Health: Stroke

Lord Lingfield Excerpts

Wednesday 23rd July 2014 Grand Committee

[Lord Lingfield (Con)]

I thank greatly the noble Baroness, Lady Wheeler, for securing this valuable debate. I declare an interest in that I am the chairman of the charity Action for Rehabilitation from Neurological Injury. Last week, I was privileged to invite to your Lordships’ House a dozen distinguished professors and specialists in stroke rehabilitation from all areas of the United Kingdom. Their aim is to create a new UK stroke rehabilitation service which is specialised and effective enough to cope with the requirements of stroke survivors of all ages over the long term.

My guest at this panel was Andrew Marr, who, as your Lordships will know, suffered a debilitating stroke last year. I pay the greatest tribute to him for two things: first, his extraordinary and determined efforts, which are bearing fruit, to return himself to health and, secondly, his generous willingness to discuss his experiences in public. He shared with us some of the concerns that have reached him, since his own stroke, from other survivors and their carers. Many seemed to describe their treatment or that of their children by the multidisciplinary teams at the acute stroke phase as really excellent. However, their following therapy was time-limited and subsequent support for them or their children back in the community was very limited indeed. This was the third point made by the noble Baroness, Lady Wheeler: that they had to fight for it.

My connection to stroke and young people is personal. My son suffered a severe brain haemorrhage, causing a stroke, in 1997 when he was 21 years old. A few years after that, we started together the charity for stroke rehabilitation, which I have mentioned and which matches rehabilitation specialists and exercise professionals to stroke survivors after they have been discharged back to their communities. I have seen a number of the young people, from six year-olds upwards, who are brought by their parents to our centres or to visit our personal therapists. I have been hugely encouraged by the way that these young people can, with the proper treatment, do very well in conquering the effects of stroke. The ultimate aim for their rehabilitation is for children to start attending school or return to it, or other education, as normally as possible.

One of the limiting problems I see with the children who visit our centres—apart from speech and language difficulties, which often seem to be overcome more quickly—is weakness, particularly upper-limb spasticity. This seems to be the most devastating impediment, which needs consistent long-term affordable therapy because it has to be tackled head-on, often with the coerced use of the limb concerned. The evidence shows that whereas children have the advantage over adults of having a more flexible template for neuroplasticity to occur, with the younger brain adapting more easily to replace lost abilities, children can often simply decide not to use, for instance, an affected hand while playing. They do not understand why they must actively work hard on their limitations as adults, such as Andrew Marr, have done. I met a young boy recently, for instance, who had been allowed to put his stroke-disabled hand in his pocket and keep it there all day long.

That is why community charities are so crucial to continuing the work of the already stretched National Health Service, whose multidisciplinary teams have often completed their work as quickly as a few months from the initial stroke incident. Rehabilitation for children must be continuous, without let-up, to keep propped open the window of time that the brain is most plastic. A number of small charities across the country do this and there is an urgent priority for national support for their work. Many have proven records of successful rehabilitation which, of course, eventually saves the public purse huge sums in carer and ambulance call-out costs. Many are run by volunteers and operate on small private sponsorship. Yet it is to those very bodies that parents turn to request the provision of community therapy and training assistance for young stroke survivors.

We need the means effectively to help the young gain the post-stroke rehabilitation that they need to lead successful lives. A national rehabilitation service of the kind that my group hopes to see, co-ordinating the often disparate services that are currently available, would be an excellent way forward.