Hansard

I am delighted to take part in tonight’s members’ business debate, and I thank members who have signed and supported the motion.

First, I pay tribute to and acknowledge world stroke day itself. Observed on 29 October each year, world stroke day raises awareness of stroke and of the contribution made by individuals who have suffered, and it is in that spirit that I once again bring this simple message to Parliament.

Back in June 2017, I secured a members’ business debate on stroke care in Scotland. My speech at that time highlighted the sheer number of people in our country who experienced stroke annually and the efforts that were being made to look after and support those who survived. I highlighted the level of stroke care that existed in Scotland and the need for the provision of thrombectomy to improve. In my conclusions in that debate, I welcomed and acknowledged the work that had taken place to ensure that we had facilities to support victims and their families. The debate recognised the general optimism about ensuring that we had high-quality support for stroke nurses, with support systems and pathways in place to support individuals. We also noted the pragmatic approach of survivors towards recovery, wellbeing and aid in secondary prevention.

That previous debate took place nearly three and a half years ago but, since that time, despite all the good intentions that were echoed in the chamber by the then Minister for Public Health and Sport, not much has changed. Why is that? The same loyal constituents are still in touch with me, the same highly dedicated healthcare professionals contact me on a regular basis and I still work with the hard-working stroke charities across Scotland. The cross-party group on heart disease and stroke, which I co-convene, holds regular meetings.

I commend the stroke charities in Scotland—the Stroke Association and Chest Heart & Stroke Scotland—for their fantastic work and their contribution. I put on record my gratitude for the commitment of their fantastic staff. I mention, in particular, Colin Oliver of the Stroke Association and Katherine Byrne of Chest Heart & Stroke Scotland. They support the cross-party group, and they support individuals right across the country. Both charities have identified that stroke care in Scotland has been failing in key areas for some years, despite the best efforts of some truly extraordinary stroke specialists and staff across the country.

We know about the commitment to improve key areas, as announced by the Scottish Government back in September 2019. That work is welcome, especially given how stroke care has been massively impacted by Covid-19. We cannot blame Covid entirely, however, as many people call for. Back in 2017, promises were made and commitments were sought in the chamber, but, over the past three years, some of those commitments have not come to fruition.

I know that there have been major difficulties in supporting thrombectomy. As we have heard, many people have suffered—600 people across the country could have benefited from thrombectomy. The treatment is cost effective, and many people know about developments in that regard. I am delighted that there have been some reassurances recently at NHS Tayside, which has definitely helped with thrombectomy in that area, and things are beginning to move forward in other areas. I welcome that progress, although it has come too late for some people. Thrombectomy is cost effective, and we have all seen the quality of stroke care, as well as the awareness and understanding of what is happening. There is a postcode lottery, however, and we must recognise that. That simple action is not helping everybody, and more people may be becoming disabled because of a stroke. Every 10 minutes of delay in treatment, between arriving at a hospital and receiving clot-busting drugs, has been shown to take a month off a patient’s life.

“Scottish Stroke Improvement Programme: 2020 National Report” on the NHS Scotland stroke improvement programme has shown that key targets in the assessment of vital stroke care were still being missed significantly in 2019, well before the pandemic started. Furthermore, the latest stroke care audit figures, which were published in September 2020, show that a third of stroke patients do not receive even the most basic level of care, which is known as the stroke care bundle. Stroke care-bundle compliance is 64 per cent across Scotland. Admittedly, that is a small improvement on the figure of 59 per cent in 2018, but overall compliance still remains far below the 80 per cent standard that has been set.

Many health boards have not managed to challenge that and ensure that the standard is reached. There have been some improvements in NHS Dumfries and Galloway, NHS Tayside, NHS Ayrshire and Arran and NHS Highland, but we have seen no statistically significant change or improvement in the other health boards. That has to change, because compliance ensures that people have the opportunity to get the support that they need.

We know that someone who lives in Scotland is more likely to have a stroke at an earlier age than someone who lives in another part of the United Kingdom, and we know that more people die from strokes in Scotland than in other parts of the UK. During the pandemic, access to rehabilitation has been limited or has stopped altogether for many individuals, who feel that they have gone backwards.

We are well aware that all those areas are devolved to the Scottish Government, so it is vital that we work together and embrace the opportunity to change the quality of stroke support, to ensure that individuals get the access and the support mechanisms that they rightfully require.

In conclusion, I support and echo the Stroke Association’s principles, and I call on the Scottish Government to continue to make urgent progress with the stroke commitments in its programme for government; to establish a regular reporting mechanism for all stroke conditions; and to ensure that the Parliament receives regular updates. Only regular progress updates will ensure that stroke care does not become lost in the midst of the current pandemic.