Many people on the autism spectrum and their families will be highly anxious about the Spending Review on 25 November. These are people who, because of the nature of their disability, may rely on public services to pay for basics such as food and heating, to carry out essential tasks such as washing and cooking and to do everyday things like travelling on a bus or going for a walk. Despite the government's promises to protect vulnerable people and be family-friendly, many of these services have seen budgets squeezed - and some have stopped running altogether.
George Osborne has asked government departments to find savings of 25-40%, with only health, the schools budget and aid protected. We, at The National Autistic Society, are deeply concerned that further cuts to crucial services, particularly adult social care, disability benefits and disabled children's services, will leave people on the autism spectrum vulnerable. Without access to support, many autistic people and their families may fall into crisis and could develop mental health problems, such as anxiety and depression, which require far more intensive - and expensive - support.
Social care
Every person on the autism spectrum is different, though it can make everyday life extremely difficult - in a 2013 NAS survey 36% of autistic people told us they need help washing and dressing, 63% with preparing meals and 83% with paying bills and dealing with letters. The 2009 Autism Act and accompanying statutory guidance set out autistic people's needs and made clear what local councils in England should be doing so that autistic people can get the help they need.
But continued cuts to local council budgets are putting this at risk. Spending on social care has fallen by £4.6billion over the last five years, meaning that people with care needs including autistic adults, are often living without basic support. The historical lack of investment in care is also a false economy - people without the care they need can fall into crisis and end up requiring more expensive care from the NHS. Indeed, 99% of NHS leaders believe that cuts to social care funding are putting increasing pressures on the NHS as a whole.
As a member of the Care and Support Alliance - a coalition of over 80 organisations campaigning on care - we want to see social care funding rise to improve the lives of people on the autism spectrum and reduce NHS costs. It must be new money and delivered in a way that ensures it reaches the frontline.
Benefits and employment
Disability benefits are a lifeline for autistic adults who are unable to work (just 15% are in full-time paid employment) or meet the extra cost of living with their disability. During the election campaign, the Conservatives signalled that they would protect disability benefits but broke their promise in July's Summer Budget by announcing a cut to the lower rate of Employment and Support Allowance (ESA). More recently, there have been rumours of further cuts to disability benefits, perhaps through the tightening of criteria for Personal Independence Payment (PIP) or the means testing of that benefit, which could risk pushing thousands of autistic people into poverty.
If the government is serious about its pledge to halve the disability employment gap, it needs to both protect disability benefits from further cuts and create more specialist employment services. The promise of funding for extra practical support for ESA and Universal Credit claimants made in the Summer Budget is a start. But, we're yet to see what this means in practice. Autism is a complex and hidden condition and so this funding needs to be invested into specialist programmes if it's actually going to make a difference. Research into the impact of one specialist autism support scheme found that almost 70% of adults found work, demonstrating the significant impact that this type of help can have. The Chancellor must make funding available for specialist employment support.
Disabled children's services
Short breaks can offer a lifeline for children on the autism spectrum and their families. They allow children to develop independence away from the family and give parents time to themselves, which helps reduce stress. Despite legal duties on local councils to provide short breaks, financial pressures have led to cuts - for example, the respected Bristol Autism Project (BAP) was under threat of a restructure earlier this year and was only saved following a concerted campaign by a local mother, and there are plans to cut short breaks services in West Berkshire.
Closing or cutting services like BAP will be extremely damaging to the development of children on the autism spectrum and put their families under extra pressure. But if there isn't enough local council funding in the Spending Review, these schemes will disappear and families will suffer, sometimes leading to separation and trauma.
Health
For most people on the spectrum, their journey to understanding and support starts with the NHS when they're looking for a diagnosis. This is a life changing moment which can explain years of isolation, give people essential information about what might help, and unlock professional advice and support. But, on average, children end up waiting more than three-and-a-half years for a diagnosis after first seeking professional help, while adults wait two. This is completely unacceptable and is why we've been calling on the Government to take urgent action to reduce autism diagnosis waiting times.
We welcome the government's commitment to investing in the NHS but this needs to be accompanied by efforts to prioritise autism diagnosis. This will not only make a huge difference to autistic people and their families, but also lead to substantial savings by reducing the number of families falling into crisis and relying on the NHS to pick up the pieces. The National Audit Office found that by identifying and supporting 8% of adults with high functioning autism or Asperger syndrome would save £67million per year.
Last thoughts
The Chancellor has a simple choice to make on Wednesday. He can risk writing off generations of autistic people and their families by cutting crucial services across social care, disability benefits and disabled children's services. Or he can show leadership and keep the Conservatives' pledge to be family friendly and protect the vulnerable. This means investing in social care, protecting disability benefits, and giving families support. If the Chancellor does this, he will help solve the growing care crisis and help fulfil the government's pledge to halve the disability employment gap in this parliament. On behalf of the autism community, please Mr Osborne, keep your promises.