Acquired Brain Injury

Martyn Day Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I am delighted to take part in this important follow-up debate on acquired brain injury. I am grateful to the hon. Member for Rhondda (Chris Bryant)—I hope I have managed to pronounce the name properly this time—for securing the debate. Being in Parliament is a learning experience. I took part in the previous debate with the information that I knew about acquired brain injury, and it prompted different groups and individuals in my constituency to get in touch, so he will be pleased to know that I have some new material today.

We have heard in this debate that the symptoms of ABI are often completely invisible, which echoes a point made to me by one of my constituents since the previous debate. He discussed his own ABI and said that he felt there was often more public and employer sympathy and support for an obvious injury such as a broken leg than there was for a broken brain, which is something we undoubtedly need to address. The importance of speech therapy to avoid people being assumed to be drunk and to get their self-confidence back are highly important points. Since it affects every aspect of our country across all our nations, the financial savings of getting it right give us a financial incentive as well as a moral responsibility to tackle the issue. Fundamentally, for me, the issue is about ensuring that people with disabilities such as ABI can live as independently as possible. Disabled people should have the freedom, dignity and choice to control their own lives. We need to help remove the barriers that stop them from enjoying full and equal access to full citizenship.

It is estimated that ABI is the most significant cause of disablement for people of working age in Scotland. We know that only around 40% of working-age disabled adults are in employment, compared with more than 80% of those without a disability, so we really have to address the employability gap. Many of those with ABI have complex rehabilitation and support needs. The Scottish Government have recently run a consultation on their first draft national action plan on improving the care, treatment and support available to the neurological community. The consultation closed on 8 February this year. They aim to publish their report this summer, and the final national action plan on neurological conditions later this year. I look forward to seeing what comes out of that.

The Scottish Government initiated the National Prisoner Healthcare Network’s report on brain injury and offending, which was published in 2016. The subject of offenders came up in the previous debate, and I admit that I was not fully aware of it at the time. The programme in Scotland was led by Professor Tom McMillan of the University of Glasgow, and it is now in implementation and has developed an empirical basis for the development of a service in all Scottish prisons. The benefits will be to improve the management of people with brain injury throughout the criminal justice system and to reduce the risk of further brain injury in prisoners.

Around 75% of male prisoners and 66% of female prisoners have multiple head injuries. Benefits will also see reduced reoffending—around 70% of those with head injuries reoffend—and improved community reintegration. Those stark figures are striking. It is also worth noting that prisoners with a history of multiple head injuries are more likely to be convicted of violent offences, so there is a lot of work to do. I am grateful that I have learnt that information since the previous debate, so the hon. Member for Rhondda gets full marks for increasing my education.

In May I spoke about the Scottish Acquired Brain Injury Network and I want to discuss more of its work today. SABIN is a managed clinical network based within the NHS in Scotland, comprising clinicians, third sector organisations, patient representatives and non-clinical staff all working to improve the access to and quality of care for patients with an ABI across Scotland. Scotland remains the only country internationally with a single set of concussion guidelines across all sports at grassroots and amateur level. The Scottish sports concussion guidance has been in place since 2016, with the most recent update in 2018 contributed to by SABIN. In addition, research into the consequences of sports brain injury, in particular the study “Football’s InfluencE on Lifelong health and Dementia risk (FIELD)”, is set to provide the first understanding globally of the late consequences of contact sports participation through a series of publications in the next few months.

SABIN was delighted to take part in the Scottish Trauma Network’s second annual conference last week, which took place on 26 and 27 June. Over those two days it was able to highlight to clinical colleagues and Government stakeholders the importance of ABI care within a trauma setting and beyond. Patients with an acquired brain injury are some of the most seriously ill trauma cases; patients are often young, with many years of rehabilitation ahead of them. The need for early access to intensive rehabilitation is a message that needs to be relayed to one and all to support investment in rehabilitation. We cannot emphasise that point enough.

SABIN is currently involved in a geographical mapping of NHS services for acquired brain injury patients across Scotland. It previously did that in 2009, and it will be interesting to see how services have changed over time. Preliminary results from the service mapping highlight key challenges across Scotland: the same key challenges that we heard about from colleagues south of the border. They include a lack of access to rehabilitation; workforce shortages, particularly in relation to staff trained in managing patients with an ABI; the difficulties of managing patients with challenging behaviour; and the need for dedicated ABI units. A full report will be circulated to NHS boards in Scotland and will be available on the SABIN website. It is due for completion at the end of August, and SABIN is keen to work with NHS boards to assist them in planning rehabilitation services. It is worth pointing out that the first of four major trauma centres opened in Aberdeen in October, and those services have not been included in the mapping exercise. Things are improving, but the report will still be of significant interest.

Alcohol Health Alliance, in advance of today’s debate, has highlighted the link between alcohol and injuries and accidents that can cause an ABI, and also the link between ABI and problem alcohol consumption. Actions taken in Scotland to reduce alcohol abuse have seen the number of alcohol-related emergency hospital admissions fall by more than 17% since 2007, so there is good practice out there. One of our more recent innovations has been minimum unit pricing. It is probably too early to say how it has affected ABI or other health issues, but sales have dropped by 3% since it was introduced last year. Alcohol sales per adult in Scotland are now at the lowest level for 25 years, so the Minister might wish to consider something similar for England, as I am sure it will have many benefits for health and not just for ABI.

It has been a pleasure to take part in the debate, and I am grateful to the hon. Member for Rhondda for securing it.