Meeting of the Parliament 30 November 2022
I thank Gillian Mackay for bringing the debate to the chamber.
Having a stroke is a life-changing event. The condition affects around 10,000 people every year in Scotland, and more than 128,000 people in the country are living with the long-term consequences of their stroke. The Stroke Association report says:
“You can’t always see the damage a stroke causes. It’s hidden inside. But we know it’s one of the biggest issues for people and their families. Emotional and psychological wellbeing for someone after a stroke is just as important as their physical recovery.”
The sense of loss and grieving for the life that has been so abruptly altered is the first and most difficult challenge that a stroke victim will need to overcome. In the simplest of terms, a stroke victim will need to mourn the person they were before they can become the person they will be. I speak from experience. In February 2021, when we were in lockdown again, my husband collapsed from a haemorrhagic stroke and went through surgery to reduce the bleed on his brain. He had no idea of what was happening and no concept of the situation. He was in intensive care in Edinburgh and I was 50 miles away at home when depression took hold. He would not eat; he would not engage in any way; he did not want to know.
Usually, I would have been able to visit and support him and simply hold his hand but, because of the extraordinary circumstances brought on by the pandemic, a psychologist’s input was requested and the doctors feared that he would not recover, even though the operation was a success. Over the course of many difficult phone calls, I had to try to describe him—his likes, his dislikes, his goals and his dreams—and even though I had no idea whether he would be able to experience those things again, I had to make sense of what little talk they had managed to pick up from him. His journey back to health was won in those conversations and that psychological intervention.
As members will be aware, not all strokes have the same outcomes, and my husband’s experience is an example of that. Most people think that a stroke is a condition that affects someone’s physical health and, of course, those consequences are extremely serious. As a result, however, it is assumed that the care ends when the physical symptoms end, and that assumption contributes to people not receiving the psychological care that they desperately need.
The Stroke Association consulted more than 100 stroke survivors, and the results were staggering. In fact, I will repeat Paul McLennan’s comments on this point. The association reported that 94 per cent of people said that they experienced an impact on their psychological and emotional wellbeing after a stroke, while 39 per cent reported severe impact on their mental and physical health. Three quarters of respondents said that they did not get enough emotional support in hospital, and 68 per cent felt that they did not get enough support when they went home.
The battle to truly survive a stroke is won or lost on the basis of what the victims believe they can achieve, but that is not being catered for, and we must do better. I have concerns that immediate stroke care is moving in the wrong direction nationally. Members will be aware of the set of standards for national stroke care, which is often referred to as the stroke bundle and includes access to a brain scan within 12 hours as well as access to aspirin as a blood thinner within a day of arriving at hospital. Meeting those targets for care gives someone the best chance of recovery; NHS Fife and NHS Forth Valley in my region are meeting those standards, but Scotland as a whole is not.
Moreover, clinicians are raising concerns about funding reductions to the thrombectomy surgery programme. A thrombectomy saves lives, reduces damage to the brain and increases the chances of a fuller recovery, and it also saves £47,000 per person in on-going treatment. That seems to me like a win-win, and I urge the cabinet secretary to consider that issue again.
I believe that the bedside psychological assessment and one-to-one care that my husband was able to receive saved his life—just as much, in fact, as the surgery did two weeks earlier—and those who provided that care will have my unending support and thanks.
I strongly support the motion.
17:36