Acquired Brain Injury

Julie Cooper Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Julie Cooper (Burnley) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank all Members who have contributed to the debate, particularly those who have shared their personal experiences and those of their constituents, as well as their expertise in various areas. I pay tribute to my hon. Friend the Member for Rhondda (Chris Bryant) for securing yet another debate on this important subject. No cause could have a greater champion. He challenged Members in the previous debate on this subject to learn how to pronounce the name of his constituency properly. Well, I can assure my hon. Friend that I will try my best to do better today. I also pay tribute to all the members of the APPG for the excellent work that they do in raising awareness of this really important subject.

We are here again today debating the subject because of the scale of the problem: currently, 1.3 million people in the UK live with an acquired brain injury. Every 90 seconds someone is admitted to hospital with such a brain injury. We have considered the human cost of acquired brain injury in this debate and we have also heard of the financial cost. In the previous debate the Minister said that it cost the UK economy £1 billion, but the APPG reports that the truer figure is £15 billion, alongside the human cost.

Consideration of this subject is not new. The Health Committee has been reporting on the issue since the turn of the century, furnishing Parliament with a raft of recommendations, many of which have never been implemented, so it really is time for change. Last year the APPG set out a range of recommendations for the kind of support and rehabilitation that must be made available. 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. It is usually caused by a trauma to the head but can be the result of substance abuse, and the Alcohol Health Alliance has reported on the growing incidence of alcohol-related brain injury. My hon. Friend the Member for Sefton Central (Bill Esterson) talked about the effect on unborn infants of foetal alcohol syndrome.

All Members have constituents who have lived with the consequences of ABI. A brain injury can happen in an instant, but its effects can be devastating and lead to lifelong challenges. My hon. Friend the Member for Rhondda mentioned that the condition is often not visible, and that sufferers can appear to be drunk. There is a tremendous lack of understanding in the community. The right hon. Member for South Holland and The Deepings (Sir John Hayes) talked about the fact that it is difficult to detect, medically, socially and culturally. There is a total lack of understanding.

Owing to improvements in medical procedures and acute care, more people than ever before survive following an injury to the brain. That is of course really welcome, but it brings with it a responsibility for Government Departments to support those affected, which is crucially all about quality of life. It is cruel to save lives without following up with support and rehabilitation. As my hon. Friend the Member for Newport West (Ruth Jones) said, sharing her expertise, not providing vital support services is where the NHS is at its weakest. My hon. Friend the Member for Darlington (Jenny Chapman) talked movingly about the experience of Nicola and her family, and the failure to get the support and help that they clearly needed to get them through.

Early and continued access to specialist rehabilitation has been shown to optimise the chances of recovery and to be extremely cost-effective. As is the case for many health conditions, however, the number of available beds across the UK is inadequate, and service provision is variable. Consequently, long-term outcomes for brain injury survivors are compromised, with many describing being passed from pillar to post. It is particularly distressing to hear the experiences of children, as my hon. Friends the Members for Blaydon (Liz Twist) and for Nottingham South (Lilian Greenwood) mentioned.

It is clear that a national review of neuro-rehabilitation is required, with particular reference to the service provision for children, to ensure that provision is adequate and consistent throughout the UK. Members have described current provision as a lottery. All affected individuals should be given a rehabilitation prescription and a well-defined pathway to recovery. I ask the Minister again to focus on that, because NR can help to avoid or minimise disability and optimise recovery. Early access is critical, and substantial evidence demonstrates that NR is both clinically effective and cost-effective.

Will the Minister ensure that every individual with an acquired brain injury gets an NR prescription and has their individual needs specified in a care pathway? Will she ensure that all health professionals in the community in primary and secondary care are trained to recognise the symptoms of acquired brain injury? I asked for those commitments from her the last time we debated the subject. She has demonstrated that she is listening, which we all appreciate, but can she ensure that the Government up their game and act on those precise commitments?

This is not just a matter for the Department of Health and Social Care, of course. In September 2018, the APPG’s report called for reform in all areas and Departments. It should be an issue for the Department for Education, because 24% of children have some sort of brain injury, compared with 1% who have autism. That has clear implications for teacher training, and it is essential that special educational needs and disability specialists are appropriately trained to recognise the signs. It is also a matter for the Ministry of Justice, as ABI can often lead to criminal behaviour. My hon. Friend the Member for Rhondda has regularly raised the issue of female prisoners who have been found to have brain injuries caused by exposure to domestic violence. All benefits assessors in the Department for Work and Pensions should be trained to understand the problems that affect individuals with ABI. Excessive bureaucracy and form-filling can be a nightmare for many vulnerable claimants, but for someone with an acquired brain injury it can present an insurmountable barrier, leading to sanctions and additional hardship.

As was mentioned in the previous debate, there is a lack of awareness among those involved in contact sports such as football and rugby. Government and professional clinical bodies must work collaboratively to improve health professionals’ knowledge of concussion management. In defence, we must work to ensure that acquired brain injury among veterans is fully recognised and that the appropriate support is made available. The Minister committed to pass on concerns to colleagues in other Departments, and I hope that she will be able to report back on their responses.

We have heard over and over again about the human cost of acquired brain injury. Frankly, it also makes no financial sense not to put the right care plans in place and deliver the support that individuals and their families need. I urge the Government to implement the recommendations of the APPG in full, and to raise their game across Departments to ensure that the people we have heard about today truly get the support they need.