World Stroke Day

Marion Fellows Excerpts

Thursday 23rd November 2023 Westminster Hall

[Marion Fellows (Motherwell and Wishaw) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Bromley and Chislehurst (Sir Robert Neill) on securing this debate. It is always better in any debate if there is a degree of experience and I think we all benefited from his. It is very good of him to share it.

The Scottish Government recently published their Stroke Improvement Plan 2023. In many cases Scotland is more fortunate because we have our own NHS and a smaller area to cover; there are only seven health boards, so there is less difference across the country. I am not saying there is not any difference, but it is much easier for the Government to work with individual health boards and organisations and produce a plan that everyone has bought into.

Unfortunately, strokes remain a leading cause of death in Scotland. The Scottish Government’s new stroke improvement plan seeks to minimise strokes. It is difficult to imagine that anyone in this room will not have had contact with someone who has had a stroke or who knows of someone still suffering. It is still the leading cause of death and disability in Scotland.

I hate to say this, but age is the most important factor. A stroke is most likely to occur after the age of 55 —I will say no more on that at the moment—but younger people can be affected as well. It is the fourth single leading cause of death in the UK.

Some good news is that the number of deaths from stroke is going down, partly due to a reduction in the incidence of strokes, but also thanks to the greater awareness of symptoms. As the hon. Member for Bromley and Chislehurst told us, the FAST programme was the first advertising campaign. It was really useful: most people can now recognise what a stroke is, what the factors are and can try their very best to get people into hospital much more quickly.

I will not go down the path of describing the treatments available because that was done in an exceptional manner—in a way that even I can understand—by the hon. Member for York Central (Rachael Maskell). But it is really important that we are all aware of what we and Governments can do to help people have better health in general. If someone has high blood pressure, high cholesterol, an irregular heartbeat or diabetes, that makes them more likely to have a stroke.

One of the things the Scottish Government are trying to do is reduce health inequalities across Scotland. It is really important that the Scottish Government use a human rights approach on this basis. Poverty is also one of the leading factors for bad health. As Lorraine Tulloch, the programme lead of Obesity Action Scotland said, those facing the choice of heating or eating amid the ongoing cost of living crisis are likely to be more focused on ensuring that there is enough food to go around than noting the nutritional value of food. In Scotland, we are having to deal with the consequences of poor diet and higher weight—we also need to look at poverty, which is the leading cause of those two things.

In Glasgow, the Scottish Government are investing £500 million through the city region deal, and regional partners have secured £300,000 of Health Foundation funding as part of their work to align economic development and improved health conditions. This will include the development of a capital investment health inequalities impact assessment tool, which will ensure that the health inequality impacts on the people who live and work in the Glasgow region—which includes my own constituency of Motherwell and Wishaw—are considered throughout the life of the project. Again, the Scottish Government are doing all they can to minimise the impact of poverty, but it is really difficult.

It is also important that the plan looks at the psychological issues referred to by the hon. Member for Bromley and Chislehurst—and it does. Often, someone who has a stroke needs not only physical recovery, but the right recovery from depression and the psychological impact. I have had some personal experience of that with people I know who have had strokes. Often, they may be accepting of the fact that they will not recover all their mobility, but they find it quite difficult to lose the life they had. That is something we must all take into account. The range of disabilities stroke can give is greater than for any other condition: limb weakness; visual problems; language and communication problems; extreme fatigue; and depression, as I have already mentioned. They are all common. The really difficult thing is that two thirds of working-age survivors are unable to return to work. That leads again to further depression and anxiety.

In order for those who experience stroke to be best placed to navigate their journey, stroke care should be provided in line with the principles of realistic medicine, which include listening to and understanding the patient’s problems and care preferences; ensuring that patients are allowed to take part in the decision making; and ensuring that patients have access to the clear and understandable information required to make an informed choice about their care.

I am not quite finished. I would like to talk about something that I find really interesting and that is a wee bit more uplifting than what we have been hearing. The hon. Member for Bromley and Chislehurst referred to self-led post-stroke care groups. He and I have to declare an interest: my son’s father-in-law leads one of those in Wishaw. I know from him and some of the people in his group how beneficial they find that kind of thing. But it would be much better for everyone if they did not have the problem of finding premises and all the other things. Across the UK, that should be something that Governments can take on and fund, because it helps with the psychological distress, anxiety and depression.

I recently heard about a tech-enriched rehab programme that recently opened at University Hospital Wishaw—or “Wishy General”, as most of my constituents would refer to it. It is to help meet the overwhelming demand for rehabilitation. I talked to a patient who was treated there, and she says how wonderful it is and how good it is to get something like that locally. This incredibly exciting pilot between the University of Strathclyde and NHS Lanarkshire is aimed at reducing disability and bettering outcomes after strokes. Recent research conducted at the University of Strathclyde has shown this type of model to be safe and feasible when used by people in the chronic phase of stroke recovery and has led to improved outcomes. It is really exciting to hear of these kinds of trials; it is something the Minister might consider looking into in order to benefit folk across the United Kingdom.

I make no apologies for being a Scottish nationalist and for praising my Government for what they do, but I do not think anyone could ever accuse me of not caring about people across the UK. It is important that we share knowledge and understanding to benefit all the people in what the hon. Member for Strangford (Jim Shannon) refers to as this United Kingdom of Great Britain and Northern Ireland. I know that the Minister will have listened carefully. I hope he will take on board what has been said and look to Scotland for answers in some of the things that we do that might help to improve lives here in England and in Northern Ireland and Wales.