Meeting of the Parliament 21 November 2024
I thank members from all parties for supporting my motion and allowing it to be debated.
As members are aware, my interest in stroke comes from personal experience. In 2021, my husband collapsed and it transpired that he had suffered a haemorrhagic stroke. I was aware of the face, arms, speech, time—or FAST—stroke awareness campaign but, because he was lying face down on the floor, it was not possible for me to see the effect that the stroke had had on him. Thankfully, he was processed at speed and that speed, and the skilled hands of the surgeon, saved his life.
Having a stroke is a life-changing event. Stroke affects around 11,000 people in Scotland every year and more than 136,000 people are living with the long-term consequences of stroke. My husband shows signs of stroke fatigue every day and those are far more pronounced on busy days when he has had more to do and is battling internally to complete tasks. The on-going effects of stroke are not widely known and he still gets strange looks when he has to take a little extra time to walk downstairs in public or navigate the aisles of a supermarket.
The Scottish stroke care audit highlighted stroke as the third most common cause of death in Scotland and the most common cause of severe physical disability for adults. The provision of hospital care for those patients accounts for 7 per cent of all national health service beds and 5 per cent of the entire NHS budget.
It does not have to be like that. We know that receiving medical treatment quickly is linked to better treatment, reduced damage and improved outcomes, many of which are clinical, but the Scottish Government has not done enough to make the clinical process faster and more available, especially in our hospitals.
Awareness is also essential and it remains a simple fact that clinical services cannot be efficiently utilised unless we can identify the symptoms of stroke and act fast. Concerning figures from a YouGov poll commissioned by Chest Heart & Stroke Scotland reveal that 39 per cent of adults—a figure that increases to 53 per cent of 18 to 24-year-olds—are not familiar with FAST. That is why I take the opportunity to congratulate organisations such as the Stroke Association and Chest Heart & Stroke Scotland for their continued work to raise awareness.
A special mention must go today to Chest Heart & Stroke Scotland for its current FAST campaign, which illustrates three of the most common symptoms of stroke and highlights the importance of acting quickly to call the emergency services. The F tells us to look at the face and notice whether the person can smile and the A reminds us to check whether the person can lift both arms. The S gets us to check whether the person can speak clearly and the T tells us when it is time to call 999.That campaign has been solely funded by CHSS and, in the first week alone, reached a phenomenal 5.4 million people.
Regular repetition of public health messaging is key, so it is disappointing that it took action by a charity to launch that public campaign, especially when priority number 2 in the Scottish Government’s 2023 stroke improvement plan was awareness raising. The plan stated:
“We will work to understand current public awareness of stroke symptoms, and the action required when they occur, and support the delivery of FAST campaigns.”
I recognise that the pandemic affected public health messaging and that a national campaign might not have had the desired effect when the improvement plan was initially drawn up. However, I ask the cabinet secretary to reflect that we are now in the last months of 2024. Given the alarming statistics that I mentioned in relation to the number of adults who are aware of FAST, I ask the Scottish Government to rethink its approach to public health campaigns.
I could talk on this subject for hours, but I want to take the opportunity before I finish to highlight the work of the BE FAST campaign group, which is working to expand Scotland’s stroke awareness from FAST to BE FAST—balance, eyes, face, arms, speech, time—by adding balance and eyes to the stroke symptoms. That follows the sudden passing of Anthony James Bundy, who was 53 years old when he suffered a fatal stroke with symptoms outside FAST. In that case, clinicians ruled out stroke after various FAST tests were completed, unfortunately leading to that fatal stroke after a five-and-a-half-hour wait in an accident and emergency department in a Scottish hospital.
The crux of the campaign is that less-common symptoms can occur in some individuals, such as changes to balance or the eyes, which could mean misdiagnosis or delay in treatment. I understand the concerns of clinicians and charities that BE FAST may diminish the focus on the three main symptoms of stroke and I understand that the evidence is not yet there to support it, but it is the “yet” that matters. Anything that could prevent loss of life should be looked at seriously. I look forward to the evidence being collated so that, eventually, any loss of life or subsequent disability from stroke becomes a thing of the past.