Lorraine Mercer describes a letter she received recently from her local job centre urging her to return to work, and throws back her head as she chuckles. “How can I work? Just look at me,” she says. Laughing and talking are almost the only things she can do unaided.

She sits in an electric wheelchair that she controls with the three functioning fingers on her left hand. The four fingers on her right hand hang limp and useless. She has no legs, just tiny feet below her hips.