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
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
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
9. My recommendations are annexed.
1. All Casualty Departments have medical
personnel skilled in the early management of severe head injury/brain
2. All Casualty Departments to screen all
head injury for any brain damage, including mild, moderate and
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
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
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.