That this House takes note of the Report from the Autism Act 2009 Committee Time to deliver: The Autism Act 2009 and the new autism strategy (HL Paper 205, Session 2024–26).

My Lords, I am delighted to introduce this important and timely debate. I thank the members of the committee for their hard work, dedication and thoughtfulness. I thank our specialist adviser, Professor Laura Crane, professor of autism studies at the School of Education at the University of Birmingham, for her expert guidance. I also thank our outstanding staff team—Stuart Stoner, Lucy Valsamidis, Abdullah Ahmad, Clayton Gurney and Aneela Mahmood —for their incredible support.

Most of all, I thank everyone who engaged with our inquiry. We were constantly struck by the moving and powerful testimonies. Without all those who engaged, our report would just not have been possible.

The Autism Act 2009 is a landmark law for and about autistic people. The Act began as a Private Member’s Bill but won government support thanks to the tireless efforts of its sponsor, the late right honourable Cheryl Gillan MP, and we pay enormous tribute to her today. The Act requires the Government to produce an autism strategy for England, backed up by statutory guidance. Our committee’s task was to examine how well the Act has been implemented and to inform the development of a new autism strategy ahead of the expiry of the current strategy, which is this July—next month. A key priority for us was to carry out our inquiry in partnership with autistic people and those who support them.

We took oral evidence from, incredibly, nearly 70 witnesses and received written evidence from almost 400 individuals and organisations. Several thousand people also contributed through surveys and consultation exercises. I think that speaks volumes for the engagement and importance of the topic. We also spoke in private to dozens of autistic people and those who support them, including invaluable visits to CareTrade’s employment scheme at St Thomas’ Hospital, just over the river, and Phoenix School in Tower Hamlets.

When the Autism Act was passed, autistic people were often invisible. The Act really helped change that, making government recognise and respond to their needs. When the Act was passed, about one in 100 people were estimated to be autistic—diagnosis rates are now higher than that among younger people but still far lower among older people. That rise is in part because of our understanding of autism, and it has evolved. But there are also worrying signs that more autistic people are struggling. The inequalities are unacceptable and, in many cases, widening. More than 270,000 people are now waiting for an autism assessment, only about three in 10 autistic people are in work and, on average, autistic people live shorter lives.

The Government’s autism strategy for 2021-26 set out laudable ambitions decided in consultation with autistic people and their families but, after the first year, successive Governments produced no plan to deliver or fund the strategy. It is now time to change that. Our central recommendation is that the Government must deliver a new autism strategy, taking effect when the current strategy expires next month. The Minister for Care, Stephen Kinnock MP, assured us that the Government are

“absolutely committed … to there being a strategy … and to there being an implementation plan”.

He said

“the strategy that we will bring forward is being shaped as we speak”,

and the Government will be

“developing the strategy in 2026”

and

“the input from this Committee will help us shape that strategy”.

But—and I am sad that I have to say “but”—the Government’s response to our report was markedly vaguer, saying:

“We recognise that meaningful engagement will take time, so a balance will need to be struck as to what level of further engagement is required, and the current strategy will remain in force while we do this”.

This is simply just not good enough. The strategy’s expiry date is now weeks away and we seem no closer to delivering for autistic people. Can the Minister tell the House what will happen when the current strategy expires? When will the new strategy come into effect? How are the Government ensuring that the new strategy reflects the findings of our report? How will the Government meaningfully involve autistic people and those who support them in the development of the new strategy? Most importantly, how will they ensure accountability for delivering the change autistic people need?

Our report examined progress against the ambitions in the 2021 autism strategy, and I will address these in turn. First, we considered how to improve public understanding. Awareness of autism has rapidly grown in recent years, but public understanding has not kept pace. The 2021 autism strategy promised a

“public understanding and acceptance initiative”,

but that never materialised. Sadly, many told us that stigma has since increased. We called on the Government to run a public understanding campaign and to commission and evaluate mandatory training for public-facing staff. The Government told us they would “consider” this recommendation. Further inaction is inexcusable, so will the Minister clarify what concrete action the Government will now take to deliver a public understanding campaign and ensure effective training for public-facing staff?

Secondly, we examined systems for identification, assessment and support. Time and again, we heard from our witnesses the powerful evidence of how autism diagnosis changes lives. However, the autism assessment system can also be a bottleneck, giving overstretched services a means to ration access to support. The assessment system is now unfit for purpose. Thousands wait years for a diagnosis and receive little to no support, even when it comes. We called for the Government to move towards a stepped, lifelong model of support, but many fear that moving away from a diagnosis-led model will become an excuse to withhold what little support now exists. The Government’s independent review into mental health, ADHD and autism could offer a real opportunity for a new approach. I would welcome the Minister explaining how the Government will reform and rebuild our broken systems for autism identification, assessment and support, in partnership with autistic people and those who support them.

Thirdly, we considered how to reduce health inequalities and the life expectancy gap. We were truly honoured to take evidence from Paula McGowan OBE, who campaigned successfully for the introduction of the Oliver McGowan mandatory training for health and care staff after her son’s tragic death. We pay tribute to Paula and to Oliver’s memory. We must build on this progress, so will the Minister now commit to setting out a plan to enable autistic people to live healthier, longer lives? Many autistic people still fall into the cracks between mental health and social care services, and too often this leads to crisis. We heard truly courageous testimony from many young autistic people who had been detained for years in mental health hospitals. We called for a national framework for low-level support to prevent care needs developing, and a plan to build strong community services, including appropriate housing, for people at risk of in-patient admission. The Government’s response promised only an annual statement on implementation of the Mental Health Act, and in the longer term a national care service, but neither of those is a plan. Will the Minister tell us how the Government will stop unnecessary detention in mental health units once and for all?

Next, we examined how to secure equal access to education and employment. We are setting up a new generation of young autistic people to struggle. Thousands are unhappy at school or are out of school altogether. The right honourable Alan Milburn’s recent review starkly showed how we are failing the million young people who are not in employment, education or training. A disproportionate number of them are autistic. We recommended that the Government build up capability for educating autistic children and young people in all settings, supporting the best special schools to become centres of excellence. The Government’s planned reforms to the SEND system offer a real opportunity to make schools more inclusive, but we also know how worried many are about changes to their rights to specialist support. It is vital that reforms are taken forward in partnership with young autistic people and their families. Young autistic people consistently told us how they face what they describe as a cliff edge in access to support when they become adults and enter the world of work. We called on the Government to develop integrated services to help them through this critical transition. Can the Minister tell us how the Government will ensure that every young autistic person has the support they need to give them the very best start in adult life, including implementing the recommendations of the Keep Britain Working review?

Finally, we looked at improving support in the criminal justice system. Like anyone else, autistic people can come into contact with the criminal justice system as victims, witnesses or offenders. But autistic people’s needs are often unmet, leaving them at risk of disproportionate disadvantage. I welcome efforts to deliver the cross-government neurodiversity action plan for adults in the criminal justice system, but the reality is that support remains patchy. Will the Minister tell us how the Government will ensure that the criminal justice system treats every autistic person fairly?

The 2021 government autism strategy set a goal that every autistic person should have the support they need to live a full and happy life. Together we can make that a reality, but to do that we need a new strategy, a credible plan to deliver it and clear accountability for change. It is time to deliver the change that autistic people in this country need to see. I beg to move.

My Lords, I begin by declaring an interest: I am a vice-president of the National Autistic Society, an honour I share with my friend, the noble Baroness, Lady Browning. More than that, I thank the noble Baroness for her work in persuading the Liaison Committee to agree to set up this committee of inquiry in the first place. She and I started out working together on that, but when I was appointed leader of the British delegation to the Council of Europe, the noble Baroness, Lady Browning, did the heavy lifting alone and I thank her for that. I also thank the chair of the committee, and the committee itself, for coming forward with a report that is imaginative and shows us a way forward.

“Autistic young people can thrive in the right environment and collapse in the wrong one”.

Those were the words of Alan Milburn in his interim report Young People and Work. The report revealed that among young people who are not in employment, education or training, 22% cited autism as their main limiting condition. Milburn went on to say that benefits assessments

“lend themselves to a binary judgement”

of whether a person is able or unable to work, but this approach does not match the reality of many young people’s life-changing conditions. Autism is a life-changing condition. Seven out of every 10 autistic people want to be in work, but only three out of 10 are actually in work.

Like many, I want to see autistic people in a job, building up their confidence and giving them the opportunity to enjoy the quality of life that we all expect. The recommendations in this report offer us hope of progress, and I certainly hope—Hope with a big H—to see a more positive response from the Government than we have seen so far.

The Autism Act was a critical step forward in the recognition of autistic people, yet successive Governments have failed to deliver the change. With the greatest respect to my noble friend on the Front Bench and the noble Lord who will be responding for the Opposition, I can tell them that Dame Cheryl Gillan—who took the Autism Bill through Parliament and with whom I served on the Council of Europe, where we produced a major report on the problems that autistic people are facing across Europe—would certainly have plenty to say about the failures of Governments of all parties if she were with us today. She would be telling Ministers to take this report’s recommendations seriously and to engage with the charitable and voluntary sector to embrace the reforms it proposes.

My most immediate concern is the next autism strategy. It is the key to deciding priorities and making sure those priorities are delivered. The Act placed a strict legal duty on the Government to prepare and regularly review a national strategy to meet the needs of autistic people by improving local services. Is it not alarming to realise that after the first year of the 2021-26 strategy, there was no plan to deliver or fund it? That is a scandal. That strategy will end soon, and the Government say it will remain in place until a new strategy is agreed. Of that new strategy, the Government say that meaningful engagement will take place, but how long will that take? How long will we have to wait?

In response to the report, the Government praise the committee for the large amount of evidence it gathered. In view of that, I ask my noble friend to use that evidence, much of it given to the committee by autism charities and experts in caring and supporting people with autism and their families. Use it in working up the new strategy; I can tell her that it will save countless hours of research by her civil servants. The committee has done the work for you, so use the work that it has done.

The report points to a way we should all embrace and welcome. It calls for the new strategy to identify priority outcomes and produce a costed, deliverable plan to achieve those outcomes. The strategy should make clear who is responsible and accountable for delivery. To me that is common sense; having said that, I remember that when I was growing up, my mother would say to me, “Son, in life, sense is not that common”. Despite that, I plead with my noble friend to take the common-sense approach. Use the findings of this report to build on the new strategy, and do it right away.

My Lords, it was a privilege to serve on this committee under the chairmanship of the noble Baroness, Lady Rock. It was a privilege not only because of the outstanding way in which our work was guided by her and supported by our clerk, our policy analyst, and our specialist adviser, but because that team brought us into contact with so many autistic people, and others with lived experience. This, of course, was what our committee was all about.

The initiatives that were taken by our team went far beyond what normally happens in committee work. This is an important point that must be made. There will be other cases where the lived experience of those whose issues a committee is considering will matter very much, hence our invitation to the relevant committees to consider ways in which such meaningful involvement can be achieved in the future, if necessary by making changes to the current rules.

It is impossible in the few minutes I have to go over every issue that is discussed in this report. As I look back over our work, however, there are one or two points to which I would like to draw attention. The first relates to the importance of diagnosis: the benefits it may bring and the harm that may be done by a failure to diagnose before other interventions are resorted to that may be wholly unsuitable. One of our autistic witnesses spent four years in a mental hospital before a diagnosis revealed what their condition really was. For obvious reasons, we did not explore the reasons for the mistaken placement in that hospital, which was such an unsuitable place for an autistic person to be. The dramatic change that enabled them to lead as normal a life as possible following release from hospital was deeply moving. The new autism strategy to be developed by the Government must ensure that mistakes of that kind do not occur again.

The other side of the coin was revealed during a visit to a special school for children and young people. All the pupils have a diagnosis of autism, or are waiting for one, and all have complex needs and are disadvantaged academically. We met a group of parents who told us of the effect that early diagnosis had had on them and their children. As one parent put it, “Before the diagnosis, I was just talking to my son. After diagnosis, I am talking with him”. An unreachable child had become reachable once the reason for the condition was explained and understood. The new autism strategy needs to address the problem that, far too often, access to a diagnosis is not available. Early diagnosis can make all the difference, not only to the child but to their family.

I turn to the matter of employment. The Government’s new autism strategy should make it a priority objective to increase the employment rate for autistic people. Some of our witnesses drew attention to the risks that taking on an autistic person would involve: there were fears that they would be unlikely to fit in, and of the disadvantages they face in the recruitment process. There is a really positive case to be made here, however, that should point the way forward. One witness—speaking as the neurodiversity and social mobility manager at Babcock International, a major employer—told us that around 20% to 30% of its employees are neurodivergent. That is a remarkable number and includes some brilliantly talented people who, as he told us, challenge the stereotypes of autism and have been able to solve problems that no other engineer could. This positive message needs to be broadcast and built on by the Government. With the right support and in the right place, autistic people have so much good to give to this country. They are valued members of the community.

I have time to mention one other matter which relates to the understanding of autism and the fact that, of course, every autistic person is different. There is no one size that fits all. This matters very much in education, especially for those who are teaching autistic children in mainstream schools. These people may struggle if their needs and fears are not appreciated and addressed. As each case is different, the teacher must be given time to assess the child, to win their confidence and to find out what is wrong. The pressures on the curriculum too often mean that this much-needed time is simply not available. That needs to be changed and the Government need to address it in the proper way, so that teachers can give these people what they need to develop their education and move forward to employment.

My Lords, I am very grateful for this opportunity to speak in this short debate, as I was to serve on the Select Committee, although I did experience certain frustrations. I thank the noble Baroness, Lady Rock, for her huge commitment to autism and the balanced way in which she chaired the committee. I also thank the clerk, advisers, researchers and staff, who had to cope with a huge volume of evidence and of witnesses who appeared before us. I thank the numerous organisations that gave evidence, in person or in written form. I also acknowledge our debt to the noble Baroness, Lady Browning, who has campaigned on these issues for several decades, and who was instrumental in getting the 2009 Act on to the statute book.

I mentioned frustration, This arose from having been involved for several years in Autism Cymru and being a Member of this House not domiciled in England. In my 27 years in the Commons, I was heavily involved in disability campaigning and, on returning to the Chamber in 2011, I looked forward to resuming such campaigning work, not least in association with the much-loved late Lord Rix at Mencap. But, on returning, I found myself in no man’s land, because many aspects of disability politics had been devolved.

As stated in paragraph 31 of the report, the UK Government’s autism strategy applies “to England only”. As noble Lords may appreciate, my role in the committee was at times limited and sometimes a cause of personal frustration. I put this on the record as it might be relevant to the authorities of the House when they select Members to serve on “England only” committees in future. The committee invited and received evidence from the Governments of Wales, Scotland and Northern Ireland, which was appreciated but could be only tangential to this inquiry.

I regret the very limited consideration given by our committee to international practices, which I raised at an early stage because of the huge benefits I had experienced as a member of the Brussels-based Autism Europe. In representing Autism Cymru on that committee, I learned a huge amount relating to good practice in European countries, including many outside the EU. It is my feeling that we could have benefited by considering what lessons we could learn from such European countries.

As soon as it was public, I passed a copy of our report to a senior member of Autism Europe, Mrs Liga Berzina of Latvia, which stated that there are certainly aspects of autism policies in England which rightly get international praise, such as the Autism Act, the ongoing development of a national autism strategy and the SEND framework of educational, health and care plans. From her experience, a key dimension is that every school should have an additional learning needs co-ordinator, with support delivered through individual development plans. Just as other countries benefit from studying experience in England, surely we at Westminster can benefit from considering successful initiatives in other countries.

With regard to the welter of evidence submitted to us, I had three abiding thoughts. First, of all the challenges and experiences we were trying to encapsulate in an integrated approach, there needs to be a flexibility to cope with the huge diversity of challenges and opportunities facing those on the spectrum; such policy applications must therefore be local, as they relate to individual needs. Secondly, we must always see the abilities and potential of those who experience such challenges. It was quite stimulating to receive evidence from such witnesses, and that underscores our responsibility to secure from government a fitting response. Thirdly, our aspirations cannot be secured without additional resources. The magnitude of the cohort crudely described as being “on the spectrum” has grown hugely as our understanding of individual needs has matured. As these individuals get the opportunity to blossom, such policies in due course bear fruit. If the Government merely respond that “There is no more available cash”, they simply have their priorities wrong.

Despite my doubts about serving on this committee, for the reasons outlined, I support the recommendations and hope that the Government will give them an urgent and positive response.

My Lords, when we speak about autism and—to expand the debate today—neurodivergence, we are speaking about people with their own strengths, challenges, perspectives and ways of experiencing the world. One point that has stayed with me came from a teacher who described the autistic spectrum as being like a unique combination of different balloons carried by each individual person. Some balloons may represent communication, sensory processing, anxiety, social interaction, confidence or learning styles; the combination is different for every person.

The report rightly highlights that many neurodivergent people continue to experience inequalities across healthcare, education, employment and wider society. Too often, support remains inconsistent and fragmented. We know that, with the right support at an early age and throughout education, neurodivergent children and young people can flourish and reach their fullest potential. Early identification, informed teaching and appropriate support matter, alongside ensuring that families and carers have access to clear guidance and support. Those with lived experience, together with their families and carers, should help shape the support and services available.

Importantly, autism and neurodivergence do not disappear in adulthood. Too often, support falls away once a young person leaves school or transitions into adult services. Many neurodivergent adults continue to face barriers in employment, healthcare and mental health support. That is why I strongly support an all-age approach, something that the committee recognises clearly in its report.

As someone from local government, I emphasise the critical role that councils and local partnerships play in delivering meaningful change. Local authorities are often the front door to support for families through schools, SEND services, housing, adult social care, public health and community services. In Lewisham, our all-age autism strategy brings together education, health, social care, employers and community partners to create a more autism-inclusive borough. A central principle of that strategy is “nothing about us without us”, ensuring that people with lived experience, families and carers help to shape services and decisions.

We should work closely with local authorities across all regions and nations of the United Kingdom to ensure greater consistency in support and opportunity. Local government understands its communities, but councils cannot deliver transformational change alone. It requires partnership and shared responsibility across the whole system. The standard of support available to neurodivergent people should not depend on where someone happens to live.

Autism and neurodivergence should be a golden thread running through government departments, public services, employers and the legislation that we bring forward in this House. Greater understanding of autism and neurodivergence within the justice system is also extremely important. Differences in communication, comprehension and body language can sometimes lead neurodivergent people to be misunderstood, particularly in stressful situations. That is why training and awareness across the criminal justice system are so important.

We also need greater training, awareness and support for employers. Neurodivergent people have enormous strengths, talents and potential, yet too many still face unnecessary barriers to employment, support in the workplace and progression. We must create workplace cultures where neurodivergent applicants and employees feel safe to disclose their neurodivergence and needs without fear of stigma.

Neurodivergent people should feel understood, respected and supported throughout every stage of life. Now is the time for joined-up action and delivery across all levels of government, in partnership with public services, employers, families and carers, and especially those with lived experience.

My Lords, I declare my interest as a vice-president, along with my noble friend Lord Touhig, of the National Autistic Society, and I hold lasting power of attorney for autistic adults. I thank the excellent chair of our committee—I genuinely think we would not have got here without her.

When the right honourable Dame Cheryl Gillan MP chose to introduce what is now the Autism Act 2009 in the House of Commons, she did so because she believed that autism is different and that the transition from childhood to adulthood was a cliff face, and that failure to understand and support autistic adults deserved its own Act of Parliament. I can confirm this with certainty, as Cheryl was a friend, and I was privileged to serve on the autism Public Bill Committee with her.

The report before us today is titled Time to Deliver: the Autism Act 2009 and the New Autism Strategy. The Government’s response to the report is described by the autism charity sector as unacceptable—that is putting it mildly. The new strategy, due next month, has been kicked into the long grass, with no attempt to set out a timetable to plan the new one and no discussion with the autism charities to agree priorities. A request I made to the Minister to discuss this was passed many weeks ago to the Commons Minister, and I have heard nothing since.

I turn to the reason for this small but important Act of Parliament, and to the report, which identifies why autism is different. Autism is a spectrum of degrees. Some will travel through life with minimal need for support and, at the other end, the need will be for 24-hour specialist support. In the middle will be so many for whom this Act of Parliament and its strategy are the blueprint for a place in society that is safe, meaningful and fulfils each individual’s potential. Many will be of average or even higher intelligence, but all people born autistic will die autistic. There is no medication, although there may be additional conditions as well as autism.

Nearly 20 years on from the Act, we still see autistic people with shorter life spans and the highest suicide rate of all neurodiverse conditions. Autistic people are detained in mental institutions and there is a 60% unemployment rate, often for life. I say to the Government that it is really time to deliver. Do not delay the new strategy because other things are going on. If the new proposed SEND policy is not going to be delivered until 2030, that is no reason to halt work on an Act that is already on the statute book. If services to support changes to the Mental Health Act, which has already been passed, will not be in place for some time, that is no reason to delay the strategy.

The 2009 Act states that the Secretary of State for Health must

“prepare and publish a document setting out a strategy for meeting the needs of adults in England with autistic spectrum conditions by improving the provision of relevant services to such adults by local authorities”

and “NHS bodies”.

The committee’s report is a year’s work by this House, which, together with discussion with autism charities and those with lived experience, would provide the Government with a new strategy that would make such a difference. It is, after all, the law of the land already. I expect the Government to abide by the law of the land and, when the Minister winds up, to explain how and when they will deliver it.

My Lords, I wish to commend this report, in particular its emphasis on the importance of the principle of “nothing about us without us”, as referenced by my noble friend Lady Dacres of Lewisham, encouraging the involvement of autistic people, as well as those who support them, in making decisions that affect them and their daily lives.

I want to talk specifically to the part of the report about relationships, sex and health education, RSE, for autistic children—or, in fact, the lack of it. As Dr Felicity Sedgewick said in her evidence, young autistic people are not typically offered RSE that meets their needs. She recommended that adapted, accessible RSE should be developed. The report then refers to the need for RSE to be tailored to the needs of all children with SEND; I agree with this wholeheartedly. I understand why RSE was mentioned fairly briefly in such a comprehensive report, and I believe that this important topic deserves ongoing attention. Does my noble friend the Minister agree that RSE for SEND children should be reviewed as a matter of urgency?

I come at this not as an expert, unlike so many of my fellow noble Lords, but with a stepdaughter who wrote her MA dissertation on the subject, in fact supervised by the committee’s specialist adviser, Professor Laura Crane. She is about to embark on a PhD on RSE for SEND children, given that there is so little research in this area. Before and during her undergraduate degree, she worked as a teaching assistant in a SEND school and experienced at first hand the consequences of a paucity of direction, guidance or policy in this area.

As the Government’s response to the report said,

“reforms should be grounded in evidence”.

This is important to parents, teachers and other caregivers, but most of all to young autistic people themselves.

My Lords, I congratulate the noble Baroness, Lady Rock, on the truly impressive way in which she chaired our committee and got this group of very knowledgeable people to produce a really tight and very good report. I also add my congratulations to Stuart Stoner and his team and to Professor Laura Crane. We had the wonderful opportunity to meet so many witnesses and organisations as part of this; I learned a lot during this process.

The central issue is about this new strategy. We really have to press government that, this time, it must have a good implementation plan. It was spelled out in the recommendation that detail matters; we are looking for a plan about what, who, when and how, as well as the resourcing and better accountability. There is nothing in the response that says that. In trying to think of a suitable word for the response to the first recommendation, I got as far as “bland”—it did not really say anything, as far as I could see, of any substance. That implementation plan and strategy are vital. Will there be an implementation plan with the strategy? Will it address all these features in the committee’s recommendation about what, who, when, how and resourcing?

Much has already been said about some of the detail, which I will not repeat. I just want to make two big points, the first of which is the human one. Throughout this, I was very struck by the pain and the love, and the private anxieties we heard about, as well as the difficulties of trying to understand and navigate the system and search for solutions, and the emotional toll on individuals and families. I was very impressed by the visit we made under the leadership of my noble and learned friend Lord Hope to the Phoenix School, which is a specialist school. There we met parents who suddenly, having come away from a position of bewilderment, were then seeing possibilities in this safe haven for what their children could be. Obviously, that is very relevant to the wider debate about specialist schools and the support for autistic people and their families.

From that visit, I also commend one thing we noticed: the Phoenix School provided an outreach service to other schools, and indeed ran classrooms in some other schools. That model is something the Government should well look at as part of their looking at specialist schools, because it looked as if it was working—although we obviously did not see it.

The other thing that came out of that visit was the importance of communications, technology and speech therapists, whom I have to confess I had not really thought about in quite this detail before. One father there, in a really emotional moment, talked about how he found out how he could communicate with his child, and his child could communicate with him. That, to me, was very impressive.

That is one big point—the human bit that we must not lose—and the second bit is about the system and the culture, a lot of which is, frankly, incoherent. Members of the committee will remember one of our witnesses saying that too often it is

“the state fighting the state”.

One set of policies does not match the other, or they are going in opposite directions, and that is a serious issue. Another issue here is the danger that we will just produce another set of rules, sent out by the centre, which people will have to train on but which are not really owned, as people are just paying lip service to them.

There are examples in other areas where people, despite having appropriate adjustments and their notes and passports written up and so on, were just ignored—with fatal consequences in the case I am thinking of. I know that in Parliament we can rely only on the tools we have of legislation, regulations and guidance—trying to get people to do what we want, if you like—but that is why accountability is so vital and why it runs through this like a thread. But it is not just about accountability: we will know we have succeeded when it is not just accountability hanging over people’s head but a feeling of responsibility. People must feel responsible to do something about the people in front of them.

My question to the Minister is an impossible one: how will the Government address the incoherence in policy and these cultural issues when taking this forward? I am conscious—I have finished my time—that I am in danger of widening this out too far, but let me just leave these points: strategy and implementation, and making sure it is owned. Both parts are vital.

My Lords, it was a privilege for me to sit on the Autism Act 2009 Committee. I am very glad that we have the opportunity to discuss the report today. I thank all my colleagues across the House, in particular the noble Baroness, Lady Browning, and the noble Lord, Lord Touhig, who gave me great encouragement when I decided to join the committee. I also thank the chair, the noble Baroness, Lady Rock, who was so inclusive towards us and was available for all sorts of extras when we wanted to do things. I thank the clerk Stuart Stoner for all the support he gave us throughout the making of this report. I think I have thanked everybody. Above all, I thank all the families and carers, as well as professionals and organisations, who gave evidence to us; without that evidence, we would not be here today, and we could not have done that report. It was difficult for them to give evidence to us, and it was difficult for us to take the evidence, but it was so rewarding.

The Autism Act was a landmark piece of legislation, and our committee’s report, Time to Deliver, is rooted in the same ambition that autistic people should not be an afterthought in public policy. Time to Deliver acknowledges the progress that has been made, but through the evidence presented to us by people living with autism, or through their experience of working with them or being part of their family or support network, we know that the system in this country is far too slow, systemically fragmented, and difficult and time-intensive to navigate. Families need support at every moment from the time they have a diagnosis or think there is a diagnosis to be made.

I welcome the Government’s response to the report, and I know that Ministers are considering these matters seriously. I hope that over the coming months the Government will work on the United Kingdom’s next autism strategy, to build on that response. To be successful, the next autism strategy must have a clear delivery plan, accountability measures, measurable outcomes and sufficient funding. Autistic people need to be able to feel a difference in their daily lives as a result of any work undertaken.

I will highlight the key findings of Time to Deliver to reaffirm how important this work is. One of the most pressing issues we were presented with was diagnosis, and we learned that nearly 90% of those waiting for an autism assessment had been waiting longer than the NICE recommendation of 13 weeks, and the average is more than 17 months. For a child out of school, as quite often happens, every day without educational support is a waste of their life and future. Every person has to work and has the right to work. We must ensure that everybody is trained. During and after diagnosis, it is a central priority that this is followed up and not left for months before the next appointment.

I will speak particularly about women and girls. The committee found that the diagnosis rate for women and girls was 0.82%, less than half the rate for men and boys, which is 1.84%. Yet waiting list data showed a much more even split between males and females waiting for an assessment. This points to what many women and girls have described for years: being missed, misunderstood or recognised only after years of masking and distress. For girls in school, we know that this exacerbates mental health conditions, while students’ educational needs are not met—as I said earlier, leading to days out of school, truancy, and so on. This has a cascading effect of late diagnosis, poor mental health, difficulties accessing work and struggling with services that do not understand the varying presentations of autism. We met a witness who had been sent to a mental home because people did not understand that she was autistic. Thank goodness, she got through that, but it was awful to hear what had happened to her. I hope that the Government will ensure that the next strategy has a specific focus on autistic women and girls.

In 2024-25, one-third of all pupils with an education, health and care plan had autism recorded as their primary need. These children deserve ambition as well as better support so that they can continue in society.

My Lords, I begin by paying tribute to my noble friend Lady Rock for her superb chairmanship of the Autism Act 2009 Committee; my fellow committee members; the diligent committee staff; and, above all, the nearly 400 individuals and organisations that submitted written evidence to us.

There is a key figure that we should all remember: 30%. That is the employment rate for autistic adults in this country, against a general working-age employment rate of around 75%. That 45% gap represents the ambitions of tens of thousands of people being unfulfilled. Sir Alan Milburn’s interim NEETs review showed that autistic young people are disproportionately more likely to have been excluded from school and locked out of the labour market. The Government’s mission to get Britain working will not succeed if we continue to overlook one of the most significant untapped pools of talent available to the country.

Sir Charlie Mayfield rightly made the point to our committee that the business case for inclusive hiring is a matter not of corporate social responsibility but of competitive advantage. Autistic employees frequently bring precisely the kind of focused, analytical thinking increasingly valued and required in a complex economy.

In my role as president of the Jobs Foundation, as declared in the register, I have seen some of these case studies at first hand. Greene King has a supported internship programme, which recruits neurodiverse employees. It finds that with simple adjustments, often, autistic employees thrive and bring real value to the company and its customers. It is not just large corporates. EdCortex, a specialist SME in Guildford, has a recruitment model built around harnessing the skills of neurodivergent workers for data and analytical tasks. I was glad that our committee’s report acknowledged that the right tax incentives are essential to help businesses hire more people facing barriers to employment.

I will touch on the issue of public awareness and acceptance of autism and autistic people. It was notable that, despite receiving a record number of public responses to our consultation, our final report received almost no media coverage and minimal social media interest. Public appetite to give evidence to the committee was inversely proportional to the media’s interest in reporting what the evidence produced. This is not a criticism of any individual journalist, but one of the key planks of the original 2009 autism strategy was raising awareness. Some 17 years on, this lack of interest illustrates the challenges in achieving that goal.

In our evidence session with Ministers, they acknowledged that there is no meaningful or regular analysis of public opinion to measure how awareness and public attitudes towards autism are changing. There is good intent—I can see that—but not the kind of structured, ministerially led initiative that our report and the strategy call for.

There is one small but telling illustration. On World Autism Awareness Day last year, there were no social media posts from No. 10, and there was none this year. What message does this send to the 700,000 autistic adults and children in the UK, and their families?

I will make one final point. It is important that people with autism, who feel comfortable doing so, are open about their diagnosis. In May, I listened to the moving maiden speech of the noble Baroness, Lady Leaman, who was sitting over there at the time and who, sadly, is not in her place. She touched on her children and their neurodiversity, I found myself thinking that perhaps I, too, should have declared a relevant personal interest during my work on the committee. I was formally diagnosed as being autistic in my early 40s, but the signs were there from an early age. To mention just one aspect, as a child, I needed extensive sessions with a speech therapist—who is over there—to coax me into speaking. At school, on bad days, I would freeze entirely when asked to read aloud—I feel like that now. But I am lucky: hyperfocus, pattern recognition and pursuit of special interests—without this wiring, I doubt that I would have had the drive to push through setbacks and methodically build seven campaign groups. I am acutely aware that this is not everyone’s story, and that is precisely why updating the autism strategy matters so much.

Too many autistic adults are not given employment opportunities, too many autistic children are being failed by the current SEND system, and too many people have to wait far too long for a diagnosis that might finally explain why the world has always felt slightly harder than it should. I was fortunate in my path. The purpose of the report and the strategy is to make sure that luck has less to do with it.

My Lords, I was delighted to be a member of the autism committee, under the very clear direction of our chairperson, the noble Baroness, Lady Rock. I was very grateful for the direction and guidance from the noble Baroness, Lady Browning, and my noble friend Lord Touhig, who have a particular interest and expertise in this area. I pay tribute to our clerks and special adviser in relation to the topic. I thank the Government for their response, which, I say to my noble friend the Minister, could have been stronger and have indicated a desire to produce an immediate strategy, as much analysis and evidence is already there, particularly from the report that we published last November.

I declare that my cousin’s son is autistic. He displays or exhibits certain characteristics and special interests, on which there is a fixation. But all in all, he is an exceptionally bright child and will do well in spite of his disability.

Far-reaching legislation for autism was enacted in 2009, followed by various strategies. The last strategy was published in 2021 and is due to expire in a month’s time. The Government have stated that it will continue until a new one is in place. I suggest that work on the new strategy should already be under way and publication should take place early in the second half of this year.

Our report called for the Government to develop such a strategy, tackling persistent inequalities experienced by autistic people in education, health, work, criminal justice and the community. Since our report was published, I note that the Government have commissioned an independent review into mental health conditions, autism and ADHD, launched a call for evidence to inform a mental health strategy and announced a special educational needs reform Bill. Although welcome, I believe this only accentuates the delay in bringing forward the strategy. Maybe my noble friend the Minister could suggest why the Government are proceeding down this course of action, rather than immediately publishing such a strategy. Will those various elements of the Government’s suggested course of action contain the elements of such a strategy?

I am not criticising the Government, but as a member of the committee that published the report, I would have expected the publication of a new updated strategy to be based on much of the evidence that already exists and on the work that has already taken place, because we had extensive interviews with many autistic people, as well as professionals in the field. I therefore ask my noble friend the Minister: why was this the case? Why have a further review, which involves much work and delay, when much work has already been undertaken? Why not publish an immediate strategy?

Our recommendations included the launch of a new initiative to improve understanding and acceptance of autism and expanding mandatory training on autism for public-facing staff; investment in driving down autism assessment waiting times while developing and scaling up an effective model for identification, assessment and lifelong support; and setting a clear timeline and road map for the development of strong community services so that provisions in the Mental Health Act 2025 to end the unnecessary detention of autistic people and people with a learning disability can be commenced. Those are some of our recommendations; there are many more. I encourage my noble friend the Minister to have a look at all those recommendations and ensure that they can be placed in a strategy.

How will the Government ensure that autistic people and those who support them are fully involved in any reform of systems for identification, assessment and support? How will they set and pursue priorities for better health outcomes for autistic people in any future autism strategy? I thank my noble friend the Minister and look forward to her response.

My Lords, I am grateful for the opportunity to speak in the gap. I was not a member of the committee but I did give evidence to it, both professionally and as next of kin for two autistic family members. I want to highlight four points relevant to the debate.

First, too many autistic people are still being detained in mental health settings without a mental disorder. Although the new Mental Health Act intends to prevent admissions of autistic people without concurrent mental illness, this provision will not be enacted until there are sufficient community services in place. The Minister knows of my deep concern that without a costed plan, this promise is rather misleading.

The trouble is that, time and again, crisis-driven care is failing people and costing lives, quite apart from being financially very costly. In my government-commissioned report, My Heart Breaks, published in 2023, I reviewed the care of autistic people and people with learning disabilities who were being detained under the Act in long-term segregation. I found no therapeutic benefit at all to this enforced isolation and warned that it causes lasting psychological harm, worsens trauma, damages relationships and can lead to a form of social death.

I am looking forward to the forthcoming annual report from the Care Quality Commission, which now manages the independent care, education and treatment review programme, and to learning about its successes in discharging people, but of course the difficulty is that as people are discharged, new people are still being admitted. In my committee we were unable to identify how many people died unexpectedly during admission, but we know that autistic people, and especially autistic women, are at a higher risk of suicide than non-autistic people. Substantial numbers think about suicide during their lifetime, and up to a third actually plan or attempt suicide.

Many autistic women end up with inappropriate diagnoses, such as personality disorder, that stay with them and delay or prevent access to much-needed care and support. We know that people are being failed long before hospital admission, and we need early trauma-informed community support to prevent crisis-driven care.

This brings me to my third point. No anticipatory care planning is required under the Care Act, despite an obvious risk when there is care breakdown, most notably parental carer death. Does the Minister agree that an effective and simple change to the Care Act would be to require an anticipatory care plan for all family carers of autistic people, perhaps carers over the age of 70? The Minister will be aware of the tragic death of David Lodge beside his elderly father who had died suddenly at home. Ensuring that anticipatory care needs are regularly discussed and reviewed would prevent many inappropriate hospital admissions for autistic people.

I want to end my remarks by reflecting on the gap in life expectancy for autistic people highlighted every year by LeDeR’s Learning from Lives and Deaths: People with a Learning Disability and Autistic People, with death occurring six to 15 years earlier. Currently, not all the LeDeR recommendations are actually implemented, and I ask the Minister to confirm unequivocally that the LeDeR programme will be both strengthened and made mandatory. The Government’s response to Time to Deliver said:

“The government remains committed to reviewing every death of a person with a learning disability or an autistic person that is notified to LeDeR and ensuring that learning from these reviews is shared”.

Is that commitment still true?

My Lords, I thank your Lordships for allowing me to speak in the gap; it is much appreciated. I also thank the noble Baroness, Lady Rock, for the opening address. I have two autistic grandchildren, and that is one of the things that has occupied a lot of my life during the time we have had them—they are wonderful. I very much thank the noble Lord, Lord Touhig, and the noble Baroness, Lady Browning, who have given me so much help over time.

I know the Minister cares about people. Care is a good word. It is not just about having a reason or a responsibility. Many things happen. I was very taken with the observation at the very beginning about people. Somebody who has played a very major part in what we are about is Professor Vivian Hill, whom many of your Lordships may know as one of the leading educational psychologists in the country. I have said many times—it is happening and the department is doing it—that we need hundreds of them to get on top of all the delays that your Lordships have talked about today.

I said several times, many years ago, that where SEND is concerned, every single head teacher must have a full SEND programme. It makes all the difference. The heads of all schools must have that. I have also suggested that it is very important indeed that everybody who is becoming a teacher should understand SEND—otherwise, nobody understands what a meltdown is all about.

I know I do not have enough time for this, but the people who suffer most, as I have seen, are the mothers. The mothers suffer hugely without very much help at all. I want to finish off by saying that, like those here, I have been to many schools, and we must do what we said we would do, care to do it and get on to do it. Over the generations, people who are autistic have been the best for music, science and all the other things that have helped the world for many centuries.

My Lords, this is one of those debates where I am not sure whether I can add anything, but I can certainly join in by saying that I agree with what has been said in front of me.

The noble Baroness, Lady Rock, led the committee, which I served on, and I have nothing to disagree with in her summing up of what the committee did. I should let the House know that I got the best-timed rap on the knuckles from her: I said autism was primarily a communication difficulty, and then, with a look that cut to the core of my being, she said, “It’s more than that”, and I went, “Yup, you’re right”.

Autism is a neurodiverse condition that probably has the greatest reach and the greatest divergence—though all of them diverge, as they are all spectrums. We heard the noble Lord, Lord Elliott, say that he got through; he is either lucky or brilliant, and I suggest it is the second category, or at least good enough and bright enough to cash in on his luck. If people are “getting through” in that way, we have a fundamental problem. They are dependent on having a tiger-warrior parent—somebody shoving themselves forward to make sure they get through—or else they have to get lucky, with somebody saying that they think they might be in this category. That is why the strategy in front of us is a good idea.

It cuts across everything. We will never get everybody at school, even with the best training in the world, and we will see these traits later on—especially in those people who are struggling through and have done well but have certain behavioural tics, traits or unusual qualities. We must have a more wholly embracing system.

As the noble Baroness, Lady Browning—who we so often go to when we discuss autism—said: it is the law, so do it. Has anybody suggested that we roll back the law? We have the law, so do it. That means we have about two or three weeks before we can ask what the strategy will be and suggest that we get something going.

What is in it for the rest of the community? We might get a few more people employed and paying taxes—that is a good thing for a start, is it not? I declare an interest: I am chairman of Microlink, which provides support packages for people with disability who are in employment. From doing that, I know that such changes are sometimes small. If people had a little understanding—as was talked about here—along with those small changes, many of them could function perfectly well in many parts of the workplace. We should take that on board.

The whole of the Government have to do this—it is not just education but employment services. It is the fact that somebody will function slightly differently in the office and so there must be an understanding and a duty to say, “Yes, they will function and they can do it. They will not hold us back”.

When dealing with autism, the thing is the meltdown—rather badly named, I think, because it suggests that somebody is going to explode, not that they will have a small moment of crisis. I know from talking to one or two people that sometimes they need to go away and be quiet, but if somebody just puts a hand on their shoulder then they are fine. It is the child totally melting down in the classroom. What about the fact that girls do not do this, as was pointed out in this debate, and so do not get discovered? The more we know about this, and the more information we have, the easier a strategy will be to implement. People have to understand the condition a little more and not be quite so frightened of it.

We are informed that we will have a special educational needs Bill and a whole new strategy. I hope that identification and diagnosis—an easier way of making sure people know that someone has a particular set of problems—is something that can be carried through. Autism is definitely something for which that would really be helpful. I hope the Minister will be able to say that, if you are diagnosed in the education system, that will be carried through into the rest of your life. As was pointed out here, you are at school and then you are not, and everything changes. That is a disaster in the making for virtually anybody who has a disability—not just autism but all of them. It will be interesting to see what information can be carried forward—that could be in the strategy or somewhere else. To come back to the noble Baroness, Lady Browning, we have the strategy so why are we not using it? It is good practice: we are going through so we can carry on.

I have a couple of questions for the Minister. When we come to the criminal justice system, are we going to make sure that we have better in-house support for individuals who are caught up in the system? Will we make sure that they are given better protection within it? When you have been in the House for as long as I have, you will know that there are numerous occasions when the police do not understand who they are dealing with and make the situation worse. Will the Government say to the police that this is their job as well? Because people might not quite understand what they are doing, there can be conflict with neighbours, misunderstandings and being led, and conflict with the police. Where is the training? We have a group of people who are used to being trained and going on courses, so what are we doing there?

When it comes to health, any group that has problems with communication—here I risk the wrath of the noble Baroness, Lady Rock, again—will have poor health outcomes. It is not just autism; those who use sign language have similar problems. What are we going to do in the Department of Health to make sure that there is an understanding—this will be made much easier with some form of diagnosis—that there must be new processes to get the information out of the patient? Our health system is still based fundamentally on the doctor’s appointment and an exchange of information on what the person thinks is the matter with them and then an interaction. If we can get guidance about what we are going to do there, it would once again help us. If that is not in this strategy, where is it? Presumably, we do not want people being ill; that is the whole idea.

As we go through the process of looking at an Act that we have passed and that we all say we want, something we can refer back to is this: why is it not happening? If the Minister can tell us that it is going to happen, that would be great. If she is going to tell us that the Government are going to do something else, let us hear it. At the moment, we seem to be saying that, yes, it is an awfully good idea and we like it, but it is too difficult and it will inconvenience somebody. If that is the situation, the Government should say so and give us something else. At the moment, we have a nice idea that is not being implemented, and we are all waiting on it.

My Lords, I begin by thanking my noble friend Lady Rock for opening this debate, for her work as chair of the Autism Act 2009 Committee, and for her wonderfully concise and coherent summary of the report’s findings. It comes as no surprise to me to hear about her chairing skills and the way she was able to convene people of vastly different views together—and to put noble Lords such as noble Lord, Lord Addington, in order, as it were.

I thank all noble Lords who served on the committee—including the noble Lord, Lord Wigley, who, despite his understandable frustration, managed to persist and contribute in a meaningful way—and the individuals and organisations who gave evidence to the committee. As the noble Baroness, Lady Goudie, said, without them there would be no report.

The Autism Act 2009 was a landmark piece of legislation introduced by the late Conservative MP, Dame Cheryl Gillan, and passed with cross-party support. I pay tribute, as other noble Lords have, to her friend, my noble friend Lady Browning, for championing this issue for so many years. I learned much from her contributions on the Mental Health Bill and from one-to-one conversations about autism.

The Act was the first disability-specific Act of its kind anywhere in the world and established the important principle that people with autism—or autistic people—should not be overlooked by government or public services and should receive the support they need to live independent and fulfilling lives. The committee’s report provides a stark assessment of what more must be done for that ambition to be realised. As others have said, why is it not being done?

Across healthcare, education, employment, housing, and the criminal justice system, autistic people continue to face barriers that limit their opportunity and diminish their quality of life. As your Lordships have heard, the committee’s central recommendations were straight- forward and unambiguous. It urged the Government to begin work immediately on a new cross-government autism strategy to come into effect when the current strategy expires in 2026.

However, the Government’s response has been commented on as notably cautious. The noble Baroness, Lady Ritchie of Downpatrick, said it could have been stronger. While Ministers agreed to consider the committee’s recommendations, they declined to commit to many of the report’s specific proposals. Since then, unfortunately, we have had little clarity about what will replace the current strategy or, indeed, whether there will be a new strategy and, if so, when it will be published. That uncertainty is clearly of concern to noble Lords on all Benches and those who work or live with autistic patients or family members.

I was grateful to the noble Baroness, Lady Dacres of Lewisham, for sharing her experience from local government. When we are talking about national strategies, we often ignore the local elements. The current national strategy, published by the last Conservative Government in 2021, established six priority areas: understanding, support, employment, health inequality, community support, and justice. While there has been some progress, as the noble Lord, Lord Touhig, said, progress has been insufficient under Governments of all colours. That means that those priorities remain highly relevant today. Regrettably, the evidence presented to the committee suggests that many of these challenges remain unresolved.

One area of particular concern is diagnosis and assessment, as the noble and learned Lord, Lord Hope of Craighead, pointed out. The number of people seeking autism and ADHD assessments has increased dramatically in recent years. The Government recognised the scale of this challenge by commissioning the independent review into autism and ADHD diagnosis. I saw that the interim report was updated today, in advance of the final report that is expected this summer. There are legitimate questions about how services should respond to the growing demand but, whatever conclusions the review reaches, one fact is beyond dispute: rising demand makes effective planning more important, not less.

The committee rightly emphasised that support should not be delayed any longer than necessary. It asked the Government to outline what steps they are taking to ensure that support is based on genuine need and is sustainable. So, in seeking answers from the Government, I repeat the questions asked by my noble friend Lady Rock. Do the Government expect to publish a new autism strategy before the current one expires? If not, when will they publish it? Will it be accompanied by updated statutory guidance under the Autism Act, as recommended by the committee? How will the findings of the independent review be incorporated into that work?

On employment, the previous Conservative Government took important steps to support disabled people into work, including through the national disability strategy and the local supported employment programme. Yet too many autistic people remain excluded from the labour market despite possessing valuable skills and talents, as my noble friend Lord Elliott pointed out when he very movingly shared his own experience. Indeed, I remember speaking to a Transport Minister, who shall remain nameless, who told me that when it comes to the timetabling for railway services, quite often the very best people in timetabling are those who are somewhere on the spectrum. That just shows that we are not taking advantage of those very specific skills that would contribute to the economy and the growth that this Government want to see.

The noble Baroness, Lady Antrobus, spoke about the importance of relationship and sex education. It is an important point, which she was right to emphasise, because it is one of the ways in which we can raise awareness and make people who are autistic—or autistic people—feel more included in our communities.

We welcome the Government’s stated ambition to reduce economic inactivity and narrow the disability employment gap, but ambitions alone are not enough—the detail and delivery matter. My noble friend Lord Sterling spoke very movingly about wanting a better future for his autistic grandchildren.

On healthcare and community support, the committee heard compelling evidence about health inequalities and the continuing challenges faced by autistic people in in-patient settings. During the passage of the Mental Health Bill, MPs and Peers on all Benches were repeatedly pressed for robust plans to ensure adequate community support. The lack of sufficient support has been made clear in the report. I thank and pay tribute to the autism charities and advocacy organisations that have continued to hold Governments of all political affiliations to account. Their message has been consistent: autistic people and their families must be at the heart of policy development.

The committee has provided the Government with a clear road map. The challenge now is not in identifying the problems but in delivering the solutions. Those of us, from all parties, who have been in government know that good intentions often come up against the Treasury’s financial discipline. That is no bad thing, since we expect the Treasury to ensure that taxpayers’ money is spent wisely. But this is where fine aspirations often meet financial prudence. So I ask the Minister: has there been any assessment of the cost of delivering the strategy? The noble Baroness, Lady Hollins, alluded to the cost. If there is an estimated cost, and if it has met resistance from competing priorities within the relevant government departments, or from other government departments, as the noble Lord, Lord Crisp, spoke about—the state fighting the state—or even from the Treasury, has the Minister’s department looked at which of the recommendations could be delivered by better deploying existing spending?

Which recommendations might actually save the Government money? As the noble Lord, Lord Addington, said, many of these people will become taxpayers, save the Government money and contribute more positively. Which of the recommendations may have to wait for future spending rounds? I hope the Minister will accept that I ask those questions in a spirit of pragmatism and trying to be constructive.

The Autism Act was a pioneering piece of legislation. Seventeen years later, the report from the committee chaired by my noble friend Lady Rock makes it clear that autistic people deserve clear leadership and a credible strategy for the future. I look forward to hearing from the Minister about the work that is under way and how, when and with whom it will be delivered. I hope she is able to provide reassurance to noble Lords across the House who have raised many concerns and want to work constructively with the Government to deliver for autistic people.

My Lords, I start by thanking the noble Baroness, Lady Rock, for leading this important debate and, as many noble Lords have said, for chairing a committee that was very thorough and gathered powerful evidence, including from autistic people, families, carers and professionals. I too extend my gratitude to all members of the committee. It is a very strong piece of work, which I believe will take us forward.

We welcome the final report and the recommendations and have set out our initial response. Straight away, I should say that I have heard the various views across the Chamber about the quality of the response and I have also heard very clearly the frustration that there is not an immediate strategy to replace this current one. I say that in all seriousness, not least because I will be sharing those views with the Minister now responsible for this very important area, Preet Gill MP. On that point, I apologise to the noble Baroness, Lady Browning, for not having had a response to a request for a meeting with the appropriate Minister. I will indeed pursue this.

As the noble Lord, Lord Addington, said, we turned to the noble Baroness, Lady Browning, as we so often do; I also often turn to the noble Baroness, Lady Browning, and very wise we all are in doing so. The work of the committee is indeed helping us to better understand the challenges, the opportunities and the changes that are needed. Yes, I say to my noble friend Lord Touhig that the work of the committee will absolutely inform development of the revised autism strategy, as indeed it should.

I am very grateful to noble Lords for bringing their personal experience to this debate. The noble Lord, Lord Elliott, was most open about his personal experience and we heard from parents, loved ones and, indeed, grandparents in the form of the noble Lord, Lord Sterling. This brings the subject about which we are speaking very much to life. I do agree that too many autistic people face significant challenges in education, employment, health and wider participation in society. That has lasting impacts on independence and well-being. I very much agree with the noble and learned Lord, Lord Hope, who observed early on in the debate that autistic people are individuals. Again, I very much take that point.

The response to that will be rooted not only in the new strategy but throughout the 10-year health plan and in—as we will see when it comes to this House—the Health Bill, particularly the moves to establish a single patient record, which will overcome a number of the points that noble Lords rightly raised. It is the case that, too often, people are expected to navigate very complex systems rather than simply secure the care and support they need and which would respond to their individual needs. I do not think that is so much to ask, and I am sure the committee would agree, and that does have to change. We are moving towards a needs-based approach, focused on early intervention and joined-up support around individual needs. That is central to our wider reforms, including changes to the SEND system.

The noble Lord, Lord Crisp, spoke about the model of Phoenix schools. I would certainly welcome, as would officials, more information about that. It is good to see good practice in action. I want to acknowledge the important local work that is under way. The noble Lord, Lord Wigley, spoke to this point. All of this is about building more inclusive communities where autistic people can thrive. The work that my noble friend Lady Dacres described in making Lewisham an autism-inclusive borough through its all-age autism strategy, was commendable and echoes with me. “Nothing about us without us” is, I think, good guidance.

The Autism Act was enacted in 2009 and I pay tribute to all those who went before us to make that happen. There have been subsequent autism strategies, but the reality is, as has been observed, that progress has been inconsistent and outcomes have not improved as they should have. We are very well aware—and I certainly am more so today—of the concerns raised about the importance of having an effective national strategy in place. I want to reassure your Lordships’ House that the current strategy does remain in place until it is replaced.

Noble Lords recognise, as I do, that the landscape has changed significantly since the current strategy was published in 2021. The challenges that face the health system now are much more acute. Services are seeing more patients with more complexity, and demand continues to outstrip supply. Indeed, as the noble Baroness, Lady Rock, and other noble Lords said, some 270,000 people are waiting for an autism assessment, and around 90% of them are waiting at least 13 weeks. That is why it is so important that we focus on earlier intervention and help people to get the support they need without necessarily needing a diagnosis as we expect now.

My noble friend Lady Goudie spoke about girls and women facing particular struggles. Data does show that we are seeing an increase in referrals for female diagnosis. There is, perhaps, a suggestion there that increasing awareness of this issue is supporting improvements in this area. I am very much looking forward in particular—but not exclusively—to the recommendations of the independent review on the prevalence of, and support for, mental health conditions, ADHD and autism, chaired by Professor Fonagy. It is expected this summer and will speak to the very point about how we can respond to increasing demand more effectively. It will look at drivers for that demand, about which, we must be honest, there is often not clarity, and I hope that this will greatly assist.

Now to the very important points raised with me about the Government’s plans for a future strategy and the timescales by the noble Lord, Lord Kamall, my noble friends Lady Ritchie and Lord Touhig, the noble Baroness, Lady Rock, and other noble Lords. As I said, we remain fully committed to publishing a revised and, I emphasise, cross-government autism strategy—the cross-government point being another aspect that I know the committee was very keen on. I will disappoint noble Lords somewhat, but I hope I can give reassurance that I am not going to disappoint them too much. In my view, it is important that the timetable for establishing the strategy takes proper account of the timelines of relevant cross-government reviews.

I will come back to this very shortly, but developing the revised strategy—the noble Baroness, Lady Browning, pressed this point—has to be grounded in evidence, shaped by engagement, as many noble Lords asked, and be realistic about the pressures facing the system. Therefore, we have to focus on ensuring that people can access support at the right time. On the point made by the noble and learned Lord, Lord Hope, we need to remove unnecessary barriers in a way that reflects individual needs. That means carefully considering a number of areas, including the recommendations of the committee’s Time to Deliver report, as well as, as I have mentioned, the findings of the independent prevalence and support review, which has not yet been published, and other important cross-government work, again spoken to in this debate, such as the independent Milburn review on the increase in the number of young people who are not in education, employment or training, and the insights from the consultation on SEND reform. All these will help shape the Government’s response and next steps.

Fortunately, we have these things in train and they are reporting soon, but not in time for the end of the current strategy. Therefore, I am not in favour, and I do not think any noble Lord would want me to be, of publishing a revised strategy to meet a timeline that does not now reflect the timelines that are more current, more evidence and more consideration. I want this to be the best strategy we can get. I want it to be a strategy that can deliver. In that respect, I cannot give a timeline, but I have indicated what is being considered and when those matters will be reported on.

I can assure the noble Lord, Lord Addington, my noble friend Lady Ritchie, the noble Lord, Lord Crisp, and other noble Lords, that we are absolutely engaging with those with lived experience. That is key to success. We will also consider the need for a new system to bring together information from autistic people. I think that is work we have to do.

To pick up some other points, I recently announced plans for a new cross-government mental health strategy—that will also be very relevant to this area. That will be published later this year. It will explicitly consider the mental health needs of autistic people and people with ADHD. Together with the autism strategy, all these areas of work, which are very practically focused, will support a more joined-up system for those with neurodevelopmental conditions or mental health needs.

Of course, the autism strategy does not sit in isolation, and we work closely with the Department for Education on SEND reforms ensuring that joined-up support is available across education and health and care services, as noble Lords have rightly expressed. It is key that we have the right support available at every stage of the education of children and young people. My noble friend Lady Antrobus referred to the RSE curriculum. The new RSE curriculum and guidance are quite clear that schools should ensure that subjects are accessible for pupils with SEND. It is ultimately the school’s responsibility to ensure that resources and teaching materials—I heard the point about the need for greater teacher time—are accessible for all pupils and are sensitive to pupils’ needs. I emphasise again that, no matter one’s age, we are all individuals. The consultation on SEND reform has just closed. The feedback is being considered before we set out the Government’s response and next steps. We are also taking steps now. On 5 June, we published guidance for the new experts at hand offer, and we have appointed a national panel of experts to develop new national inclusion standards and specialist provision packages.

I want to refer to some other points that were raised. I am happy to write to the noble Baroness, Lady Hollins, with further detail on her assertion that a simple change to the Care Act to require an anticipatory care plan would be one way to manage that.

I will write to the noble Baroness, Lady Rock, my noble friend Lady Dacres and the noble Lord, Lord Addington, who raised matters relating to the justice system. The final update of the neurodiversity action plan was published in February. It highlights significant progress made across the criminal justice system in supporting autistic people. I should add that to improve prison screening processes and practices, a new additional learning needs tool was introduced in October 2025 as part of the new prisoner education service. The tool identifies adjustments that might support them.

I say to the noble Baroness, Lady Hollins, that our reforms to the Mental Health Act will limit the scope to detain people with a learning disability and autistic people so they can be detained for treatment only if they have a co-occurring medical health condition that requires hospital treatment. That is something we correctly spoke about at some length during the passage of the Mental Health Bill.

The noble Lord, Lord Kamall, pressed home the need for greater training for employers. I am sure that all of us in this Chamber know that employment rates remain significantly lower for autistic people. That is not acceptable. Our £1 billion connect to work programme will support around 300,000 people. This is alongside reforms to Disability Confident. We continue to work with employers to build more inclusive workplaces. Of course, the work of the former Health Secretary, Alan Milburn, through his review will be very helpful in this regard.

The noble Baroness, Lady Hollins, raised the fact that autistic people, especially women, are at higher risk of suicide. I recognise that. In the suicide prevention strategy, autistic people, children, young people, pregnant women and new mothers are priority groups for the provision of tailored and targeted support. On the matter of training, raised by the noble Baroness, Lady Rock, mandatory training on learning disability and autism for health and care staff will support the necessary shift to empowering patients and preventing sickness rather than just treating it. Again, that is key.

I agree with the noble Baroness, Lady Hollins, that avoidable deaths are unacceptably high. We remain committed to reviewing every death notified to LeDeR and ensuring that learning from reviews is shared. On the point about local services, every integrated care board is expected to have an executive lead on LeDeR and to prioritise LeDeRs.

I am most grateful for the questions and for the way in which noble Lords have pressed the importance of the strategy. I accept that. I want to ensure that we get this right. With the assistance of the committee’s report, I know that we will.

My Lords, I thank all participants in today’s debate. Passion, care, empathy and understanding have really shone through, and I am grateful to Members of this House. It is incredibly important that we support our autistic community.

I know that many people have thanked them, but I think it is worth paying tribute to my noble friend Lady Browning and the noble Lord, Lord Touhig, for bringing the committee to life. We would not all be here without the two of them. I pay tribute to all the hard work that goes on behind the scenes in the committee as well.

I want to thank one person above all else: my son, who is 25 and autistic. He has taught me so much about the extraordinary way in which autistic people can contribute to our wider community, as was recognised by many Members today.

We have a unified voice here today. We heard a lot about what we need to do and what needs to be delivered. We need a new strategy and I am grateful to the Minister for reassuring us that there will be one, but we did not hear from her about an implementation plan or accountability: that was another unified message that came through loud and clear from Members today. But we are weeks away. It is reassuring that the strategy will continue, but we really need a sense of urgency from the Government.

It is disappointing—I know the Minister has used the word “disappointing” a number of times in her response—about the timing. Perhaps the Government need to read our report again, because we have done all the heavy lifting and the hard work. This can be delivered and we do not need to wait for other things to go on; in my opinion, they should not be holding up a new strategy. I thank the Minister kindly for her enthusiasm in making sure that we get this right, because we really need to do so, but it is not a surprise that we are meant to be having a new strategy in July: we have known about this for a long time.

I sum up by saying: we need a new strategy, an implementation plan and accountability, and it is up to the Government now to deliver.