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NHS must prioritise health of children and young people

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1116 (Published 14 March 2018) Cite this as: BMJ 2018;360:k1116

Re: The government must face up to the autism pandemic, and so must the RCPCH

This year Easter doubles up with All Fools Day. Today the BBC suddenly discovered data nearly a year old about waiting lists for special needs cases in school [1].

"A shortage of special needs funding means growing numbers of children are being left without suitable school places, a teachers' leader has warned."

The figures (a rise in England from 1,710 children to 4,050) were published in the on-line journal Schools Week on 10 June 2017 in an article by Jess Stauffenberg [2], and cited by me in a letter to these columns dated 19 July [3]. It should be mentioned that in Stauffenberg's article the emphasis seemed to be about more children rather than the shortage of resources (though I am sure resources are short). The BBC, by rather similar sleight of hand, in an earlier report last year turned a story about autistic children turning up for diagnosis in catastrophic numbers into a story about a shortage of resources [4]. Services for five London boroughs geared to diagnose 750 children a year were getting almost double the demand, so we might be looking at nearly 300 new cases a year for each borough - which perhaps no one ought to consider normal.

In an article principally about service cost cutting in Surrey it is mentioned that educational statements have risen by 44% since 2010 (and no council easily grants statements because they are so costly) [5].

Similarly, according to a report from Scotland from December 2016 [6]:

"Neil Findlay, convener of the Scottish Parliament's Health and Sport Committee called for an investigation after 6,931 referrals to Child and Adolescent Mental Health Services (CAMHS) were rejected in 2015.

"Evidence to the committee suggested that a surge in diagnoses for autism and attention deficit hyperactivity disorder (ADHD) was putting pressure on services, while the number of children under-15 in Scotland prescribed anti-depressants has more than doubled since 2009 from 560 to 1,123."

This was, of course, before the 11.5% rise in the number of children with an autism diagnosis in Scottish schools between 2016 and 2017 which I reported in my last letter [7]. Also from December 2016:

"The number of children in Northern Ireland currently waiting for an autism assessment has increased by 280% in the last five years - and almost 50% more children are being diagnosed with the condition.

"The statistics, released by the Health and Social Care Board, show that the number of youngsters on waiting lists is up from 607 in 2012, to 2,325 this year [8].

"The figures were disclosed in response to an Assembly question from Upper Bann MLA Jo-Anne Dobson."

The media may be swamped with feel good stories about autism but it is simply not possible that this is a spontaneous gene driven manifestation: it is a disaster for the children, it is a disaster for their families and it will be the greatest economic burden facing future generations. It is a much bigger, more costly problem than infectious disease - it is also linked with the crisis in mental health - but the neither the paediatric profession or the government apparently want to talk about it.

[1] Hannah Richardson, 'Special needs cash shortfall 'leaves thousands of pupils unplaced'', 1 April 2018, http://www.bbc.co.uk/news/education-43604865
2] Jess Stauffenberg, 'Pupils with special needs waiting for school place more than doubles', 10 June http://schoolsweek.co.uk/pupils-with-special-needs-waiting-for-school-pl...
[3] John Stone, 'The Writing is on the Wall', 19 July 2017, https://www.bmj.com/content/357/bmj.j2449/rr-16
[4] Jane Dreaper, 'Autism diagnoses 'could be reduced under NHS plan'', BBC News 27 May 2017, http://www.bbc.co.uk/news/health-40058482
[5] Isabel Dobinson, 'Parents secure legal aid funding to take county council to court over 'unlawful' £21m savings to services supporting children with disabilities', 30 March 3018 Get Surrey, https://www.getsurrey.co.uk/news/surrey-news/parents-secure-legal-aid-fu...
[6] Helen McArdle, 'Call for investigation as 20 young Scots a day are rejected fro mental health care', Sunday Herald 20 December 2016, http://www.heraldscotland.com/news/14975962.Call_for_investigation_as_20...
[7] John Stone, 'The government must face up to the autism pandemic, and so must the RCPCH', 26 March 2018, https://www.bmj.com/content/360/bmj.k1116/rr-0
[8] Brett Campbell, 'Autism assessment list now at crisis level, says MLA', 22 December 2016, http://www.belfasttelegraph.co.uk/news/northern-ireland/autism-assessmen...

Competing interests: No competing interests

01 April 2018
John Stone
UK Editor
AgeofAutism.com
London N22