recent consultation on the autism code.

My officials recently met with representatives from royal colleges to discuss continuing pressures on health services. And those workforce challenges are real, and they're not easily solvable, but we have a plan and we are making more progress. I want to see the pace and scale of that improvement continue to increase, and to be transparent about the progress that we have made and the challenges that still remain. So, I've commissioned an additional review on the continuing barriers to reducing assessment waiting times and alignment of autism and neurodevelopmental services, and, again, I will publish that report as soon as it is available. I expect it to be so over the summer. 

It confirms to me, though, the concerns that I've heard directly from families and autism support groups about demand and capacity in assessment services for children and adults. It is evident that there is a clear need to understand in detail how the pressures impact upon current services, and by that I mean autism services and related mental health and children's services. So, we'll undertake this work with our partners over the next year. I will provide more detail on our plans once they're finalised. 

Finally, we are progressing our autism improvement programme with the delivery of an autism code of practice under the Social Services and Well-being (Wales) Act 2014 and the National Health Service (Wales) Act 2006. Earlier this year, we consulted on our proposals. We held seven engagement events across Wales with the autistic community and we received 65 written responses. I published the consultation summary of responses last week and I'm pleased that, in general, there is good support for our approach. Over the next few months, we will continue to work with stakeholders, including, of course, autistic people themselves, to develop the code. This will include examining all of the recommendations that have been made through committee reports, our evaluation, recent consultations, and to map our priorities for action.

We intend to publish the draft code of practice for public consultation by the end of this calendar year. It is vital that the autism code that we introduce is deliverable, so we have to ensure that the services expected to deliver the duties it contains are equipped to do the job without detriment to other services that other people will continue to rely upon. The work that we are embarking on now will inform future decisions on the longer term funding and reconfiguration of services for people with neurodevelopmental conditions and autistic people. I remain fully committed, as I have stated on a number of occasions in the past, to ensuring that services continue to improve and to the long-term investment that I recognise will be needed to make that happen.

Thank you. Can I call on Janet Finch-Saunders to reply to the debate?

Thank you, Deputy Presiding Officer, and thank you, Minister for your response. But, let's be clear here today, no-one can doubt that the Welsh Conservatives and others in this Chamber are passionate about ensuring the improvement of sufficient provision for those with autism and their families. We've been reminded of this only today and need only to look back to January, when the Welsh Labour Government shamefully rejected the Bill by Paul Davies AM, the autism (Wales) Bill. A Bill that—

Will you take an intervention?

No, I won't, no. 

A Bill that, when it came forward in 2015, was voted through. Yet, it is after that stage that the politicisation came in—[Interruption.] I'm sorry, Hefin, but that's the fact.

As my colleagues in this Chamber have explained, it is paramount to the overall success of the IAS that the Welsh Government fully considers the issues raised by the evaluation of the integrated autism service and the autism spectrum disorder strategic action plan final report, and that it implements its recommendations. Indeed, even the National Autistic Society Cymru has described it as providing a clear picture of where improvements now need to happen. Mark Isherwood was quite right to highlight the calls for better implementation, strengthening autism empowerment and an action plan for education and employment and the value that they bring to the workplace.

The Welsh Government has nowhere to hide, so it needs to agree to the change requested by Members sitting on these benches and some over there. Indeed, it is not acceptable to simply advise that this will be considered by the Welsh Government autism policy team as part of the development of the autism code of practice and policy development in 2019-20.

I am concerned about the fact that the autism spectrum disorder strategic action plan annual report 2018-19 is vague in its proposals, and many of my constituents and their families are. There needs to be financial support to support the development of the IAS beyond the 2021 deadline. Surely, service users should be given relief now through you agreeing to clarify the future funding arrangements for the integrated autism service. Calls have been made for the development of a clear and consistent monitoring system to provide sufficient support and services to those with autism and their families that reflect the wide range of needs that they may have, placing the integrated autism service within a broader approach to support autistic people and to deliver the priorities of action including the increasing of education opportunities.

Helen Mary, you were quite right to endorse the need to listen to the families in all this and those suffering with autism—how they can actually play a part in delivering the very services that they need, and how, sadly, as of today, people with autism—[Interruption.] What's outrageous is that you rejected the Bill, so enough said from you.

I implore the Chamber to agree to our motion.

Can you wind it up, please?

Okay. We are fed up on these benches of 'delete all and replace with'. It's about time you had respect for your opposition, it's about time that you had respect for all Members in this Assembly, and when a Member has the chance to introduce a Bill, it's about time that you actually showed some brave—

Are you winding up, please?

—and allowed Bills like that to go through. Frankly, it is me that's ashamed of you and your benches.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Thank you. We'll defer voting under this item until voting time.

Voting deferred until voting time.