Acquired Brain Injury

Debate between Chris Bryant and Paula Sherriff

Thursday 9th May 2019 Commons Chamber

[Chris Bryant (Rhondda) (Lab)]

I beg to move,

That this House notes the report of the All Party Parliamentary Group on acquired brain injury and supports its conclusions; and urges the Government to work through all of its departments to ensure that those who have sustained brain injuries are guaranteed full neuro-rehabilitation as needed.

I rise to speak in support of the motion in my name and those of my hon. Friends, including those on the other side of the House—I see the right hon. Member for South Holland and The Deepings (Sir John Hayes) taking his place now.

Sometimes a brain injury is really obvious—jagged bone where the skull has been fractured or penetrated—but often the sheer force of the soft tissue colliding at speed against the hard inside of the skull bruises the brain, leading to a contusion or a haemorrhage that is outwardly invisible. Likewise, blunt trauma, where the head smashes into a windscreen or the road, means that the brain is pulled away from the opposite side of the skull, leading to even worse damage. The same can happen on the rugby, football, or hockey field, in the boxing ring and on the racecourse. Repeated incidents, even minor ones, can lead to chronic traumatic encephalopathy or what is often known as “punch drunk syndrome”.

Injuries can also be caused by stroke, tumours, infection, carbon monoxide exposure and hypoxia—oxygen starvation. These are hidden injuries with complex and fluctuating life-changing effects that strike close to the heart of what it is to be human, to be conscious, to be alive and, in many cases, to want to be alive.

[Paula Sherriff (Dewsbury) (Lab)]

I am sorry that I cannot stay for the whole debate but, prompted by my hon. Friend’s excellent work in this area, I recently visited the Second Chance Headway Centre in Wakefield, which supports people with brain injuries. I was struck by the spectrum of conditions that the centre deals with and by the dedication of its wonderful staff and volunteers. I encourage all Members to visit a Headway centre in their constituency, and I want to make the House aware that it operates a free helpline, which is driven by nurses, that people can call for advice.

[Chris Bryant]

My hon. Friend is absolutely right. I know that many Members in the Chamber today and others, including Ministers who are unable to participate in the debate due to their ministerial responsibilities, have also visited Headway groups in their constituencies. I have been to the group in Cardiff, which does a magnificent job. This is also about those who work in the NHS and alongside many of the voluntary organisations that do magnificent work. For many people, the work is thoroughly rewarding, because somebody can be taken from complete dependency on others to needing much less frequent support through neuro-rehabilitation, enabling them to stand on their own two feet and have the quality of life that they had before.

--- Later in debate ---

[Chris Bryant]

That specific point has not been raised with me in relation to brain injury because it is one of the seeable bits. It is the unseeable bits that are particularly difficult for PIP assessors and other assessors to get right, which is why it is important that they all have proper experience and training in assessing brain injury.

I do not want to take too much time because I know that many others want to speak, but I will refer to a few more elements, the first of which is the prisons system. All the latest research shows that a very high percentage of inmates, both male and female, have had a brain injury. One survey shows that 47% of inmates at Leeds Prison have had an ABI, and Huw Williams’s work shows that more than 60% of prisoners at Exeter Prison have had a traumatic brain injury. In both surveys, the majority of injuries occurred before the prisoner’s first offence, suggesting that the brain injury may be a key factor in why they offended in the first place. If we really want to tackle their reoffending, we will have to deal with their brain injury, too.

Research at HMP Send and HMP Drake Hall also finds that the most common way for women inmates to acquire brain injuries is through domestic violence— 45% of injuries. Again, we may be criminalising people who are actually victims. We need to get this right. If we really want to tackle reoffending, we must do a better job of recognising and treating brain injury. That means screening all new prisoners, training prison staff, providing proper neuro-rehabilitation for all prisoners with a brain injury and making special provision for women that recognises the likely different causes of their injury—particularly domestic violence.

I will not say much about education, because I know other hon. Members will. The Government have been good in responding to our report in detail, but the section of their response with which I am most dissatisfied is on education. There is a hidden problem across our schools estate, and we will store up problems for the future if we do not take this issue seriously. In particular, I urge the Government to reconsider our recommendation that acquired brain injury should be included in the special educational needs and disability code of practice.

The final area is sport. I make it clear that sport is good for people’s health, and I do not want to prevent anyone from taking part in sport. I do not want all our sportspeople and youngsters to be mollycoddled and wrapped in cotton wool, but the record on sports concussion is shockingly bad, particularly in football. I am no football expert.

[Paula Sherriff]

You don’t say.

[Chris Bryant]

All right. I am no expert, but I know about concussion in football. The last season has been especially bad. Mohamed Salah, Jan Vertonghen, David Ospina, Anthony Lopes and Fabian Schär have all been involved in high-profile, very dubious decisions by the on-pitch medics. UEFA rules since 2014 seem clear:

“In the event of suspected concussion, the referee stops the game to allow the injured player to be assessed by the team doctor. In principle this should take no more than three minutes, unless a serious incident requires the player to be treated on the field of play or immobilised on the field for immediate transfer to hospital”.

Honestly, three minutes is nowhere near enough to be able to judge whether somebody has suffered a concussion or any other kind of brain injury. Moreover, FIFA, UEFA and the Football Association have different definitions of concussion and, unlike rugby—where it is now standard that a player should be off the pitch for 10 minutes and can be replaced—football allows no subs for concussion, so all the incentive is to get the player back on and playing as fast as possible and in less than three minutes.

Let me be very clear to the football authorities. Football is failing its players. It is giving a terrible message to youngsters, parents and amateur coaches. Those authorities are putting players’ lives at risk. If they do not get their house in order, they will face massive class actions in the courts and we will have to legislate to protect players from what is, frankly, an industrial injury.

I want to end by talking about my own patch. I am delighted that south Wales will soon have a new major trauma centre at the University Hospital of Wales, but it would be cruel in the extreme to save people’s lives without ensuring that we can guarantee their quality of life. So we must make sure that when the centre opens there are proper neuro-rehabilitation services in Wales and that there is continuity of care once people leave hospital.

There is another issue for us in south Wales. In 2009, Kyle Beere was a typical healthy, intelligent, active 12-year-old—a bit too interested in fishing for my liking, but none the less. That November, he suffered a massive brain haemorrhage that left him fighting for his life. With no paediatric rehabilitation service in Wales, Kyle had to travel to Surrey for treatment. He is grateful for his treatment and his family is working all God’s hours to ensure that he gets all the support he needs. But I would dearly love there to be paediatric rehabilitation services in Wales.

Many medical miracles have been performed over the years, and I pay tribute to the doctors, nurses, scientists, pharmaceutical companies and staff who have constantly experimented and reviewed their work to see whether they can do more. I pay tribute to Chloe Hayward and everybody involved in the UK Acquired Brain Injury Forum. But we need a political miracle now.

The Health Committee produced a great report in 2001, but many of its recommendations have never been implemented. That cannot happen this time—please. We need a champion in Government to instil a real sense of urgency into dealing with brain injury: someone who can bring together all the different Departments and make them work together to deliver a quality of life that is more than just a collection of vital functions. I dearly hope that that champion will be speaking from the Dispatch Box in a few minutes.

Acquired Brain Injury

Debate between Chris Bryant and Paula Sherriff

Monday 18th June 2018 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

This has been an excellent debate, and I thank all Members for their contributions. I congratulate my hon. Friend the Member for Rhondda (Chris Bryant), whose persistence week after week has undoubtedly facilitated the debate. I thank the Government for allowing it time.

Although we have first-class acute care in this country, and advances in medicine in recent years that have resulted in many more lives being saved following a brain injury, it is undoubtedly in long-term rehabilitation where much more support is required in order to save and preserve the quality of lives for those suffering from acquired brain injuries—and, of course, their loved ones. Somebody who has suffered a traumatic brain injury could have had three months in intensive care, six months in therapy, and maybe a year in residential care, and then they are often sent home and the help stops. Quite often personalities will have been affected, and the person who comes home could barely resemble the one before the accident or incident that led to the acquired brain injury.

A report by the Centre for Mental Health stated that 1.3 million people live with the effects of brain injury, at a cost to the UK economy of £15 billion per annum, based on premature death, the health and social care required, and lost work contributions and continuing disability. This cost is the equivalent of 10% of the annual NHS budget.

[Chris Bryant]

Two suggestions have been made about rehabilitation that might change things: first, that we should have a rehabilitation prescription just like a medical prescription so that the person knows, and the family know, what support there is going to be on an ongoing basis; and secondly, that every single major trauma centre should have a rehabilitation consultant, because one in four do not. Is that not essential to be able to make sure that we change this world?

[Paula Sherriff]

I thank my hon. Friend for those suggestions, and I hope that Minister will respond to them. It is clear that my hon. Friend cares very much about this issue.

Neuro-rehabilitation is one of the most cost-effective services that the NHS provides, and one of the few services in medicine that results in long-term decreased costs to the economy. However, the number of available beds across the UK is inadequate, service provision is variable, and consequently long-term outcomes for brain injury survivors are compromised.

ABIs can result from many different causes, including stroke, tumour or brain haemorrhage. They can also be caused by a trauma to the head through assault, a road traffic accident, and accidents at work or in the home, as we heard from my hon. Friend the Member for Barrow and Furness (John Woodcock). Sporting injuries are the cause of many acquired brain injuries and have been subject to much media attention in recent years, with concern growing surrounding the long-term effects of concussions sustained through sporting activities. Awareness must be raised as to the dangers of head injuries in sport in order to prevent ABIs, along with stricter guidelines on how long an individual should rest following a concussion.

As we heard from my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), one of the most common effects of an ABI is breakdown in marriages, relationships and family units as people struggle to cope with the changes in circumstances, and often personalities, following an ABI. The hon. Member for Cheltenham (Alex Chalk) discussed the increased propensity to commit crime after an ABI. Today I spoke to Peter Taylor, the business manager of a charity based near my constituency called Second Chance Headway, which specialises in caring for people with brain injuries. He talked about the amazing work that they do. He also mentioned that quite often families fall apart as children struggle to understand why the lady who looks like mummy can no longer do the things that mummy used to be able to do—simple tasks like making tea or washing—and wonder why she is angry a lot of the time when she used to be so patient and loving. Obviously this can apply to daddy too. Those are just some of the devastating effects of ABI that often happen behind closed doors.

Peter stressed the importance of raising awareness, and especially of the fact that an ABI is a brain injury for life, that a person could face 40 to 50 years of trying to adjust and come to terms with a devastating change in their life circumstances and that they may have to learn how to live again, with some of the most basic tasks having to be relearned, including how to make a cup of tea and how to dress themselves—things that we all take so much for granted.

Peter also spoke about the lack of funding and the finger pointing between social services and health commissioners over who should foot the bill for rehabilitation services, with no clear direction over where the money should come from. Second Chance Headway survives without a penny from the Government, as do many other similar charities across the country. There has to be a more co-ordinated and systematic approach to ensure that everyone with an ABI has the same quality of care and the same life chances. This service should not be reliant on the charity sector, especially in these times of austerity in which charities are struggling to access vital funds.

I would like to end by echoing the requests of my hon. Friend the Member for Rhondda for a Government taskforce across all relevant Departments, including Health, Education, Justice, Work and Pensions and Defence and for adequate funding for services. In the words of Peter Taylor of Second Chance Headway, “A life has to be worth living, otherwise what is the point in saving it?”