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Welfare Reform Bill

I certainly agree. Indeed, sometimes the person with a particular condition underestimates the problems that they have with it, so having a partner or a carer with them can be of great help. Understanding of autism is still lacking among professionals. If the employment and support allowance is to work for people with an autistic spectrum disorder, more training for personal advisers, jobcentre staff and health professionals is essential. A tiered system of training could be developed to ensure that all personal advisers had a basic level of knowledge and could call on people at a regional level for more in-depth knowledge. Any organisations that are in receipt of contracts to work with individuals should also have adequate understanding of the needs of people with different impairments. As the hon. Member for Tiverton and Honiton (Angela Browning) said earlier, about 260,000 of the estimated 330,000 people of working age in the UK with an autistic spectrum disorder are thought to be of average or above average intelligence and yet only 6 per cent. of all people with an autistic spectrum disorder are in full-time paid employment. We need to do better. However, unlike some of the disabilities, once a suitable job is found for someone with an autistic spectrum disorder, it is essential that continuing support is available while that person is in work. Because of difficulties in social interaction and communication, working environments can present many problems. Regular meetings or access to someone to call on can prevent the breakdown of a job and the sense of failure that may follow that. That support to individuals in employment is best delivered by specialist agencies that have a deep level of understanding, as well as a commitment to ongoing support. For those with an autistic spectrum disorder, the National Autistic Society’s prospects service has a proven success record of achieving lasting employment. Several patients’ organisations have expressed their concern that contracts are tending to be awarded to larger, less specialised providers who may not be able to provide effective support for individuals with particular needs. It will be necessary to monitor closely the categories of those who are found employment and who receive support in that employment. In that respect, there is concern about outcome-based contracts, if that outcome relates to numbers rather than the detailed analysis of those who have received help and are continuing to receive ongoing support. There is a great deal that the voluntary sector can offer in the provision of services. I was particularly interested to hear of the Citizens Advice suggestion that it and other organisations could be involved in the delivery of certain services, such as providing independent financial advice to people who are considering a return to work or advice to employers who need to know about the new benefit structure and their rights and responsibilities to employees with mental or physical health problems. Such use of the voluntary sector would also bring reassurance to those with an illness or disability. One area of concern that has been raised by several organisations, and this evening, is that much of the detail of the legislation has been left to regulations. May we have a reassurance that sufficient time will be allowed for consultation on that detail? The effectiveness and responsiveness of the new system will depend on the detailed application of the legislation. Another point of concern is the extension of the use of sanctions from attendance at interview to involvement in work-related activity, especially since it is suggested that that work-related activity could be changed by a personal adviser at any time. Sanctions should be applied only by qualified staff who understand the medical conditions or disability of the individual who might lose some financial benefit, rather than private or voluntary sector providers. If necessary, reference should be made to a person with greater knowledge of the condition, such as a hospital consultant. Care will need to be taken before applying sanctions in all cases. It will be necessary to consider the impact of a person’s disability on his or her ability to comply. For example, there must be consideration of whether people with a learning disability can understand what is required of them and whether they receive sufficient support to enable them to comply with the requirement. I welcome the Secretary of State’s earlier reassurance about those with mental illnesses, but Rethink has concerns about clause 17, whereby people could be disqualified from receiving ESA if their capability of work was reduced through their own misconduct, their failure to take medical advice without good cause, or their failure to observe the prescribed rules of behaviour. Patients with mental health problems might cease medication because of side effects. They could present with unusual behaviour, or might not attend for interview because of their condition. People with autism might appear to be not engaging with the process because they have difficulty with social interaction. The difficulty that people with an ASD have with social communication can affect verbal and non-verbal communication, so facial expressions and tones of voice might cause misunderstanding. Along with difficulties with social imagination, which includes planning ahead and the flexibility of thought, those problems make it difficult to acquire and maintain a job. It is important that great care is taken when applying sanctions to those with chronic, long-term conditions that might fluctuate, such as lupus.