Acquired Brain Injury

Julie Cooper Excerpts

Thursday 9th May 2019 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

I thank all Members for their contributions to an excellent debate, as well as the Backbench Business Committee for selecting this important subject. I congratulate my hon. Friends the Members for Rhondda (Chris Bryant) and for Blaydon (Liz Twist), and the right hon. Member for South Holland and The Deepings (Sir John Hayes), who tabled the motion before us. In particular, I thank my hon. Friend the Member for Rhondda for his extensive work to raise awareness of acquired brain injury. I acknowledge the important work of Headway and the United Kingdom Acquired Brain Injury Forum, and I pay tribute to the excellent APPG for its sterling work to improve our understanding of the wide impact that ABI can have. Its comprehensive report, “Time for Change”, sets out a range of recommendations for the kind of support and rehabilitation that must be made available. I found that excellent report immensely interesting and informative, and I will now go on to champion awareness of acquired brain injury.

As the term suggests, acquired brain injury applies to injury caused to the brain after birth, and it can happen to anyone at any time. All Members have constituents who live with the consequences of ABI. A brain injury can happen in an instant, but its effects can be devastating and lead to lifelong challenges. The effects of ABI vary; those affected may suffer from headaches, dizziness, memory loss, extreme fatigue and depression, as well as diminished co-ordination and motor skills, irritability, and inability to concentrate. The right hon. Member for South Holland and The Deepings reminded us that we must be aware of the dynamic nature of the condition, and we heard about the wider impact of ABI when my hon. Friend the Member for Swansea East (Carolyn Harris) spoke about George’s experiences and the wide impact that ABI has across all walks of life.

Improvements in medical procedures and acute care have led to improved survival rates for those who acquire an injury to the brain. That is welcome, but it brings its own challenges and places further pressure on already overstretched health and social care services. Early and continued access to specialist rehabilitation has been shown to optimise the chances of recovery and to be extremely cost effective. As for many health conditions, however, the number of available beds across the UK is inadequate. Service provision is variable; consequently, long-term outcomes for brain injury survivors are compromised. As my hon. Friend the Member for Rhondda powerfully reminded us, this is all about quality of life, and it is cruel to save lives without the following support and rehabilitation.

Many Members spoke of the scale of the problem, and many people—including me before this debate—have little awareness of ABI, even though the numbers affected are so great. Currently, 1.3 million people in the UK live with ABI, which has rightly been described as the invisible epidemic. Some 900,000 people attend A and E with a traumatic brain injury every year, and every 90 seconds someone is admitted to hospital with an acquired brain injury.

It is estimated that 24% of children have some sort of brain injury, compared with 1% who have autism. ABI in children is often misdiagnosed as autism or attention deficit hyperactivity disorder. The point about misdiagnosis across the board was made effectively. A particularly good example was the misunderstanding of cases involving servicepeople. The combined cost of brain injury, including health and social care costs, disability support, lost work contributions and premature death, is estimated to be £15 billion a year, which equates to about 10% of the NHS budget. This is an issue of such seriousness and magnitude that it cannot and should not ignored.

In September 2018, the APPG report called for reform is all areas and Departments. This is not just a matter for the Department of Health and Social Care, although that would be a good starting point. As the report so rightly demonstrates, this should be an issue for the Department for Education, the Ministry of Justice and the Department for Work and Pensions, too. The report recommends change in several key areas. A national review of neuro-rehabilitation is required to ensure that service provision is adequate and consistent throughout the UK. We have heard Members describe current provision as a lottery. All affected individuals should be given a rehabilitation prescription, and there should be a significant increase in the number of neuro-rehabilitation beds. We heard about excellent trauma centres, but would it not be wonderful if an ABI consultation could be available in each of those units?

On education, Members expressed disappointment that the Timpson report made no mention of this issue. My hon. Friend the Member for Blaydon talked about small details, such as adjusting lighting or the colour of paper, that could be embedded in education. That would require all education professionals to have a minimum level of awareness and understanding about ABI and the educational requirements of children and young people with the condition. It is essential that special educational needs co-ordinators are given special training and that it is embedded in all SEN provision.

It was shocking to hear about the record of football in this country, and that, as a football nation, we have so little regard for sports-sustained concussion injuries. There is much work to be done in that area. Sport, Government and professional clinical bodies must work collaboratively to improve health professionals’ knowledge of concussion management.

Criminal justice procedures, practices and processes need to be reformed to take into account the needs of individuals with ABI. My hon. Friend the Member for Rhondda made the powerful point that ABI could be at the root of some crime and that, in the instances of female victims of domestic violence, we may be punishing victims. An assessment carried out ahead of imprisonment and sentencing would be useful in getting to the root cause of the problem, and would hopefully prevent further crime and further custodial sentences.

All benefits assessors in the DWP should be trained to understand the problems that affect individuals with an ABI. The story of Jordan Bell and his experience of filling in forms and the exasperation with the bureaucracy of the system was powerfully told. Those issues need to be addressed by the appropriate Department.

Much has been done to prevent ABI. The hon. Member for Ayr, Carrick and Cumnock (Bill Grant) talked about the benefits of seatbelts and airbags in reducing such damage. Comments were made about the considerable work of charities, but we cannot rely on charity to deliver on its own.

As this debate is being held under the aegis of the Department of Health and Social Care, may I ask the Minister, in the first instance, to focus on neuro-rehabilitation? NR can avoid or minimise disability and optimise recovery. Early access to NR is critical and there is substantial evidence that demonstrates NR is both clinically effective and cost-effective. Outcomes for those affected would be significantly enhanced if every individual was given an NR prescription that specified the individual’s specific needs and a care pathway. Will the Government ensure that every individual with an acquired brain injury gets just that? Will the Minister commit to introduce a neuro-rehabilitation consultant in every major trauma centre? The UK is facing a shortfall of 10,000 beds for neuro-rehabilitation services. Will the Minister commit to addressing that issue? Will she ensure that all health professionals in the community in primary care and secondary care are trained to recognise the symptoms of ABI?

We heard the powerful personal story from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), which reminds us all about the impact on the families of ABI sufferers. So many people find themselves in a frightening situation. They need structured and planned support that is assured wherever they live. Significant mention has been made of the great work Headway does, but, as I have said, addressing ABI cannot be left to the work of charities.

Will the Minister commit to work with her colleagues across Government Departments to implement the recommendations in the APPG’s report on education, justice and welfare? As the debate has shown, there is support for action in all parts of the House. The report’s recommendations cannot be ignored, but must be regarded as the beginning of a journey. In the words of the all-party group, it really is time for change.