Michael McCarthy (Cork South West, Labour)

I thank the Ceann Comhairle for selecting this matter. My interest in it was born out of the frustration I felt on recently receiving a reply to a parliamentary question confirming there are no plans at present for the development of a national autism strategy or for the introduction of specific legislation on autism. Such a statement is disappointing given the increasing prevalence of autism in Ireland and because the Department's stance is wildly out of sync with international standards. In this context, I appeal to the Minister to review the position and to consider taking a different approach, based on the arguments I am about to outline. I note for context that in the United States, the number of children diagnosed with autism has doubled over the past decade. While no equivalent figures are available yet for Ireland, an estimated 600 children are born here each year with this condition and that figure is rising. It is hard to determine whether the increase can be attributed to an actual rise in the incidence of autism, improvements in diagnostic tools or greater access to psychological services. However, there is no doubt but that autism has risen dramatically in Ireland in recent years.

At present, Ireland is the only country within the British Isles that does not have autism-specific laws or a national autism strategy in place. In 2008, the Welsh Assembly Government issued an autism strategy and began to implement it immediately. In 2009, the House of Commons brought into force the Autism Act 2009 and quickly followed it the following year with its strategy for adults with autism. In 2011, the Scottish Government launched its national autism strategy and the Autism Act (Northern Ireland) 2011 was passed. The latter legislation compels the authorities there to publish an autism strategy within two years of the Act being passed. In recent years, there has been a general move towards implementing autism-specific strategies in many western democracies. As the aforementioned examples illustrate clearly, this movement has been prompted by the increasing prevalence of autism, the soaring cost of providing autism services, a squeeze on resources and the need to prioritise such resources effectively. There are many lessons to be learned from the Government's counterparts in the British Isles. For example, the proposed Scottish autism strategy Bill would place a statutory duty on the Government to prepare and publish a strategy to meet the needs of children and adults with autism and to consult with appropriate organisations and people. It also would oblige local authorities and local health boards to comply in respect of the provision of diagnostic services, the identification of children and adults with autism locally, the assessment of their needs, the planning and provision of services, the training of staff and leadership at local level.

As I noted earlier, approximately 600 children are born in Ireland each year with autistic spectrum disorder. However, these are merely approximate figures as the absence of a national autism strategy leads to an abject absence of prevalence rates. Naturally, this has huge implications for the provision of services nationally, as without access to a reliable bank of statistics in this area, it is difficult for service providers to know what policies and guidelines should be put in place for future planning of services. One should bear in mind that behind the figures are real individuals, real households and real families who are struggling with this condition. Autism spectrum disorder is a complex and lifelong developmental condition and while some people can live relatively independent lives, others have high dependency needs and require specialist care.

Autism also presents a significant public health challenge to the State. Until such time as a national autism strategy has been put in place in the State, there will be an ongoing cost to society of the resources that are wasted. For as long as services fail to be properly targeted, ineffectiveness and waste will continue and society will fail to equip people with autism with the right supports that ultimately will enable them to lead independent and productive lives. If one borrows from the example of the United Kingdom, components of a national strategy could include a national autism programme board similar to that which exists in the United Kingdom, a programme to develop training with health and social care professional bodies, autism awareness training for those who work with people with autism and guidance on making available public services for adults with autism, such as improving buildings, public transport and communications. In conclusion, the latter point already has been addressed in the HSE national review of autism services that was published in February 2011. It undertook to carry out a review of existing services and aimed to identify pathways on how services can be accessed and delivered.

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