It is strange that but a couple of handfuls of Members are here to discuss one of the largest budgets that the Government dispose of. We never analyse the expenditure very closely as it goes through Parliament; personally, I feel that a new system of assessing expenditure—more like a proper budgetary process in a local authority, frankly—is long overdue.
I will speak primarily about acquired brain injury, which may not come as a surprise to many Members. I know that people think that it looks as if I have had a brain injury of my own of late—it looks far more dramatic from behind than it is on the inside, but I am enormously grateful to people who have commented.
I want to talk about the issue because all too often an acquired brain injury, which might have come about through a road traffic accident, carbon monoxide poisoning, a stroke or a whole series of other means, may not be visible to the naked eye when we meet somebody. I have said this before in the Chamber, and it is true: the person standing in front of us in the queue, who is being difficult and seems drunk, might have a brain injury. All our judgmental attitudes may say more about us than about the person standing in front of us.
When somebody is being assessed by the Department for Work and Pensions for benefits, it is really important that the assessor has a full understanding of brain injury, for a multitude of reasons. First, such judgmental attitudes might be of no assistance whatever; and secondly, because the person’s condition may vary—not only across time, but from day to day or at different times of the day.
One of the most common symptoms of an acquired brain injury, even a relatively mild one that may have followed concussion, is chronic fatigue. I do not just mean feeling tired, as we might from day to day in the normal course of things, but real debilitating fatigue that means that we simply cannot get out of bed—not through laziness, but through utter fatigue at the core of our being. The Department for Work and Pensions has found it very difficult to cope with assessing somebody in that situation without resorting to language of, “Pull your socks up, chap!”
I know that the Minister is keen to see whether there are ways for us to work this out better, and I, along with the all-party parliamentary group on acquired brain injury, am really keen to make sure that every single assessor has some understanding, at least, of acquired brain injury—and, if they are not sure, the ability to refer the individual to another person.
There is another element to the issue. Fatigue is one of the most common elements of an acquired brain injury, so someone with one needs to harness all the energy they do have to strengthen their brain and recuperate. That requires a superhuman effort. I have spoken to individuals who have been through major road traffic accidents. They know that all the stuff they do with their doctors and clinicians—all the neuro-rehabilitation—is about how they strengthen their brain. But the benefits system is so complicated that it makes them feel like a number rather than a person; they find that they are using their energy just to deal with that, rather than making themselves better.
There could be a real advantage if there were a grace period of four or five years for people who have had a brain injury, so that once they had their first assessment they would know they would not have another for a set period. This is not about spending money; it is simply about enabling people to resuscitate and revitalise their own brains.
There is an additional problem which is known as the frontal lobe paradox. People may present extremely well and do well in tests, but some of the other elements of their executive function simply do not work as well as they might. That is why it is so important for us to have a system that can respond to individual needs. I hope very much that in the coming months we will be able to develop the system further, and that Ministers will work onside, to ensure that we can address those needs.