Acquired Brain Injury

Debate between Liz Twist and Jim Shannon

Thursday 9th May 2019 Commons Chamber

[Liz Twist]

I thank the right hon. Gentleman for those comments. I most certainly agree that we need to have very specific proposals on how we can support people and to make sure that the support is actually put into place as well. As we know, there can sometimes be delays in achieving the ECHP, so I hope that more work can be put into that as well.

The Child Brain Injury Trust, which does excellent work in this area, has issued a call for action that includes some quite practical steps. It tells me that professionals across the field of acquired brain injury educational psychology are working hard to achieve the changes needed to support children in education following an acquired brain injury, but this requires all parties to listen and to implement the recommendations of the “Time for Change” report.

An acknowledgement of the support and interventions needed for paediatric acquired brain injury is required to limit the long-term societal costs and impact that this disability can have. Of course, it affects society as a whole, not just the individual. We want to give people the best chance in life, and that is why it is particularly appropriate to look at how we can support children who have an acquired brain injury. There needs to be improved training for newly qualified teachers—currently, acquired brain injury is not covered in that training—and a national campaign of recognition that acquired brain injury affects an additional 40,000 children and young people every year and has a significant impact on society.

The Child Brain Injury Trust says that acquired brain injury continues to be misdiagnosed and misunderstood, and our current system, and lack of knowledge and support, is letting down thousands of families. Funding is required for whole-family support. We need improved training for educators and youth justice teams, because over 60% of young people in custody report prior head injury. As other Members have mentioned, many young people affected by acquired brain injury are excluded from school due to their “inappropriate behaviour” and then go on to commit crime. Therefore, better knowledge of the condition and improved support has the potential to save society huge sums of money otherwise needed for youth justice.

The Child Brain Injury Trust calls for involvement and commitment from the Department for Education to support and fund some of these recommended initiatives. As I said, I hope that the Department for Education will take a more active part in looking after these young people and look again at its response to see how it can be improved.

The other area I want to touch on, which has already been mentioned by a number of Members, is acquired brain injury and carbon monoxide poisoning. This is not something that I had thought of myself. It shows, again, how many areas of our lives and our environment affect people and can cause acquired brain injury. I am a member not only of the APPG on acquired brain injury but the APPG on carbon monoxide, and earlier this year we had a special roundtable meeting chaired by my hon. Friend the Member for Rhondda. One of the difficulties is recognising when people are suffering from carbon monoxide poisoning, especially the impact that that can have on the brain. The shortage of support is particularly difficult for people with an acquired brain injury caused by carbon monoxide poisoning, as they are less likely to receive specialist treatment if they experience low-level carbon monoxide exposure that results in more subtle neurological effects. To address this, the APPG on carbon monoxide recommends that NHS England develop a specialist clinic for people with long-term neurological effects caused by carbon monoxide exposure. This will help to plug the gap in care provision and enable future studies that will innovate treatment methods.

We must also remember that, as the Government said in their November 2018 health and social care policy paper, prevention is better than cure, and preventing carbon monoxide poisoning will also prevent some of these acquired brain injuries. The APPG recommends that the Government introduce preventive measures, including mandating carbon monoxide alarms in all tenures. I know that the Government are already looking at this in certain tenures, but it should be across all tenures. Carbon monoxide monitors should be provided for those in first-time pregnancy. We must tackle substandard housing that increases the risk of carbon monoxide exposure. We also recommend that Public Health England and the Foreign and Commonwealth Office do more to raise public awareness of carbon monoxide, to encourage risk-lowering behaviours at home and abroad. The special roundtable meeting that we had was very productive. We had a high number of medical people there who were recognising this problem that perhaps the rest of us had not recognised until now. We need some practical steps to improve that.

I have mentioned the Child Brain Injury Trust’s recommended actions, particularly on education. There is so much more that I could say, but much of it has already been said, so I will only mention a few things. We are seeing more people survive severe trauma, and we must give more effective support after they recover from their immediate injury, to help them develop their life.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way. I have personal experience of this through my brother, who unfortunately had a very severe accident, which left him brain-damaged. Owing to the determination of my parents and family, who took the time to care for and look after him, we were able to give him some sort of an independent life, which is very important. He is happy and safe with his carers, friends and family. Does the hon. Lady agree that more needs to be done to support the families of those with ABI, to give them hope that there can be more than Sunday visits to a designated place—there can be a home life as well—and there is a chance of a semblance of normal life for people with ABI? Intensive care packages are essential to rehabilitation, and funding must be available for them. It is so important to give people who have acquired brain injury a normal life, if at all possible.

[Liz Twist]

I thank the hon. Gentleman for his comments. I certainly agree that we must give more support to the carers and families of young people or adults with acquired brain injury, while allowing the person who is directly affected to have as full and good a life as they can.

I want to mention the “One Punch” campaign. We are becoming increasingly aware of the impact that one punch on a night out, perhaps after a lively evening, can have. It can be devastating, and I am glad to see campaigns around the country aiming to ensure people are aware of that. We have talked about how sports must keep up the level of support and awareness and, if in doubt, sit people out. That is really important. We have also heard about the huge impact on our prison community. We must develop a response to that, so that we can take account of acquired brain injury and how it affects people’s behaviour and development.

Headway has made some recommendations. It says:

“Brain injury can happen to anyone, at any time. Living with the effects of a brain injury creates challenges in almost every area of life.”

That is so true. Headway is calling on Members of Parliament to recognise and support the needs of service users, families and carers, including greater understanding of the complexity and hidden effects of brain injury; wider recognition of the symptoms of brain injury, to ensure rapid and accurate diagnosis; access to timely, specialist rehabilitation and support services; an end to lengthy waits for social service assessments for support funding; changes to disability benefit assessments, which currently fail a large number of brain injury survivors and their families—Headway has a campaign called “Right First Time”—and more effective data gathering across the NHS, to provide clearer evidence of the needs of survivors, around diagnosis, acute care, longer-term rehabilitation and support to regain independence. Acquired brain injury is life changing, and we must do everything we can to support people across all spheres of life.

Blaydon Quarry Landfill Site

Debate between Liz Twist and Jim Shannon

Monday 1st April 2019 Commons Chamber

[Liz Twist (Blaydon) (Lab)]

I am very pleased to have secured this Adjournment debate on the Blaydon Quarry landfill site. It is a matter of great concern to my constituents in the communities surrounding the site.

My constituency has had more than its fair share of landfill sites, both in the past and more recently; there are landfill sites on either side of the main road from the town of Blaydon out to the west, so complaints about them are a constant. In 2016, there was a major incident at one of them, Path Head, when for months a heavy, sulphurous smell hung over large parts of Ryton, causing intense concern about the impact on health and seriously affecting residents’ ability to enjoy a normal life. Thankfully, that site has now closed and is being restored, but it has left an enduring concern about the effect that landfill sites have on our communities. In particular, it has had an effect on the established former mining community of Stargate and Crookhill, within just a few hundred yards of the site, which have had to endure odours and other problems throughout its life, but it also affects the Stella area. It is in that context that this debate and the concern of my constituents must be understood.

I turn to the subject of tonight’s debate. Blaydon Quarry is a landfill site in the west of my constituency. It is located in the village of Greenside, but is surrounded by the communities of Greenside, Winlaton, Barlow, Stargate, Ryton, Blaydon Burn and Blaydon itself. It is very close to each of those communities, and each has felt the impact of the site over many years. Over the years, there have been a number of different site operators—Premier Waste, Niramax, Octagon Green Solutions—each bringing its own problems. The site is now owned by a company called Recyclogical, but following the refusal of a transfer of the environmental permit to it last year, Octagon Green Solutions remains as the permit holder and site operator—an issue to which I intend to return later.

Over the period that my predecessor, Dave Anderson, was the Member of Parliament for Blaydon, and while I was a local councillor, residents have consistently—perhaps I should say, persistently—complained about the Blaydon Quarry landfill site, so this is by no means a new issue, but it is a very current one.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Lady beforehand to seek her permission to intervene. As her case is very similar to ones I have had in my constituency of Strangford, I wanted to make a short intervention. Does the hon. Lady agree that it is essential that quarry landfill sites are held to the highest standards when it comes to neighbourhood issues? A little common sense and perhaps a little money as well from quarries in due season would go a long way in ensuring good neighbour relations and, subsequently, result in fewer complaints. In the council I served on, Ards Borough Council—it is now Ards and North Down Borough Council—there were some issues, and we were able to have those issues addressed. Does the hon. Lady agree that people have a right to live in peace at night and without offensive smells, no matter what their postcode is?

[Liz Twist]

I agree, of course, with the hon. Gentleman’s last statement, but I disagree with some of his earlier comments, because I think the time is now ripe for us to go beyond monitoring, controlling or whatever. We need a totally different approach to landfill for the benefit of our communities.

As I was saying, over the period that my predecessor was in post and I was councillor, there were persistent complaints about the site, so it is by no means a new issue, but it is a very current one. Most recently, about two months ago, as they have done on many previous occasions, many residents contacted me about a bad smell in the air. I call it a smell, because calling it an odour, as the official documents do, is far too polite. In fact, residents did not need to contact me about it, as I could most definitely smell it myself when I was at home. The smell was persistent and very unpleasant. Some people reported the smell to the Environment Agency’s incident hotline, and many more complained to me, to councillors and to neighbours.

I raised the issue with the Environment Agency team, who were responsive, as always. Residents were very pleased to hear in mid-February that the site had been stopped from receiving waste for a period of up to two weeks while the operators fixed the problem of the smells from uncovered waste that were affecting our communities. The required action was taken and the tip reopened for waste, but problems continue.

That was just one of the latest incidents at the site that have blighted our communities over several years and, frankly, our communities have had enough. They have had enough of bad smells, enough of heavy vehicles on our country lanes, enough of litter from the site and trucks being scattered in our fields, and enough of dust from the site. They have had enough of the site and want to see it closed, and so do I. That will come as no surprise to the site owner or operator as I have made my views clear in the site liaison meetings, when we have had them—they are often very heated—and elsewhere.

In early 2015, during a period of high winds and despite advice from the Environment Agency, there was a huge escape of litter from the site, with litter sprayed around the hedges, in fields and in trees. Our usually green and pleasant area was festooned with rubbish. It was, frankly, disgusting and not easy to clear, and still today the tatter of plastic bags can be seen in trees and bushes around the periphery of the site. It created a huge outcry, with residents protesting, angry at this littering of their local environment. It was environmental vandalism of the highest order. No lay person could fail to see the devastating nature of this rubbish escape. Astonishingly, after consideration by the Environment Agency legal team, we were told that it was not possible to prosecute that breach, even though the scale of the devastation was clear to local residents.

Over the years, there have been other issues too. The Winlaton Action Group was set up by local residents after many people found dust settling on their cars and became extremely concerned about the impact that this and other issues at the site were having on their health. That remains a concern for local people, particularly in the context of the major problem that I mentioned earlier at the Path Head site causing really bad smells over a long period.

Another issue is the height to which rubbish is being tipped. I met some residents recently in Stargate, Ryton, who showed me photographs of an uninterrupted view past the landfill site over to a neighbouring village. When we lifted up our eyes from the photograph, all we could see was a mound of rubbish with a digger on top. The Environment Agency has been out to check the height and I understand that some action is being taken, but the tip has changed our local landscape.

Then there are the large lorries that transport waste from other parts of the country to Blaydon. It is not even our rubbish that is being tipped at the site—it comes from all over. Our waste goes to an energy from waste site under the South Tyne and Wear Waste Management Partnership. Not only is it inefficient for trucks to transport rubbish for miles and miles, but it is a hazard on the narrow roads immediately surrounding the site, creating mud and dust for other road users.

The Environment Agency, with whom I meet frequently, has sent me a list of enforcement actions taken since 2012—I am sure that the Minister will have a copy. It shows that there have been a number of formal interventions as well as the usual monitoring and advice that takes place.

In December 2014, an enforcement notice was served under regulation 36 of the environmental permitting regulations requiring actions following an escape of litter from the site. That ensured that any escaped litter was collected and that the site-specific litter management plan was revised. In March 2015, another enforcement notice was served under regulation 36 requiring actions following a further escape of litter from the site. That ensured that the further escaped litter was collected and that the site-specific litter management plan was again revised. Additional control measures were installed on the site.

In February 2016, a regulation 36 enforcement notice was served requiring the progression of engineering works to manage landfill gas. This notice ensured additional gas extraction wells were installed within a recently completed area on the site. In July 2017, a regulation 36 enforcement notice was served requiring improvements to the leachate management system on site. This notice ensured that more leachate was removed from the site, rather than just being recirculated around the site. In January and February 2018, two further regulation 36 enforcement notices were served, requiring the implementation of additional engineering works to manage landfill gas. These notices were served following odour issues identified from landfill gas emissions. The notices required the installation of additional gas extraction and further areas of capping.

In February 2019, a regulation 37 suspension notice was served, preventing waste inputs while remedial works were carried out. The notice was served following complaints of odour from the site. The odour complaints were linked to an area of waste not properly tipped or covered. The notice required that this area of waste be re-profiled and covered appropriately. The notice was served on 19 February. The work was completed and the notice lifted on 26 February. As we can see, there is a whole series of issues concerning smells, leachate and litter, on top of the day-to-day concerns residents have raised and continue to raise through liaison meetings and meetings with the Environment Agency.

Of course, it is not just the Environment Agency that is concerned with regulating the site. Gateshead Council also has a part to play through planning enforcement. There is quite a catalogue here, too. In May 2018, there was a report to the planning committee which summarised the outstanding issues, including: restoration of some completed areas; ecological provisions, including nesting for sand martins; and, perhaps most importantly, proposals for the drainage scheme on site. As late as last week, the council issued the company with a letter refusing to discharge all but one of the planning issues that had been raised. All that came after a stop notice was issued by the council in April 2018 requiring the removal of caravans from the site. The caravans were removed, but really they should never have been there in the first place.

On top of that, we have a very real concern that the split between the operator holding the environmental permit and the land owner, who appears to be actually working the site, represents a real danger for the effective running of the site. There have now been three applications for the transfer of the environmental permit and none has been granted. That has to raise real questions about the sustainability of the current arrangements and people are quite understandably concerned that this exposes our communities to further risks, as clearly the current operator, having sold the site itself, wishes to give up the permit.

My constituents and I are well and truly fed up with the impact the landfill site is having on our environment and our lives. We just cannot understand why repeated breaches on planning and environmental grounds cannot lead to the landfill site being closed, safely, once and for all, and the site restored. I should say that in my experience, staff at both the Environment Agency and Gateshead Council have been very good and helpful in pursuing the issues we raise, but we have had enough and believe that the site should be closed forthwith.

So what am I asking the Minister for? First, to strengthen the law covering landfill and waste sites to ensure that, where there are recurring problems, communities do not have to continue to endure the problems arising from landfill sites. We need much stronger powers for the Environment Agency to act to really protect our environment and to deal with landfill operators that fail to meet their duties as good neighbours.

Secondly, I ask the Minister to work with her colleagues in the Ministry of Housing, Communities and Local Government to strengthen planning enforcement, but moreover to ensure that no landfill sites should be allowed so very near to where people live, as is the case in Blaydon. There are families living immediately around the perimeter of the site who, over the years, have suffered from incidents directly affecting their properties, as have the villages and the people who live in communities just that little bit further out. Living next to a landfill site is never going to be pleasant and we must tighten up planning to ensure that this can never happen again.

Thirdly, I ask the Minister to take practical and legislative steps to end the use of landfill sites by strengthening environmental legislation and reducing waste to landfill. Fourthly, and perhaps most importantly for my community, I ask her to work with me, my constituents and statutory bodies to see that the Blaydon quarry landfill site, like the neighbouring Path Head quarry site, is closed safely and restored, to bring an end to the years of misery my constituents have had to endure.

Transport Safety: Blind and Visually Impaired People

Debate between Liz Twist and Jim Shannon

Wednesday 6th June 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

The hon. Lady has secured an Adjournment debate on an important subject. Does she agree that, with 250 people a day starting to lose their sight in the United Kingdom of Great Britain and Northern Ireland, there is a real need for an increase in the number of specialised public buses and trains for the sight impaired in both rural and urban locations, to ensure that constituents with a sight impairment are not isolated?

[Liz Twist]

I very much agree that it is important not only that there is specialised transport, but that all public transport is accessible to people with a visual impairment.

NHS Wholly Owned Subsidiary Companies

Debate between Liz Twist and Jim Shannon

Tuesday 6th March 2018 Westminster Hall

[Liz Twist]

I most certainly do agree with my hon. Friend. We know that NHS trusts are under incredible financial pressure and are looking for ways to stretch the available funds. Some trusts have seen wholly owned subsidiaries as a way of reducing costs. Those trusts include the Gateshead Health NHS Foundation Trust, which provides excellent hospital services to many of my constituents.

The cost savings come about in two main ways: through saving VAT and by saving on staffing costs. For some, there may be a third area of income—advising other NHS trusts on going down the same path, which is one of the reasons why they are spreading across the country. In November 2017, the then Health Minister, the hon. Member for Ludlow (Mr Dunne), stated that:

“NHS Improvement is aware of 39 subsidiaries consolidated within the accounts of foundation trusts”—[Official Report, 14 November 2017; Vol. 631, c. 129.]

We know that more are being created even now.

[Jim Shannon (Strangford) (DUP)]

The issue of pensions is very much at the forefront of the minds of myself and others in this House. Does the hon. Lady agree that it is essential that staff working through the front door of the NHS or the back door of the wholly owned subsidiary company must be entitled to retain their NHS pension? Any attack on the pension scheme must be wholly rejected and the trusts must all be made to understand the position on pensions when these types of actions are taking place.

[Liz Twist]

I most certainly do agree, not just for pensions but also for terms and conditions.

What is the problem with these companies? First, it is that they come at a price, which for the most part is met by the staff who work for them. Secondly, the VAT saved by trusts with these companies is not new money coming into the NHS—the money that trusts save will be lost elsewhere in public services. Already, the Department of Health and Social Care has reminded trusts by letter that they should not engage in any activities that may be construed as tax avoidance, and the loophole could be closed in the future. Thirdly, the establishment of wholly owned subsidiaries leaves the services open to privatisation in the future, continuing the fragmentation of our NHS.