Hansard

I start by congratulating Alexander Stewart on having secured this important debate. I also thank all our fantastic NHS staff, who go above and beyond in caring for all those who have experienced a stroke or who are living with the consequences of having had a stroke, as well as in supporting families who have been struck by a loved one suffering a stroke and its consequences.

I repeat what Alison Harris said at the end of her speech: I thank third sector organisations, which do a tremendous job, not just in advocating in Parliament on what our policy priorities should be and for advising and briefing us for our speeches, as they do for debates such as this, but for their delivery of care, which so many organisations provide in partnership with the NHS and local authorities.

One such organisation is Chest Heart & Stroke Scotland, which has supported this debate. I also put on record our thanks to the Stroke Association. Many members will have visited the Stroke Association’s reception just a few weeks ago to take part in its purple month, wearing all things purple in order to help to increase the knowledge of stroke and to highlight the risks of high blood pressure. I look forward to welcoming the Stroke Association at its stand here after recess, which will give members an opportunity to check their blood pressure in order to reduce their risk of stroke. I cannot see why any of us would ever have high blood pressure, but somehow it seems to affect us.

I will pick up on a couple of issues that Alexander Stewart raised in his speech, focusing particularly on community care, on our ageing population and on the reduction in the mortality rate from stroke. That means that people are living longer lives, but they are longer and more complicated lives as they live with the consequences of stroke. Indeed, 50 per cent of people with disabilities have had a stroke, and that brings challenges. In total, 124,000 people are living with the consequences of a stroke. That places challenges on community care and on after support, particularly after-support nursing care. It presents challenges relating to other health risks—impacts on physical health and on mental health, including anxiety, depression, social isolation and loneliness.

Some people face challenges around self-management. It is important that we focus on self-management and that we emphasise community care, but that needs to be backed up with investment. There is a postcode lottery in respect of the support and care that people receive in their local authority areas, or in integration joint board or health board areas. We should view the challenges of integrated health and social care also as an opportunity when it comes to what kind of support we can give to communities.

It is also worth noting that, although the mortality rate is falling, the incidence of stroke is predicted to increase by 44 per cent by 2035, according to research that has been done by King’s College. That is a challenge that we need to face head on.

Health inequalities, which have been mentioned briefly, are another key challenge. It is a sad reality that stroke mortality among people from the most deprived backgrounds is 42.3 per cent higher than it is among people from least deprived backgrounds. That gives us real challenges in respect of how we support people—especially in our most deprived communities—to access care when they have a stroke, and to access interventions to limit the risk of their having a stroke in the first place.

We have workforce challenges, too, around care from specialist follow-up nurses. People have access to differing amounts of support depending on which health board area they live in. There are consultant vacancies in specialties involving support for cardiology, and there are specific challenges with thrombectomy. There are only three specialists in that field in Scotland; there are 80 in England and Wales. Unfortunately there is no access to thrombectomy outside Edinburgh and Glasgow. The question how we support people in other areas is crucial.

I end by encouraging all members, please, to come and get their blood pressure checked after the recess.