Select Committee on Health Appendices to the Minutes of Evidence


Memorandum by Mr David Turner (H 92)

  This evidence is submitted by Mr David Turner, a Social Worker by profession, and the father of a severely brain damaged son, injured in a road traffic accident at the age of eight in 1977. I have been a trustee of Headway the brain injury association for the last 20 years, variously holding the offices of Chairman (twice), Deputy Chairman and Vice Chairman. Additionally I am a founder member of Second Chance (the Wakefield based local group of Headway), and have variously held the positions of Secretary and Chairman (twice).

  1.  Whilst the provision of effective rehabilitation has improved enormously since the launch of Headway in 1979, there are still significant defects in the levels of expertise within the various professional disciplines involved, and also with regards to universal accessibility to good quality rehabilitation; sadly the "postcode" lottery still prevails.

  2.  The lack of Government leadership in imposing service level standards on both Health and Social Services, has led to a mushrooming of private sector facilities. These facilities are of variable quality, and are generally expensive to purchase. It seems very clear that they aim to target those who receive considerable financial damages in respect of their injuries.

  3.  Facilities for those reliant on State provision, are less available, because of financial constraints, lack of knowledge/expertise within large populations of publicly employed medical, nursing, therapeutic and community care staffs.

  4.  Because of the often global effects of traumatic brain damage, its full implications are not always recognised by clinicians, as efforts tend to be put into the readily observed problems eg physical disabilities.

  5.  One of the main reasons for non recognition/action is indeed the global effects created by severe brain damage. The effects can fall into each of the usual Community Care Plan client groups ie Mental Health; Elderly; Learning Disabilities; Physical Disabilities, but, most people with a severe head injury will fit into two, three or four of these divisions - a great bureaucratic barrier in finding the right services for the individual and his/her family.

  6.  Headway has long campaigned for traumatic brain injury to be recognised as a separate disability in its own right. This has now been done by some of the European Union organisations.

  7.  A recognition of traumatic brain injury as a separate disability to be included in local Community Care Plans would go a long way towards universal recognition and action.

  8.  A number of Government sponsored reports have advocated various pathways to achieving better services for traumatically brain damaged individuals and their families and carers. Sadly they appear to have disappeared in the bureaucratic jungle. Resurrection of some of these eg The Social Services Inspectorate Report, and more work on the Warwick University study of the 12 Government sponsored community rehabilitation programmes (which was sadly lacking in direction) would give a good basis for a way foward.

  9.  My recommendations are annexed.

February 2001



  1.  All Casualty Departments have medical personnel skilled in the early management of severe head injury/brain damage.

  2.  All Casualty Departments to screen all head injury for any brain damage, including mild, moderate and severe.

  3.  Any patient with detected or possible brain damage to be transferred to a specialist neurosurgical unit as soon as possible.

  4.  All hospital NHS Trusts to provide easy and universal access to specialist traumatic brain damage rehabilitation.

  5.  All hospital NHS Trusts to appoint a specialist co-ordinator to ensure that each patient with traumatic brain injury is identified and tracked through appropriate treatment/rehabilitation pathways.

  6.  All Local Authority Social Services Departments to appoint a specialist traumatic brain injury case manager to work closely with hospital colleagues to ensure good and appropriate discharge plans, and to arrange satisfactory care plans for all such patients/clients.

  7.  Traumatic Brain Injury to be defined as a separate disability in its own right.

  8.  All local Community Care Plans to include Traumatic Brain Damage as a separate category in its own right.

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