Interim NHS People Plan

Jamie Stone Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

The hon. Lady is right: that culture is not acceptable and must be driven out. She will have read the interim people plan, which talks explicitly about ensuring that we create leadership that stops that culture. There is a chapter on making the NHS the best place to work. She will know that we have been working across the country to ensure that all staff know that they are valued, that they have the right to speak up and that the culture of bullying must be driven out. I shall speak with Baroness Harding, as I do regularly, to ensure that that message is spread throughout the NHS and that staff know that they are valued.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I realise that health is devolved to the Scottish Government. Nevertheless it has to be said that the Scottish Government are having enormous trouble with their workforce planning, which means that doctors and nurses have to pick up the slack and that we are wasting good money on employing agency staff, which need not happen. May I make a plea to Her Majesty’s Government to share workforce planning and best practice with the Scottish Government so that they can get that right?

[Stephen Hammond]

As the hon. Gentleman rightly pointed out, health matters in Scotland are devolved, but I am delighted to share any of the excellent initiatives that are set out in the draft people plan with the Scottish Government.

Tessa Jowell Brain Cancer Mission

Jamie Stone Excerpts

Monday 13th May 2019 Commons Chamber

[Matt Hancock]

The hon. Gentleman is right to say that, and I send my condolences to his constituents. The truth is that brain cancer is one of the most, if not the most, predominant cancers among children. Although it is relatively rare among all cancers, that is not true among children. Thousands of people still die from brain cancer, which is why it was right that Parliament and Tessa Jowell came together to highlight the lack of research in the area—something that we are determined to put right.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

May I too thank the Government for today’s statement? I was heartened by the answer given to the hon. Member for Worthing West (Sir Peter Bottomley), because early diagnosis is incredibly important. There are certain things that people can recognise, such as the effect on vision. Ironing a pinstripe shirt, for example, can lead to an odd effect, which is an early sign. Early screening in built-up areas and cities is quite easy, but it is harder in rural areas, so I make a plea for the Government to consider sparsely populated regions such as mine.

[Matt Hancock]

The hon. Gentleman is right that screening is vital. One of the reasons why we are looking at the whole screening programme is that the use of technology has not been nearly good enough. For many people, but not all, that can be valuable, especially in rural areas. Technology is not only used for the screening itself, but for notification and for ensuring that we get to everybody who needs to be reached. Professor Sir Mike Richards is undertaking the review of all screening, and I would be happy to put Sir Mike in contact with the hon. Gentleman to ensure that the review properly considers the impact of rurality on the need to get screening to everybody who needs it.

Acquired Brain Injury

Jamie Stone Excerpts

Thursday 9th May 2019 Commons Chamber

[Chris Bryant]

That is one of the key points that everyone on the all-party group wanted to make. It is all very well saving someone’s life but, because we have seen so many miracles done by good neuro-rehabilitation in the community, we need to make sure it is available where people live. Otherwise we are condemning people to a half-life existence when we could restore real quality of life—they might go back to work and be fully independent.

The hon. Gentleman is absolutely right to say it is a matter of getting social care to work with NHS and getting all the different organisations to work as a whole. That is why we hope that the Government—there are signs of this, but we would like to see more signs—will not work in silos of departmental and organisational thinking. We have to think across the whole, because this affects nearly every Government Department.

Many patients lose their executive functions, so they find it next to impossible to plan, make decisions, monitor what they are doing or control their emotions—that can make it difficult even to cook for themselves. In particular, a brain injury to the frontal lobes during the teenage years, when that part of the brain is still developing, can turn a charming, ambitious and able young person into an out-of-control youngster. All too often, if the brain injury is missed or misunderstood, they get into trouble, they are excluded from school and they fall into the criminal justice system. I read Edward Timpson’s report this week. It is an important piece of work, but it is a shame that it does not mention brain injury at any point. I will be writing to him about that to see whether it is another element that we need to address if we are to stop exclusions, which are currently so prevalent.

Even a minor brain injury can lead to headaches, dizziness, fatigue, depression, irritability and memory problems. Sometimes the effects last long after the injury, and sometimes they do not even appear until some time after the injury, which makes them particularly difficult to spot.

Partners and family members have a tough time, too. The hon. Member for Ochil and South Perthshire (Luke Graham) will know from his own family how complicated it is to make sure that people get the support they need. Loved ones have the terrible fear of the unknown. What is going on inside their loved one’s head? Will the anger and frustration they seem to be suffering get stronger, or will it ease off? How much will they be able to recover their former abilities and personality? And how hard will they have to struggle to get the support they need?

In too many instances, families and patients are being pushed from pillar to post when it comes to benefits. Listen to what happened to Jordan Bell, who had a motorcycle accident some six years ago, when he was 17. The accident left him in a coma for six weeks and in rehabilitation for six months before he went home. He had to learn to walk, talk, eat and socialise all over again. I am glad to say that he has made a remarkable recovery and is now a father, but he lives with significant, serious and completely unseeable impairments.

Jordan’s father describes dealing with the welfare system as

“the most demoralising and depressing experience for us all.”

This is a professional family. The initial application for personal independence payment took six months, with interventions from the family’s MP. David Bell writes:

“A year or so after our son’s condition had improved we contacted the relevant department to advise them that he was in our judgement no longer entitled to some elements of the PIP. We were ‘quietly’ advised not to inform them of the changes at all, but as we are honest people we felt duty bound to inform them of our son’s improvement. The advice given to us was correct; instead of adjusting the PIP in what would have been a sensible way the PIP was cut entirely. This then set in motion another six months of huge effort and stress and again the involvement of our MP to get the PIP reinstated. We eventually succeeded. But two years later it was reduced again to nothing.”

I cannot emphasise enough the stress this process puts on people with ABI.

One woman told me:

“I know I should use all my energy to try and get my brain back together. But I end up spending all my energy on forms”—

filling in forms and fighting bureaucracy. An unresponsive, intransigent welfare system is effectively preventing people from healing. I beg Ministers to take this issue seriously and to make sure that all PIP advisers are trained in the fluctuating and unseeable nature of brain injury. After all, one common feature is that patients become over-keen to please people. Often, they will tell the assessor everything they think the assessor wants to hear, because that is part of the condition.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Notwithstanding what I will say later, in casework I find that a surprisingly high number of disability living allowance claimants are having the mobility element carved away as they move to PIP, perhaps because, as the hon. Gentleman says, they have exaggerated their ability to get from A to B or to move into work.

[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.

--- Later in debate ---

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I thank the hon. Member for Rhondda (Chris Bryant) for bringing forward this debate and I compliment all the speakers on their contributions. It would be churlish of me not to say a word of congratulation to the Minister on her appointment. It is a delight to see her in her place. I am going to give the House something of a personal account, which I will try to keep fairly brief. I hope that I can draw from that personal account a number of conclusions and suggestions.

Yesterday and today, several Members have remarked on the fact that this is the 20th anniversary of the foundation of the Scottish Parliament. In early 1999, I was canvassing in north-west Sutherland. I always start canvassing early, but don’t tell the SNP. I pulled up at a phone box at Inchnadamph—this was back in the days when we had phone boxes even in remote parts of the highlands—I tried to ring home and there was no reply. So I carried on. When I got home at 5 or 6 o’clock that night, I discovered that my wife was in hospital—at Raigmore Hospital in Inverness.

My wife had been due to drive to Inverness to get the messages, as we say in the highlands, but found—as it turned out, very luckily—that the car had a flat tyre, so she caught the bus to Inverness. Having got her shopping, she was at the bus stop waiting to come home again when she took a massive epileptic fit. She woke up in Raigmore Hospital. Very shortly afterwards, when the staff took an X-ray of her head, they discovered that she had an extremely large meningioma, which is a form of tumour. Luckily, it is a benign tumour, but they reach some size. Within weeks, she had an operation to remove the meningioma. Unfortunately, in the recovery ward shortly after her operation, she took a further brain haemorrhage and had to go straight back into surgery. She was then in intensive care, but she did survive. I want to say that, for my family, for me and for my dear wife, it was an incredibly difficult time. How my eldest daughter, who was then aged 17, got through her studying for her highers, I will never know. I always think that my three children were in fact braver than I was; I put that on the record.

I want to say something else for the sake of the record. Reference has been made to the NHS and just how good it is. The then consultant neurosurgeon at Aberdeen Royal Infirmary, where my wife was operated on, was Mr David Currie. He and his team, as well as the nursing staff, were absolutely astonishing. I owe them and my wife owes them absolutely everything. They may think it was churlish for me to carry on canvassing to be an MSP but, when my wife could speak, which was not for a few weeks, I said, “Look, it’s only March and the election isn’t until May, I think I’ll pull out”, and she said, “Don’t.” She said it very quietly—she could only speak very softly. She said, “You must carry on. I think you might win.” And so I did. So there is a happy end to the story.

My wife is left somewhat disabled—she has a weak left leg and she has lost the use of her left arm—but, as we always say in my family, she is alive. She remains better than I am at the crossword. I cannot tell hon. Members how annoying that is, but that is just the way it is. She suffers from mild anxiety about things; much comment has been made about the side effects of this sort of surgery. However, I am intensely grateful to the NHS.

There are one or two conclusions that I would draw in this short contribution. The first is that we could see that Mr David Currie, the consultant neurosurgeon, and his staff—I admit this was 20 years ago—were stretched. Mr Currie always said to my wife for some years afterwards, “You see these white hairs. I got these operating on you for the second time.” But they were pushed. They were working extremely hard, but we could see they were pushed.

Secondly, as I have said already, we could see the sheer importance of the NHS and what a great British institution that is. I think, rightly, all parties in this place cherish and nurture it. I have to say, as an aside, that when I hear some of the comments coming across the Atlantic from the United States about how they do not want anything like the NHS, I think that they are just plain dotty. It is something of which we are very proud.

A third point arises from this experience, which was difficult. I admit that it was 20 years ago but, when my wife came out of hospital and came home, there was the business about what occupational therapy and physio help she could get, what was the social work package and how that was going to be handled. I think things have improved since then—I give credit to the Scottish Government for that—but how this is put together is very traumatic for the patient and for the patient’s loved ones. I was 44 and my wife was 42, and we had a family in their teens. An event such as this is a crisis and a change that you can hardly understand at the time. But, as I say, life goes on and we are where we are.

I have a habit of talking about disability issues because of my wife. One of the reasons why I volunteered—I was probably completely insane—to go on the small Committee charged with building the Scottish Parliament was that I could see that the old temporary Parliament at the top of the Mound in Edinburgh was utterly unsuitable for disabled people. Because of my wife’s experience, I got involved in what was known as the Holyrood project. It damn nearly lost me my seat at my second Scottish election because it was a very controversial issue, as I am sure the hon. Member for Ayr, Carrick and Cumnock (Bill Grant) will recall.

I have mentioned several times in this place the issue of getting disabled people back into work. At a time, whatever happens with Brexit, when we must play to all our strengths—we must play every card we hold—we have a lot of people who have been ill or are partially disabled who have great abilities that they could contribute to the functioning of the United Kingdom and to forging a new and better future for the United Kingdom. It remains a challenge for Governments of all colours to harness those people. If nothing else, it makes them feel that they are contributing to the country and it makes them feel useful and that they are important. Self-esteem and the esteem of your peers is incredibly important to happiness and to quality of life.

I want to take up the point, which I think was made by the hon. Member for Rhondda, that notwithstanding the desirability of local delivery of services, there is something to be said for amalgamation when it comes to something as crucial as neurosurgery. At the time of my wife’s treatment, there were four neurosurgical units in Scotland and Mr David Currie was the sole consultant neurosurgeon at Aberdeen Royal Infirmary. Had the four units been put together as one, there would have been better peer working and peer support. I think the hon. Gentleman made the point that, when it is something as traumatic as neurosurgery, people do not mind travelling. From the northern highlands, it did not really matter to me whether it was Aberdeen, Edinburgh or Glasgow—I just wanted my loved one to get the best possible treatment. I know it is always the case that we will get a local campaign saying, “No, no, no—not this”, but I think we can draw a line on some services, where centralisation for the maximisation of making people better is important. We should not lose sight of that.

A meningioma is a tumour that can kill you. It is a meningioma whether people live in Scotland, England or Wales—anywhere at all. I therefore appeal both to the Scottish Government and the UK Government for maximum co-ordination across borders on health delivery, the health service and making people better. I would hate to think that a line drawn by people on a map would in any way get in the way of that because this is about saving lives and making people better, which is surely one of the most important things.

I am going to end, as is my wont in this place, with a very short anecdote. I was lucky in May 1999. I would not say if they are sad enough, but if Members have a dull moment they can look at this week’s edition of Holyrood magazine and remark how young I looked then; I have aged terribly badly since then. I did win my seat. The Times decided to do a vox pop of my new constituents only a few days after I was elected. It asked one lady from the village of Kildary in Easter Ross, “How do you feel about Jamie Stone being elected to be an MSP for this constituency?” She replied, famously, “Well, at least it keeps him off the street.” When I read that to my wife in her hospital bed, she roared with laughter and I knew then that she was better.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 27th November 2018 Commons Chamber

[Caroline Dinenage]

I will of course meet my hon. Friend. She is right that we need to keep such valuable local resources right in the community, where they are most needed and where they keep people out of acute hospital services and surrounded by their friends and family.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The usage of Caithness General Hospital in Wick in my constituency is way below what it was originally designed for, causing my constituents great anxiety if they have to travel over 200 miles to Inverness and back. Mr Speaker, you will tell me that such matters are devolved, so will the Government share best practice on community hospitals with the Scottish Government and NHS Highland?

[Mr Speaker]

What a wily fellow to get the question in order. Well done, man.

Budget Resolutions

Jamie Stone Excerpts

Tuesday 30th October 2018 Commons Chamber

[Brendan O'Hara]

I refer the hon. Gentleman to the commission’s report and advise him to read it, rather than simply taking the crib sheet handed out by his party.

Much has been made of the Chancellor’s announcement that £20 billion of new funding would be made available to the NHS over the next five years. We are told that that funding will be transformational for the national health service, but let us put it into perspective. The new money, which we welcome, averages out at a 3.4% increase per annum for the next five years. That is actually still less than the average funding increases received by the NHS in the first 60 years of its existence. All the Chancellor announced is that NHS funding, having been squeezed mercilessly by the Tories in the past decade, is returning to a position that is a little below its historical average. The reality is that in releasing this money, the Chancellor has simply removed the Treasury’s heavy boot from the neck of the national health service. If the Chancellor had had the good manners to remain in the Chamber until my right hon. Friend the Member for Ross, Skye and Lochaber (Ian Blackford) had spoken yesterday, he would have heard him ask why the Scottish national health service is being short-changed in the Budget to the tune of £50 million a year, which makes a cumulative shortfall of £250 million over the five-year period. That £50 million is enough money to pay for 1,200 nurses in Scotland.

In his Budget, the Chancellor had the perfect opportunity to do the right thing: stop the roll-out of universal credit dead in its tracks until the well-publicised faults in the system, which are hurting the poorest and most vulnerable in our society, have been fixed properly, once and for all.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Further to that point, is it not a scandal that the Highland Council has to fork out £2.5 million of its carefully hained resources to pay for the roll-out of universal credit? What might that £2.5 million have done for some of the poorest people in areas such as Argyllshire and my constituency?

[Brendan O’Hara]

I could not agree more. The hon. Gentleman is absolutely right to highlight the cost to councils and individuals of the appalling roll-out of universal credit. The Government know that it is wrong, but they are pigheadedly determined to see it roll out. The Budget was the Chancellor’s perfect opportunity to stop it, but he refused. For reasons best known to himself, he decided instead to tinker around at the edges, with the promised money coming nowhere close to meeting the shortfall that was created by his predecessor. The Chancellor has decided to do almost nothing for those who are currently on universal credit and are struggling under the work allowance, the two-child cap and the benefit freeze.

As Gillian McInnes, the manager of the citizens advice bureau in my Argyll and Bute constituency, said:

“The Government has still not done enough to address the real problems of universal credit, which are causing serious hardship for many families. Without further support for families, many parents and children will be left in a desperate situation, with many”—

indeed, many more—

“forced into using food banks.”

This was the Chancellor’s opportunity to end austerity—he chose not to. This was his opportunity to stop and fix universal credit—he chose not to. Instead, he and the UK Government chose to hand out tax cuts to the wealthy while continuing to try to balance the country’s books on the backs of the poorest in our society. Heaven help us all if this was the Chancellor’s “good guy Budget”—the one that was based on the Government securing a half-decent Brexit deal. One shudders to think what he has up his sleeve when we are all forced to reconvene in this place early next year for his fiscal event, if and when the Brexit negotiations go totally pear-shaped.

Clinical Waste Incineration

Jamie Stone Excerpts

Tuesday 16th October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend will be aware that the Environment Agency is an independent body, so it will be for the Environment Agency to reach a decision on whether such a suspension should be raised. I can reassure the House that the issue is subject to great scrutiny at present and that the Environment Agency is looking at it very closely.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It seems to me that there are two ways of looking at such issues. Factoring in numbers, statistics and logic is one way and leads to one conclusion, but when we think about human decency and human dignity it becomes something entirely different. The public’s confidence in the methodology is absolutely paramount at this stage. First, does the Minister recognise that, and secondly, can he tell me what he is doing to restore that public confidence?

[Stephen Barclay]

The hon. Gentleman is absolutely right, and I very much recognise that. The emotive nature of the topic and the way in which some of the headlines have been written do cause alarm. We are being very strategic. First, we are ensuring that our key priority, which is continuity of service in hospitals, is maintained. Secondly, we are ensuring that a supplier is mobilised as quickly as possible. He will recognise that to mobilise a supplier over so many contracts, where those contracts are not uniform—there are different legal provisions in them—is a complex issue. Thirdly, where there is an interregnum with regard to contingencies and waste that needs to be stored on site, we are ensuring that that is done in the safest way possible and that the waste is then cleared at the earliest opportunity.

Baby Loss Awareness Week

Jamie Stone Excerpts

Tuesday 9th October 2018 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is a great privilege to take part in this debate. The hon. Member for Eddisbury (Antoinette Sandbach) and others have set an almost unsurpassable standard in their comprehensive, thoughtful and moving accounts of the issue before us tonight. When I thought about what I was going to say today, I found myself strangely circumspect, reticent and shy about what I might or might not say, possibly because I am old fashioned—probably more so than I should be. At the back of one’s mind there is always the thought, “Is it in good taste? Should I go there? Should I not?” But in a flash it came to me: I have only one sibling, my younger brother, who is nine and a half years younger than me, and all my mother ever said about this—she is dead now—was that she had a number of miscarriages between me and my brother. It is very much to my detriment, to my dishonour, that I never broached this subject with my mother and said, “What happened?” I very much regret that. My parents were immensely British, and they got on with it and suffered in silence, but I wonder how many miscarriages she had and what that agony was like. It is too late now, and “too late” are some of the saddest words in English.

The point has been made about parents, and I am a parent, all three of whose children were born relatively easily and successfully. As one or two Members of this place know, I am also a grandparent and a brother-in-law, and for that reason am not untouched by the type of tragedy that has been described today. One thinks, “It is not going to affect me”, but it comes damned close. So I have the experience. The second thing I found to be almost like a searing wound to me personally: witnessing the extraordinary grief of what happened. This was a searing, dreadful, ghastly grief. The hon. Member for Colchester (Will Quince) has said that we must reach out, give people a hug and ask how we can help, but that grief has to be seen to be believed and it is terrible.

[Victoria Prentis]

I have really appreciated the hon. Gentleman’s input into our group. We should, of course, have mentioned the importance of grandparents and wider family. They have been present in the all-party group, in the form of my father, right from its inception in the middle of the night, when we were waiting for a late vote, and they play a crucial role in helping parents and others to get through the awful loss of a baby. Of course grandparents matter!

[Jamie Stone]

The hon. Lady makes the point much better than I can. I take great comfort in the thought that I may be slightly more than just a doddering old fellow who amuses the kids. I like to think, and I hope, that I helped my two daughters through their trauma.

The hon. Member for Colchester made the point about the partner—about the man in the equation—several times, and nothing was ever truer. How terrible it must be to witness a stillbirth—a child who arrives too early to survive. I would dare to suggest that the man is emotionally every bit as bruised as the woman.

I wish to conclude simply by saying that in a debate such as this the House is at its best, and I give credit to the hon. Member for Eddisbury and others for that. I hope and believe that if people out there chance upon this debate online or read the record of it, they will find some human comfort—some milk of human kindness—which shows that we care. The hon. Member for Banbury (Victoria Prentis) mentioned to me the service in the Crypt on Thursday, and I will take part in the service and contribute a reading with the greatest of pleasure. Finally, I cannot even begin to surmise how, but when we had my family traumas, to my great surprise several Members, from all parts of the House, came up to me and said, “We understand. We know what you are going through.” When a completely unexpected hand reaches out like that, it is pure gold and reminds one of what friendship is really all about.

Acquired Brain Injury

Jamie Stone Excerpts

Monday 18th June 2018 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Thank you, Madam Deputy Speaker. That is now in Hansard. I am sure the Minister will enjoy it in the months and years to come.

It is an honour to speak in this very important debate, and I thank the Government for allowing the time for it. I pay tribute to my hon. Friend the Member for Rhondda (Chris Bryant) for calling for it and for his tenacity in ensuring it went ahead, against all the odds, when we all doubted it would and even though we are very pushed for time. I thank the all-party group on acquired brain injury and the right hon. Member for South Holland and The Deepings (Mr Hayes) for all their work and for their excellent campaign for better support and recognition for people living with ABI. I join the Minister in praising the work of the late and great Baroness Jowell. I, too, will never forget her last appearance in this Chamber in the Under Gallery.

Last month, along with colleagues from across the House, I was pleased to attend the rally for people with acquired brain injury at which they, along with their families, friends and carers, talked about their conditions and the services available to them. As we have heard, 1.3 million people in the UK live with the consequences of ABI, and each year approximately half a million patients attend UK emergency departments for traumatic brain injury. That is nearly 1,500 patients with traumatic brain injury attending A&E departments in the UK each day; one every minute. Brain injury can happen to anyone at any time, and all Members will have constituents living with the consequences of an ABI.

Despite the fact that so many people are living with ABI, it is little understood, which is why I am so pleased that the time has been allowed to discuss it in this place this evening. A brain injury can happen in an instant, but its effects can be devastating and last a lifetime. Thankfully, due to excellent advances in emergency and acute medicine, more and more children, young people and adults now survive and live with an ABI, but this brings its own challenges. As ever more people survive an ABI, further pressure is put on the vital services that people require.

For example, many individuals with an ABI require early and continued access to neuro-rehabilitation to optimise their recovery. The United Kingdom Acquired Brain Injury Forum says that the average cost of the initial rehabilitation programme is offset by savings in the cost of ongoing care within just 16 months and that this leads to an average saving over a lifetime in care costs of £1,475,760. That is a huge amount of money. Neuro-rehabilitation is therefore one of the most cost-effective services the NHS provides and one of the few services in medicine that result in long-term decreased costs to the economy. However, as is the case for many health conditions, 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. What plans do the Government have to address those issues and improve the lives of patients living with an ABI? The UKABIF recommends a review of neuro-rehabilitation to ensure that service provision is adequate and consistent throughout the UK. Does the Minister agree that that is needed?

Many children and young people with an ABI are in education, and therefore the majority will receive most of their rehabilitation at school. Yet among education professionals there is a lack of awareness and understanding of ABI, its consequences, and its impact on learning. A pupil with an ABI may also require extra support when transitioning between primary, secondary and further education. What discussions has the Minister had with his colleagues in the Department for Education to ensure that children with an ABI receive the support that they need throughout their journey through the education system? Will he discuss with them the inclusion of ABI in the code of practice for special educational needs co-ordinators?

Brain injuries can be difficult to detect for people who are not already aware of them, which is why all education professionals should have a minimum level of awareness and understanding of ABI. In fact, that requirement goes beyond education and into everyday life. People living with ABI are discriminated against because of the general lack of understanding of their condition. For example, earlier this year Grace Currie was escorted out of a pub on a Saturday night because the bouncers believed that she was “too drunk”. In fact, Grace, who had suffered life-changing injuries after being hit by a car in 2010, had had just one drink. The incident must have been extremely upsetting and embarrassing for Grace, and I am sure that it really knocked her confidence.

Sadly, such encounters are not rare, and the level of misunderstanding of brain injuries is high among the general public, including assessors for employment and support allowance and personal independence payments. A study conducted by Headway found that 71% and 60% of respondents felt that assessors for ESA and PIP, respectively, did not have an understanding of brain injury. Further, assessors were widely reported to lack empathy and patience, resulting in a stressful and even traumatic experience for many brain injury survivors. Many respondents also said that their medical evidence was not taken into consideration, and that the assessment location and environment were not suitable for them, despite requests made in advance. Consequently, a strong sense of frustration and anxiety was reported by brain injury survivors and their carers about the failure to recognise or respect their needs throughout the application process. Has the Minster had any discussions with his colleagues in the Department for Work and Pensions about that issue? Will he look into those concerns with his colleagues, and ensure that they are properly addressed?

Living with a brain injury is difficult enough for people without their having to struggle to explain and prove their disability to anyone who lacks understanding of the condition. Each brain injury is different, which is why it is so important to raise awareness of ABIs. However, it is also important to recognise that such injuries affect not just the people directly concerned, but their families and friends. Headway aimed to highlight that during brain injury week last month for its “you, me, and brain injury” campaign. Headway found that 69% of brain injury survivors reported breakdowns in their friendships after the injury, and that 28% of relationships ended after an ABI. However, it is not all doom and gloom: 47% of survivors reported improvements in their relationships with family members. It was clear from Headway’s study that a little bit of understanding and time really can go a long way. That is the kind of service that is provided by its 127 groups and branches across the country.

Headway Wearside, whose representatives I met recently at the rally in Parliament, provides information, support and social activities for brain injury survivors, and works with the local community, relevant professionals and organisations to promote understanding of ABI. I spoke to Neil and Jimmy, who use the Headway Wearside service, and was touched when they explained that Headway had brought them together as a community, and they had formed friendships that they never expected to form. Headway Wearside does not just teach new skills, but helps people to form and develop friendships at a time when doing so might otherwise be hard. When I met with Neil and Jimmy we feared that this service might soon be lost, and I am pleased to say that it has been extended to June 2019, and I hope it will be extended still further so that patients can have access to this life-changing service. I pay tribute to Headway Wearside and all the work it does for the local community, and I will continue to support it so that this vital service can continue to support its 4,000 patients.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

My wife suffered exactly this problem in 1999. The eldest of my three children was sitting her exams—her highers—at school, and while that school and the education system in general supported them fantastically well, there is the issue of supporting the children, quite apart from supporting the sufferer of an injury like this. Will the hon. Lady elaborate on how we might increase the support and help for families caught up in such situations? My children got through it, but it was touch and go, and I remember these events without much happiness.

[Mrs Hodgson]

I thank the hon. Gentleman for sharing such a personal anecdote from his own experience. It demonstrates why it is important that we support the Headways across the country that are giving this vital support to families in the position his family was in, and he is right to mention the children of people with acquired brain injuries; they must not be forgotten in all of this.

Unfortunately, not every patient with an ABI will have access to a service like Headway Wearside. If the Minister is to take away one thing from this debate, I urge him to recognise the need for services such as Headway Wearside and the other 126 across the country, so that the more than 1 million people living with a brain injury can access the support they need and deserve.

--- Later in debate ---

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute pleasure to speak in this debate on behalf of the Scottish National party. I worked in the NHS as a psychologist for many years, and I was involved in carrying out assessments of people who had acquired brain injuries. This is often a hidden disability. I would describe it as invisible much of the time and that contributes to much of the discrimination. It can have a major impact on people’s cognition, their personality—particularly if it is a frontal lobe injury—and their planning ability. It can have an impact on individuals’ speech. Some have to relearn vocabulary and the names of people they once knew. In severe cases, it can have a significant impact on someone’s memory. Consequent to all that is the impact on people’s mental health and their confidence.

I pay tribute to the agencies that work so hard with those individuals and their families, because a systematic and systemic family approach is what is needed to support individuals. The hon. Member for Strangford (Jim Shannon) is absolutely right in that regard, as he is in so many others. It is important to provide support to all members of the family. I also pay tribute to the hon. Member for Rhondda (Chris Bryant), who has played a crucial role in bringing this debate to the House. He is vociferous on this important issue, and he has again made sure that we have time to debate it.

My own husband suffered a head injury when he was serving in the armed forces many years ago, when his tank was overturned. He was a member of the Royal Electrical and Mechanical Engineers and is now a local veterans’ spokesperson. He was fortunate to have fast, intense rehabilitation. It is important that that is provided not only to those in the armed forces, but to the general population. I am interested in what the Minister has to say about medical spending on our veterans and their access to rehabilitation services in this regard, alongside our NHS trauma units.

There are also difficulties in relation to welfare benefit assessments, particularly for employment and support allowance and for personal independence payments. Those with an acquired brain injury often feel that their difficulties are not understood and not well assessed under the current procedures, so we need not only further training for assessors, but possibly to review the assessment process itself. Assessment sometimes does not pick up the fine changes that can have such a crucial impact on the daily living skills of people with an acquired brain injury. Support will be necessary because it can be difficult for those with such injuries to complete forms, gather adequate evidence and so on. The Minister for Disabled People is in her place this evening, so I will be grateful if she will meet with me, as chair of the all-party parliamentary group for disability, to discuss that further.

[Jamie Stone]

Does the hon. Lady agree that there is some evidence that the mobility aspect of PIP is not being recognised in this regard?

[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.

NHS Outsourcing and Privatisation

Jamie Stone Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Mr Hunt]

I can give the hon. Lady that assurance. I am most grateful to her for raising that issue and reassure her that my hon. Friend the Minister of State responsible for hospitals was at the hospital on Friday, going into detail about how we make sure that there are no delays on that issue.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

rose—

[Mr Hunt]

I will give way one last time and then I will make some progress.

[Jamie Stone]

I thank the Secretary of State for giving way. On the issue of freedom of access and equality of access, would he at least concede that where there are issues of distance, rurality and remoteness of location, that is a challenge—although health is devolved to the Scottish Parliament—which means that it is not quite as free for some of my constituents as it is for people who live in Glasgow, Edinburgh or London?

[Mr Hunt]

The hon. Gentleman makes a fair point, which would be echoed by many Government Members who represent rural constituencies. There is a balance to be struck between the benefits of specialist surgery, where greater volumes of a particular procedure are done, leading to better outcomes for patients, and the trade-off that we make with travel times. I know that that is something that the local NHS, in all parts of the UK, thinks through very carefully.

There is another myth we always get from the Labour party that I think it is very important to dispel: the narrative about the NHS being in total decline. Let us be clear about the pressures facing the NHS. We had to deal with the financial crisis of 2008, which left this country’s coffers empty. We have had to deal with the fact that over the last seven years, we have had half a million more over-75s. We had to deal with a crisis of care at Mid Staffs, which turned out to be a problem affecting many other parts of the NHS.

Yes, it is true that we are missing some important targets at the moment, but let us not forget the extraordinary things that have been achieved despite that pressure, such as for cancer. We inherited some of the lowest cancer survival rates in western Europe. In 2010, only 10% of patients got intensity-modulated radiotherapy; that figure is now 44%. We have two new proton beam therapy machines—at the Christie and University College London Hospitals—and there are 7,000 people alive today who would not be had we stayed with the cancer survival rates of 2010. Every day, 168 more people start cancer treatment than did in 2010. This is a huge step forward.

On mental health, previously we had no national talking therapy service for people with anxiety and depression; today, 1,500 more people are starting or benefiting from talking therapy services every single day, and we have huge plans to extend mental health provision to 1 million more people.

NHS 70th Anniversary

Jamie Stone Excerpts

Wednesday 16th May 2018 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is a pleasure to serve under your chairmanship, Mr Hosie. I am grateful to the hon. Member for Blaenau Gwent (Nick Smith) for securing this important debate. I wish the NHS a very happy birthday. I cannot understand—I get angry—when I hear politicians on the other side of the Atlantic rubbishing the NHS as a service. It is one of the greatest achievements of this country and, as has been said, credit is due to Clement Attlee’s Government for doing what they did.

Being born when I was, and being brought up in the Highlands, as a child I was part of the nascent NHS service. My late father told me what it was like before I was born. He spoke of the inequalities—how, if someone did not have enough money, their life would be shorter, because they could not pay for the doctor. That is how unfair it was. The NHS is about fairness, and that is why it is such a great achievement for this country.

I extol the virtues of the staff. Through my wife’s illness, I know how dedicated the neurosurgery team in Aberdeen Royal Infirmary is, and how fantastic the nurses were at a critical time in my wife’s life. She recovered, thank God. If there are angels on this earth, they wear nurses’ and doctors’ uniforms, believe you me.

The issue for Scottish Members is that the NHS is of course devolved, but I want to touch on something I mentioned in the summer when I questioned the Prime Minister. Within my vast and scattered constituency, we face really big challenges owing to remoteness and distance. There was a story in the national press recently about a mother who lived in Wick who had to make a 520-mile round trip to Livingston to give birth. That was due to an accidental coincidence of unavailability of services more locally. I do not want to give the staff a hard time—staff morale is crucial—and, for the record, I am not getting at the staff, but the fact that it happened should worry us all.

What we see in remote parts of Scotland, including my own constituency, is that there seems to be an impression that our network of local hospitals is not being used to the maximum it could be, in terms of treating people locally. I believe it is an issue of funding, which other hon. Members have also highlighted. What bothers me about what I think is happening in my constituency is that it seems to be taking us rather worryingly near to the sort of inequalities that my father spoke of. In other words, a person who lives in a very remote area of Caithness or Sutherland might not get the same deal as someone who lives in Glasgow, Edinburgh or Aberdeen, because it is harder to access services. That is the challenge for the Scottish Government, and for us all. Surely to goodness a person should not be disadvantaged because of where they live. That is what lay behind the Beveridge report, which in a way was influential on Nye Bevan bringing into being the NHS: the idea that no matter who someone was, or where they lived, they had an equal right to the service.

I do not know the answer. Health is devolved to Scotland, which I accept. It is rightly the property of Members of the Scottish Parliament and Ministers in the Scottish Government, who I am sure do their level best, but if there is a perception in Westminster that one part of the UK—it may be Wales, Northern Ireland or Scotland—is perhaps not functioning quite as it should, and on something as fundamental to our lives as the NHS, at the very least there has to be a conversation between UK Ministers and Scottish Government Ministers to say, “Is it going okay for you? Is there something we could do better? Is there something that can be co-ordinated better throughout the UK to make sure that whether someone lives in Scotland, Wales, England or Northern Ireland, they have the same access to health services?”

I give notice that this is an issue to which I will return, while of course always recognising the difficulty of the fact that health is a devolved matter and there are therefore limits on what I can say. I do not intend to be silent on the issue.