Acquired Brain Injury

Debate between John Hayes and Steve Baker

Thursday 9th May 2019 Commons Chamber

[Sir John Hayes (South Holland and The Deepings) (Con)]

It is a pleasure to follow the hon. Member for Rhondda (Chris Bryant) and to endorse and amplify his remarks about the Minister. Many people achieve office in this House, but few are more deserving of that opportunity than the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy). We are delighted to have her with us today. We will be even more delighted when she answers some of the questions posed by the hon. Member for Rhondda and gives us an assurance that the Government will continue—for they have begun well—to take this subject seriously and will act on the recommendations in this excellent report, which would not have happened without the initiative, enterprise and energy of the hon. Gentleman. His commitment has been exemplary.

The work of the all-party parliamentary group on acquired brain injury is illustrative of this House doing what it does best: coming together, highlighting a subject, and bringing it to the attention of the wider world and of those who exercise power. We have, I believe, done a good job, but it is only the beginning of a journey. The destination we seek is our recommendations being enacted in full. Perhaps I am being a little ambitious, but at the very least the Government have taken a renewed and reinvigorated interest—I would not for a moment suggest that they were not interested already—in this subject, which affects so many people.

Perhaps that is the place to start. The hon. Gentleman spoke about the definition of brain injury, but I want to speak about the scale of the problem. The number of families affected by acquired brain injury, which, as the hon. Gentleman described, includes anything from traumatic events through to brain tumours, is immense. Hospital admissions for head injuries number 162,544—one every three minutes. ABI admissions have increased by 10% since 2005-06. Although men are 1.6 times more likely than women to be admitted for head injury, the incidence of female head injury has increased by 24% since 2005-06. Families across our nation and in all our constituencies are affected. The challenges are profound, for the reasons that the hon. Gentleman described.

[Mr Steve Baker (Wycombe) (Con)]

I, too, welcome the report. May I add to my right hon. Friend’s list what I have discovered in my constituency? Even babies can acquire brain injuries from contracting meningitis, or during childbirth. I hope he will join me in encouraging the Government to consider that issue as well.

[Sir John Hayes]

I will—very much so. I have been terribly unlucky, by the way, having suffered a severe head injury as a result of a road traffic accident and, like the hon. Member for Rhondda, contracted bacterial meningitis. We both speak with some authority on this subject.

The patterns that those families endure are similar, one to another. Initially, of course, there is shock—a sense of disbelief—and the question that most people pose in these circumstances: “Why me?” Then there is a gradual realisation of the depth and scale of the effects of acquired brain injury, and an unhappy initial concentration on what the person can no longer do, followed eventually by a reconcentration on what they can do. Most families follow that pattern when they suffer this kind of event, and that is why all that is done beyond the treatment of the initial trauma is so critically important.

Neuro-rehabilitation is vital because of the dynamic character of these conditions. Most people who acquire a brain injury will change. Many will recover fully and some will recover partly, but all that takes place over a long period and is particular to each case. There is an unpredictability about the effects of acquired brain injury; it can affect physical capacity of course, psychology and cerebral function, as well as personality. Families dealing with that must cope with those kinds of changes, which can be terribly frightening for the individuals concerned and those who love them. The point is that a difference can be made by the quality of care that they receive during that rather difficult journey.

2019 Loan Charge

Debate between John Hayes and Steve Baker

Tuesday 20th November 2018 Westminster Hall

[Mr Baker]

I obviously cannot comment on individual circumstances. However, this is a good opportunity to draw a distinction between taking people on as contractors and insisting that they join schemes that could end up with their using disguised remuneration arrangements. On the one hand, contracting is a legitimate way of going about business; on the other, engaging in disguised remuneration schemes—an aggressive form of tax avoidance—is not desirable.

[Mr John Hayes (South Holland and The Deepings) (Con)]

My hon. Friend is doing a sterling job of raising this matter in this place. On that basis, will he challenge the Minister on how many firms have been investigated, how many promoters have been pursued and prosecuted, and how many of those had some connection to Government contracts or payments?

[Mr Baker]

I join my right hon. Friend’s call for the Minister to set that out, which my hon. Friend the Minister will have heard. I will now make some progress.

The Loan Charge Action Group says that the human impact of receiving a bill for up to 10 years’ worth of tax will have a catastrophic effect on individuals and their families. On whom among us would it not have a catastrophic effect? It goes on to say that we are looking at thousands of bankruptcies, family break-ups and suicide attempts, as well as mental illness, unemployment, loss of abode and more. That is a catalogue of human suffering and misery.

HMRC’s impact assessment of the measure says:

“This package is not expected to have a material impact on family formation, stability or breakdown.”

However, that looks at aggregates, not the impact on individuals, which it seems to me is a common mistake of Government. As a Conservative, I wish to focus first and foremost on the individual, not the collective.

I will foreshorten my remarks, given the interventions I have taken. One specific complaint is the lack of warning. A freedom of information request revealed that HMRC has issued about 23,000 loan charge awareness letters, which were only issued from the second quarter of 2018. HMRC says that 50,000 individuals may be affected, so many will be unaware of the impending charge. The Loan Charge Action Group points out that the opportunities to settle new tax affairs with HMRC ahead of the charge were similarly not widely publicised, nor was the deadline of 31 May 2018, leaving people in a terrible fix, although I understand that the deadline has been quietly dropped.

The Loan Charge Action Group suggests that historical users of schemes who left many years ago are probably completely ignorant of this new legislation and will only hear of it after receiving a large bill some time in 2020. This is a dreadful risk, which the Government should forestall.

I am keen to conclude, so I will come to some solutions that I ask the Minister to consider. As I outlined in a letter to the Chancellor in September, there should be clarity about what DOTAS—disclosure of tax avoidance schemes—registration means. There should be a legally mandated text accompanying every advertisement of a DOTAS-registered scheme that explains that the purpose of registration is to enable HMRC to identify tax liabilities and to recover them when such schemes are proven not to work. It does not imply any kind of legitimacy, and registration with HMRC is not for the purpose of endorsing the schemes. When HMRC becomes aware that a taxpayer has subscribed to a DOTAS-registered scheme, it should contact the taxpayer and make them aware that registration has the purpose of enforcement and does not convey legitimacy. HMRC must take into account people’s circumstances, and the threat of insolvency should never be used as a kind of extrajudicial punishment.