Acquired Brain Injury

Debate between John Hayes and Lisa Cameron

Monday 18th June 2018 Commons Chamber

[Dr Cameron]

Yes, that is a fair point. Mobility is about not just how far someone can walk, but being able to plan a journey and many other aspects of day-to-day living skills that people can find so difficult. People may require support for such things, but that may not currently be picked up properly by an assessment.

Psychology is important in the assessment of such cases, because access to neuropsychology means that individuals can have memory and cognitive assessments at the time of injury and six and 12 months later to examine which functions have been recovered. That is important because different parts of the brain can take on functions that have been lost and because the individual’s pattern of recovery can be mapped, meaning that a rehabilitation plan can be specifically adapted to their needs. Access to neuropsychology is a key part of rehabilitation, so I will be interested to hear the comments of the Under-Secretary of State for Health and Social Care on neuropsychology services, particularly for those with an acquired brain injury.

Prisoners have been mentioned. Yes, there is a high level of acquired brain injury within that population and that has an impact in three ways: acquired brain injuries can increase impulsivity, they can lead to people making the wrong decisions and not thinking through the consequences, and they can lead to difficulty in undertaking the normal treatments available in prisons, such as cognitive behavioural therapy, meaning that such treatments may have to be adapted for prisoners to benefit from them. I am unsure whether that is occurring in our prison system, but it should happen right across the United Kingdom if cognisance is taken of such difficulties.

[Mr John Hayes]

This will be my last contribution because I know that others want to get in. The change in a person’s cognitive function, which is often perceived as a change in their ability to do things, is often also about them knowing how to do things, what to do, when to do it and why. That is different from losing a skill. It is about losing the ability to order things and to prioritise them, and that has a dramatic effect both on education and on their subsequent ability to work.

[Dr Cameron]

Individuals with a frontal lobe injury find planning extremely difficult and, in fact, may never again be able to plan in the way they once could. These are some of the issues that treatment would have to take on board, and perhaps further support will be required. The types of cognitive behavioural treatment that rely on people thinking things through in a sequence, which is particularly difficult for those with a brain injury, will not always be appropriate and may need to be adapted.

So many Members want to speak on this important issue, so I will finish by mentioning the funding for a new Scottish trauma network. Since January 2017, four major trauma centres, in Glasgow, Edinburgh, Aberdeen and Dundee, have been working extremely hard to try to ensure a good care pathway for those in Scotland who suffer brain injury. It is incumbent on us all to communicate and to find evidence-based practice right across the United Kingdom.