Health: Stroke Victims

My Lords, I thank the noble Lord, Lord Rodgers of Quarry Bank, for instigating this debate on the Department of Health’s report, Mending Hearts and Brains. Some problems can complicate both conditions and there is often confusion in the minds of the public as to which is being referred to, so I am pleased the noble Lord has chosen to concentrate the debate on stroke victims. Strokes seem to be the poor relations, as great progress has taken place in heart disease. Regrettably, I have to declare an interest as my husband suffered some strokes and I feel strongly that everything possible to prevent them should be done. The treatment and aftercare should be improved across the country so that everyone who suffers a stroke gets the correct treatment, and as quickly as possible, as stated in the report. I have immense admiration for the several members of your Lordships’ House who have had strokes and have been able to continue work in your Lordships’ House. I know that has not been done without great concentration, determination and hard work in getting better. The report stresses that strokes could be prevented if people kept their blood pressure under control, monitored cholesterol levels, ate healthily, stopped smoking and took regular exercise. That is the reason I have been badgering one of your Lordships who is taking part in this debate to get his blood pressure down. It can be a hidden danger. Not all stroke victims are old, by any means, and they may look the picture of health. They need the co-operation of their doctors. When my husband’s stroke happened he was watching cricket on the TV. I was talking on the telephone and went over to ask him something, and to my horror found he was having a stroke. We called a doctor and an ambulance and I followed him to the local hospital. When I arrived I found him on a bed, and a young South African student nurse and I had to try and get him undressed. First, she started filling in the admission form, but after a few questions she threw it down and said that most of it was irrelevant. My husband was a big man, and I told her we would have to roll him like one would do with a tetraplegic. No sooner had we got his pyjama bottoms on than we had to change them, for obvious reasons. All my husband wanted was to continue watching cricket on the TV. When I left his room I was surprised to find the charge nurse chatting to some young nurses, no doubt about their social life. I felt that the young student nurse and I should have been given some help. My husband was admitted at about midday, and by 8 pm he had not seen a consultant, so I rang the chairman of the hospital, who was a friend. She telephoned and found the consultant at his house. There seemed to be no sense of urgency, only apathy, and no communication, which was distressing for the family members. I apologise for reliving the frustration of that experience, but it has made me adamant that what is written on page 8 of the report must be the aim for all stroke patients: "““You need to go from paramedic, to specialist, to scan, to clot-busting drug within three hours of the stroke hitting. So the speed with which you get a patient to a specialist is even more important. Some strokes are caused by bleeding rather than a clot and giving a clot-busting drug to these patients is extremely dangerous. Patients need a scan to show whether the stroke was caused by a clot or a bleed””." I understand that all hospitals have not got enough personnel to provide 24-hour scanning provision. That is always a concern for the many people who have raised money for scanners, and they would like to see them working 24 hours a day, 7 days a week. The report suggests the sensible compromise of bypassing hospitals without 24-hour scanning facilities and taking stroke patients to special stroke units that can save lives and long-term disability by scanning, but it remains a very great problem in rural areas, as has been stressed by the noble Lord, Lord Rodgers. Last Thursday I read an article in the Yorkshire Post headed ““Postcode lottery affects care after stroke””. Maybe the noble Baroness will read that paper. The article says: "““Hundreds of stroke sufferers could be dying needlessly because of a postcode lottery for specialist care, new figures have revealed. More than a third of patients do not receive treatment in a stroke unit where their prospects are considerably better, a national audit found. Huge differences were found across the country and in Yorkshire. Only one in four patients treated in Dewsbury, Pontefract and Wakefield were treated on a dedicated stroke unit compared to nine in 10 in Bradford and two in three nationally … Only 19 per cent of patients in Harrogate received a home visit before discharge compared to 94 per cent in neighbouring York. ""… The audit of 224 units by the Royal College of Physicians criticised some hospitals for ‘failing to recognise that their stroke patients need 21st century management’””." I would like to ask the Minister a few questions. Is there going to be a vaccine for strokes? Is eating mangos useful? I heard a young child carer of a stroke victim say last Saturday on the radio that paramedics would no longer come and pick up somebody who had fallen. If this is the case, what can be done? Many disabled people fall at home so something must be arranged. I saw recently on TV that a hand-held scanner was being developed in India. Might this be of use in the future? I hope that this debate will help to motivate better treatment and care for those unfortunate people who suffer a stroke and I congratulate the Stroke Association on raising awareness and campaigning for the needs of stroke victims. I feel there is a need for trained volunteers to help patients who are recovering from strokes in hospital with such things as feeding, shaving and helping with communication rehabilitation. It takes time and patience. Perhaps the Stroke Association can help meet these needs, which often get neglected when hospital staff are too busy.