Health: Stroke

Lord Rodgers of Quarry Bank Excerpts

Wednesday 23rd July 2014 Grand Committee

[Lord Rodgers of Quarry Bank (LD)]

My Lords, this week, in advance of today’s debate, I looked at my copy of the second edition of the manual, first published in 2000, that is simply called Stroke. It was written by a team headed by Anthony Rudd, now the distinguished Professor Rudd of St Thomas’ Hospital. I could find no reference to children and young people in the index. I also looked at the NHS Stroke Handbook put together by the NHS North Central London Cardiovascular and Stroke Network and published a couple of years ago. Again, I could find no reference to children and young people.

There have been rapid advances, as the noble Baroness, Lady Wheeler, mentioned, in dealing with stroke over the last dozen years, and books and documents may have been revised to take account of stroke problems for children and young people. I see, for example, that there has been a Royal College of Physicians paper dated 2004. Either way, I am delighted that the noble Baroness, Lady Wheeler, introduced this debate and pleased that the Stroke Association is making a stand.

Every six weeks or thereabouts I walk across Hampstead Heath to the Royal Free Hospital in north London for a blood test to regulate my warfarin. Most of the patients are elderly, although a few are middle-aged. Others are physically disabled. However, I have not seen any children and young people. The problem is not visible to those many adults who have suffered a stroke and learnt to live with its consequences.

The Stroke Association says that the causes of stroke and the recommended treatment for children are different. In that case, how often is stroke diagnosed in children and how quickly can the necessary action be taken? Over the years, in debates in the House, I have asked whether GPs are trained and equipped to recognise the symptoms of stroke. I remain concerned that many GPs know little about stroke in the absence of direct experience of handling their own patients. On the assumption that the Minister will share our concern, can he tell us how the message can be passed on to GPs and reach those who have day-to-day contact with the public through their surgeries?

The noble Baroness, Lady Wheeler, expressly addressed the outcome of children and young people but the Stroke Association says that there needs to be research into the causes of childhood stroke. There is growing awareness of the characteristics and consequences of sickle cell disease and teachers should try to identify the potential signs of stroke. One of my daughters, a head teacher, tells me that among her 500 primary schoolchildren there is a girl who had a stroke at the age of two, resulting from moyamoya syndrome. She can understand but she cannot speak. Her teacher is almost one-to-one: she needs to communicate to the child in a very different way.

Seven years ago, my noble friend Lord Darzi set out a report called Health for London: A Framework For Action. It led to a major consultation and an agreement that certain hospitals should offer a top-quality service to stroke problems, recognising that all general hospitals could not offer the same level. I am not aware of how far this trend has successfully spread over and out of London and through the country. Given the need for services for children and young people, where are the services located—in general hospitals, existing stroke units or a high-quality specialist hospital?

There are many and rising demands on the National Health Service and costs have to be limited. The Stroke Association—a charity—has put £140,000 into research on childhood stroke at Bristol University. Does the NHS contribute to that Bristol fund? Can the Minister give an overall nationwide figure of money coming from public funds covering research on childhood stroke and where that research falls?