Memorandum by Headway Cardiff (H4)
While the health Select Committee relates to
England we feel that changes in England often pave the way for
those in Wales. We feel that our experiences of statutory services
reflect those in the rest of the United Kingdom.
1. Background to Headway Cardiff
2. Preservation of life over quality
3. Delay in discharge
4. Health v Social Service responsibility
5. Lack of ongoing community health provisions
6. Proposals for new community brain injury
7. Lack of Social Service recognition of
the needs of people with acquired brain injury
8. Suggested reading.
Headway Cardiff was established in 1985 by therapists
in Rookwood Hospital as a support group for survivors of acquired
brain injury. Over the years it has evolved to breach the gap
in statutory services. It is now a Ltd company and charity providing
services to people with acquired brain injury from South East
Wales. These services include a day centre twice a week, an information
and helpline and counselling service. We employ two staff who
are supported by a team of volunteers. We have received lottery
funding and are presently funded by charitable trusts. We receive
spot contracts from Social Services for eight of our 30 clients.
These pay for the attenders with the most severe physical disabilities.
The local health trust allows us free use of the premises from
which we run our service.
Many resources are spent on preserving life
but an ethical debate needs to be entered into, exploring quality
of life in relation to preservation.
3. DELAY IN
There is often an unnecessary delay in discharge
while adaptations in the home take place, suitable accommodation
is found or care plans are implemented by social services.
4. HEALTH V
This is because of unnecessary bureaucracy and
lack of community provision such as appropriately adapted or supported
Often people with brain injury and their families
are caught between social service and health authority departments
while each argues that it is the other's responsibility to provide
5. LACK OF
While survivors of brain injury receive a great
deal of input while in hospital, community services are very limited,
with one specialist brain injury nurse covering the whole of South
Wales. It is very difficult to access therapies such as physiotherapy
as there is no separate community service. Our clients are in
direct competition with the patients at the local hospital. Similar
problems are experienced accessing psychological and occupational
therapy. Other than hospital therapists, there is only one part-time
speech therapist available as an aspect of the day service provided
by the local psychiatric hospital.
After the damming report on "Severe Head
Injuries Rehabilitation" published by the Welsh Affairs Committee
in 1995, Bro Taf Health Authority Head Injury Working Party responded
with "Putting our Heads Togethera rehabilitation service
for people with severe head injury". This proposal put forward
a design for an acquired brain injury multi-disciplinary community
team of therapists. This was published in 1996 and we are still
awaiting a practical implementation of the proposal although recently
there has been a commitment by the health authority of £100,000
to fund this service. This will in no way fully meet the recommendations.
7. LACK OF
Social Services do not recognise brain injury
as a separate category within their Social Care plan so only those
with the most severe phsyical or mental disabilities receive support.
Those with more subtle, but equally disabling problems, such as
memory loss or organisational problems receive no input. This
can result in people struggling to live independently and experiencing
family, financial or mental health problems. The eventual outcome
of this can be families splitting up, people gaining criminal
convictions or being sectioned.
Severe Head Injuries: RehabilitationWelsh
Affairs Committee, 1995.
Putting our Heads Togethera rehabilitation
service for people with severe head injury. Bro Taf Health Authority
Head Injury Working Party 1996.