Acquired Brain Injury

John Hayes Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Sir John Hayes (South Holland and The Deepings) (Con)]

It is always a pleasure to follow the hon. Member for Rhondda (Chris Bryant), but particularly so on this subject, on which he has done such great work. The report produced by the all-party parliamentary group on acquired brain injury, which he leads, is a fine example of what can be done when politicians from across the spectrum come together, look at a specific subject about which more needs to be done, and produce a report that is thorough, well researched and not antagonistic towards the Government—indeed, it shows a desire to work with the Government to bring about the right kind of solutions.

I therefore thank the hon. Gentleman for the work he has done; he deserves an immense amount of credit. I myself deserve a bit of credit, but much more is owed to those who helped us produce the report, by adding to our investigations, informing our findings and supporting us throughout. Across the scale, the brain injury community, if I may so describe it, deserves great credit for the work we have done so far. As he said, the Minister and the Government, who have given the matter a fair wind and a good hearing, have shown a willingness to listen and a preparedness to change, both of which are absolutely essential.

The last time we spoke about acquired brain injury, I recounted the pattern that most people follow when they have a traumatic event that leads to a brain injury. Of course, not all head injuries lead to brain injuries—it is important to draw that distinction at the outset. Nevertheless, the pattern is straightforward: shock, disbelief, fear and then, with the right support, care and encouragement, realisation and recovery. It might be argued that that is a familiar pattern for most kinds of traumatic injuries that have profound consequences, but there is a difference with acquired brain injury: namely, the effects are immensely variable and sometimes, as the hon. Gentleman said, hard to recognise or discern. Actually, they can be quite hard to discern medically, as well as socially and culturally, as recovery from a brain injury can go on for a very long time indeed, even for many years.

The hon. Gentleman spoke of changed personalities. When I had my own brain injury in my early 20s, the medical experts who were treating to me said that my personality might change. My parents said, “Oh, you don’t know him,” but the doctors said, “No, clinically we have to tell you that his personality might change.” I do not know if it has changed; I might have been less talented, less charming, less accomplished and less clever. [Laughter.] I do not know, do I? How could I know that? For the hon. Gentleman is absolutely right; one does not know what one might have been.

The reason I have taken a great interest in this subject since being elected to this place 22 years ago is that I am very conscious that my recovery was sufficient to allow me to fulfil my ambitions, and to allow me to do much of what I would have done anyway. That would not have been easy had I wanted to be a great musician, for example, as I am now extremely deaf and have suffered from tinnitus since my accident. But I did not want to be a musician. It would not have been easy had I wanted to pursue a number of other careers, but the one I wanted to pursue was that of a Conservative Member of Parliament—there is nothing more noble.

My injury did not prevent me from achieving that aim, but I am profoundly and constantly aware that others cannot say the same. As I was in hospital being treated for the immediate effects of my injury and then recovering over a considerable time, I was conscious that others were not as fortunate, that I could have been in a very different place and that, if my life had changed beyond measure, I would have been unable to do what I have done. That subtlety in the changes that take place following an acquired brain injury is the second thing, along with the variability, that I wanted to highlight.

But there is also unpredictability. One cannot be clear at what pace and to what degree recovery will take place. The combination of variability, subtlety and unpredictability makes the aftercare—the neuro-rehabilitation that the hon. Member for Rhondda rightly highlighted—a complex and challenging matter for all concerned; clearly for families and friends and those close to those affected, but also for the medical professionals and all the services that people in these circumstances engage and interact with. The Government must therefore employ the same subtlety and flexibility in dealing with the effects of brain injury.

I know that other Members wish to speak, so I will not go on forever—there will be a sigh of relief in some parts of the Chamber, and probably some disappointment in others. None the less, I want to highlight some things that the Government will need to do. As I said, last time I spoke on the matter it was about the pattern that follows an injury, but I now want to talk, from my experience in government, about what the Government need to do. First, they need to be highly responsive to the changes in the condition of sufferers, and I do not think that Governments are all that good at that; they do many things well, but I am not sure that responsiveness is one of them.

Secondly, the Government need to marry, in their work, the changing diagnostic environment and neuro-rehabilitation. I was recently at my old university, Nottingham, looking at the latest technological changes that will enable people to diagnose the effects of injury through improved scanning, and that is the sort of advance that needs to be married with neuro-rehabilitation. The University of Nottingham is also studying how different modes of rehabilitation can have different effects—which strategies work best for different kinds of individuals in recovery.

Thirdly, the Government need to adopt a cross-departmental approach—that is heavily emphasised in the APPG report. We highlight that although some Departments take the matter extremely seriously and are doing an excellent job, others need to raise their game. That is no surprise, I suppose, but none the less it needs to be emphasised. Various people here will know that we recently had a meeting with a Cabinet Office Minister to discuss how that Department can play a part in co-ordinating that cross-departmental approach. A glance at the report illustrates just how wide that approach needs to be; everything from the Department for Digital, Culture, Media and Sport, through to the Ministry of Justice, the Department for Work and Pensions, obviously the Department of Health and Social Care, and so on. Almost no Department is unaffected. The Home Office is clearly affected and, with housing, we have responsibilities for ensuring that people are properly accommodated. As almost no aspect of Government is untouched, the cross-departmental approach needs to be re-evaluated, with new thinking about how we can ensure consistency and collaboration in dealing with brain injury.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Will the right hon. Gentleman give way?

[Sir John Hayes]

I will happily give way. I am most impressed that no less than a third of the Democratic Unionist party’s Members of Parliament are in attendance.

[Mr Campbell]

I suppose a cynic might say that it is a good job that a third of Labour and Conservative MPs are not here, because otherwise we would not get into the room. The issue that the right hon. Gentleman touches upon is very important. Does he agree that although those directly affected, and their family and friends, want to hear this debate and see that there is support, there needs to be a tangible expression from Departments, both centrally and in the regions, to show that it is more than just words? Action needs to follow, which is exactly the point I believe he is highlighting.

[Sir John Hayes]

The hon. Gentleman always makes valuable contributions to our considerations, across a range of subjects, but rarely does he make a contribution that tees me up for the next part of my speech more than that one did.

I was about to move on to the specific measures that the Government can take, which are all drawn from the APPG report but also—I say this less critically than I might—from the Health Committee’s 2001 report on these matters. For example, that report suggests:

“We recommend that the Government requires the statutory services to improve their supply of information on head injury to head-injured people and their families; such information should be given to these people in written and verbal form during their stay in hospital, should be available to GPs and should include the literature produced by Headway—the Brain Injury Association.”

It goes on to say:

“We recommend that those assessing brain-injured people for disability living allowance have specialist skills which enable them to understand the complex combination of physical, cognitive and behavioural impairments characteristic of this type of neurological disability; and that the assessment process is adjusted to allow the input of a patient’s advocate”.

It continues:

“We recommend that the Government makes explicit the level at which responsibility for planning different levels of rehabilitation for head injury should be located”.

Almost every recommendation made in 2001 is pertinent to the circumstances today. That is not to say that Governments since then have done nothing; I emphasise again that the new Minister and her predecessor have given us a very positive response since the publication of our APPG report. We have high hopes of the Minister, who I know wants to end her time in the job by saying just how much she did. [Interruption.] Well, that may be in a number of years, but whenever her time in the job does end, she needs to say, “I did so much for those with acquired brain injury.” That needs to be on her record, and we want to ensure that it is—thus our continued advocacy.

I have just a few points from our report for the Minister to consider. I will rattle through them—there are only six. First, there should be a national review of neuro-rehabilitation, to ensure that service provision is adequate and consistent. Secondly, acquired brain injury should be included in the special educational needs and disability code of practice. Thirdly, all education professionals should be trained, or at least have a minimum level of awareness. Fourthly, all agencies working with young people in the criminal justice system, including schools, psychologists, psychiatrists, general practitioners and youth offending teams, should work together to ensure that the needs of individuals are assessed. Fifthly, in the welfare system, all benefits assessors should be trained to understand the problems that affect individuals with acquired brain injury. Sixthly, a brain injury expert should be on the consultation panel when changes in the welfare system are proposed. I do not say that those are the only important things; we could talk about sports injuries and all kinds of other things that are in our report and have been debated before. But doing those six things alone, or six others taken from the report, would make an immense difference to so many people.

Finally, I want to quote C. S. Lewis—not Jesus but certainly a man who knew Jesus. C. S. Lewis said that

“courage is not simply one of the virtues, but the form of every virtue at the testing point”.

Courage is required by those who suffer from acquired brain injury, but it is also required by Ministers to make a difference, and I know that this Minister, inspired I hope by the efforts of Members across the House and also by the needs, plight and interests of all those affected by acquired brain injury, will employ the necessary courage to make a difference.

[Several hon. Members rose—]