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As has been said, stroke affects others besides the victims. I urge the Government and the Under-Secretary to remember during the consultation that stroke affects family, friends, neighbours and colleagues. Stroke has devastating consequences, yet it is frequently forgotten compared with high-profile subjects such as cancer and heart attack. Why is much more notice taken of cancer and heart attack when, if we examine the figures for causes of death among women, we find that stroke is well ahead of breast cancer? Remedying the deficiencies in the service could
11 July 2007 : Column 1502
make a significant difference not only to the figures but to literally thousands and thousands of people’s lives.

I welcome and acknowledge the impact that organisations such as the Royal College of Physicians, the National Audit Office and the Public Accounts Committee make to raising awareness of stroke. That also applies to charities and voluntary bodies such as the Stroke Association and, in my constituency, TALK, which does a huge amount to support people who have suffered strokes and to make them believe that there is life after stroke.

The consultation document mentions involving the third sector. Funds will need to follow if the Government are genuinely committed to using voluntary associations. The Stroke Association has acknowledged that, and expressed its concern that, as my hon. Friend the Member for South Cambridgeshire said, it is not clear how we move from the document to delivery. The task should not be underestimated. As I said, the issue has been talked about and discussed for some 20 years—yet prevention, treatment and rehabilitation following stroke have never really had the time and commitment they deserve.

I urge hon. Members to join us in supporting the motion. It calls on the Government to act now to save the lives that can be saved; to act now to ensure that we have the community and long-term services necessary to improve the outcomes for people who have had strokes; and to act now to show those who have had a stroke that with the right services, there is life beyond stroke. I commend the motion to the House.

3.41 pm

The Parliamentary Under-Secretary of State for Health (Ann Keen): I start by welcoming the hon. Member for Isle of Wight (Mr. Turner) back to his place today, and I commend hon. Members for having the courage to talk about their personal lives and how stroke has affected them. The House has led by example today, showing those outside how we can be courageous and how we can reach a consensus, stemming mainly from the work of the all-party group on stroke.

I would particularly like to praise the group’s chairman, the hon. Member for South Cambridgeshire (Mr. Lansley). We joined the House at the same time and have shared many a discussion on the Health Committee. I am pleased to join the team and look forward to further health discussions in future. I think that all members of the all-party group made generous contributions to the document launched by my right hon. Friend the Secretary of State on Monday. I particularly commend the work of Professor Roger Boyle, as members of the group wanted me to thank him and his team for the excellent work they did.

As the hon. Member for East Devon (Mr. Swire) mentioned, stroke may not necessarily be the best description. I agree that it is really a cerebral-vascular accident, which is how I was trained to describe a stroke. “Brain attack” and other terms used to characterise this serious condition should also be considered—perhaps as part of the consultation.

The all-party group has raised many important issues for my Department to reflect on for its new strategy. “A new ambition for stroke” is now on the
11 July 2007 : Column 1503
table for consultation. I understand why the hon. Member for South Cambridgeshire asked about the continuation of the consultation. In fact, we now need champions to go out and promote the work because there is so much to do and we need to realise that there are different ways of treating this condition. Much good work can be done if we have those champions in place—and I believe that that will develop out of the consultation. We can build on the good progress made by cardiac units. We need to reflect on the arrangements and positioning of cardiac units, which helps to explain why they have been so successful. That is important for future treatment of these emergency brain accidents.

We are determined to reduce the impact of strokes through our new strategy and to ensure that those who have experienced strokes are well supported through the months and sometimes years of rehabilitation and recovery. That demands a transformation of attitudes. We need to end the pessimism associated with stroke and recognise that it is a preventable and treatable condition. As I said earlier, the courage of hon. Members here today has marked the beginning of the end of that pessimism.

Medicine is very dynamic and has moved on tremendously. We now know that if we can diagnose strokes quickly and treat them appropriately, there is every chance of helping people to a good recovery. That is why it is important to act now. We have seen a reduction in mortality from strokes and an increase in stroke specialist services. Those achievements and a strong evidence base for stroke care mean that we are now in a position to drive forward improvements in stroke services.

Modernising the services will not be a quick or easy task. We have a lot to do on prevention, commonly described as “lifestyle.” We are now smoke-free across the countries of the UK, we have obesity and exercise programmes and we are looking at a genuinely healthier lifestyle. People need support to change their lifestyle; it is not easy. People cannot be lectured at, and they need help and assistance. I hope that we continue to provide positive and reasonable health education.

We need to raise awareness of symptoms and improve action on risk factors. We must ensure rapid diagnostics—something that many Members mentioned. We need to improve integration across health and social care, a point raised by the hon. Member for Guildford (Anne Milton), particularly in relation to integration with social services. That is absolutely critical and my ministerial colleagues and I will be working together on it. Much work has been done for carers and I am pleased with the Government’s approach in terms of flexible working for carers who are in work, training, a new deal and even pensions.

The hon. Member for Guildford tried not to make a political point in referring to her time as a district nurse. I, too, nursed through the 1980s and 1990s and I, too, do not wish to make a political point, but many of my patients and families were very cold because they did not have a heating allowance. Their pensions were miserable. Many were trying hard to rehabilitate
11 July 2007 : Column 1504
themselves on small incomes and they did not know whether to put on their heating or to eat. Many of the rehabilitation services were not in place. I hope that we share enthusiasm for change and for the improvements that the Government have made.

Change is difficult and we need leadership to bring it about. Much has been said about the organisations providing stroke rehabilitation and care. I want to mention a nurse consultant in Portsmouth, Jane Williams, who had the confidence to close an in-patient ward and transfer the resources to community care. She had the confidence, over three years, to win the hearts and minds of more than five organisations, and did it because it made patients feel better to be in their own homes. Care is now provided nearly 24 hours a day, from 7am till 9pm, seven days a week. Those involved work within an inter-professional team and have a better success rate in Portsmouth than they would have achieved in-house. I am sure that the whole House would want to congratulate Jane and her team.

Ours is an ambitious programme and we know that success is possible. Greater Manchester was mentioned by the hon. Member for South Cambridgeshire, but clinicians have already agreed a strategy to ensure that every stroke patient has the chance to benefit from the clot-busting treatment. Today in London my colleague Professor Ara Darzi has published proposals to develop hyper-specialised stroke centres serving the whole capital. The hon. Member for Ilford, North (Mr. Scott), who raised important points, may like to participate in the review to see how his local services might be affected. We have asked officials to look into the matter and I will get back to the hon. Gentleman.

It is right to be ambitious as there is overwhelming enthusiasm for the new strategy, not only in this House but from the stroke community. Many people have helped us to develop the consultation document, and I thank all of them. Throughout the country, people with first-hand experience of stroke—survivors, carers and professionals—have told us in no uncertain terms what needs to change. The consultation exercise gives us a chance to listen to a still wider range of voices. I urge Members to contribute and to encourage their constituents to give their views. I will attend my centre at St. Paul’s church in Brentford, to which I am a regular visitor. That exercise should give us the opportunity to launch this coming winter a strategy that truly galvanises the revolution in stroke care that we have discussed today.

Much has rightly been made of the audit report. It says:

We can all be proud of that, and I hope that Members will refer to it when we are in our constituencies.

Jane Williams made the bold decision to go forward with changes in five organisations over three years. We can only imagine how difficult a task that must have been for a nurse consultant. She told me that she did it because it was right for patients—that it was the right way to progress in the management of care. It is now up to all of us to take up that challenge and to do right by patients.


11 July 2007 : Column 1505

Tim Farron (Westmorland and Lonsdale) (LD): On the point that it is important to make the right decisions for patients, does the hon. Lady accept that one size does not fit all? In my part of the world—south lakeland—the stroke unit at Westmorland general in Kendal is proposed for closure. Residents of Grasmere will be more than an hour away from their nearest stroke unit if we close the Kendal unit.

Ann Keen: It is unacceptable for the hon. Gentleman to arrive in the Chamber towards the end of the debate and then to raise that point. Let me just say that there must be lots of local accountability, but that that is not all there must be.

Mr. Simon Burns (West Chelmsford) (Con): Does the hon. Lady agree that as this has been an important debate, if the hon. Member for Westmorland and Lonsdale (Tim Farron) were so concerned about the constituency point he raises, he would have been present for the entire debate?

Ann Keen: Not for the first time, I agree with the hon. Gentleman.

On that note, I ask the House to support the amendment in the name of my right hon. Friend the Prime Minister.

Question put, That the original words stand part of the Question:—

The House proceeded to a Division.

Mr. Deputy Speaker (Sir Alan Haselhurst): I ask the Serjeant at Arms to investigate the delay in the No Lobby.


The House having divided: Ayes 195, Noes 300.
Division No. 177]
[3.53 pm



AYES


Afriyie, Adam
Ainsworth, Mr. Peter
Ancram, rh Mr. Michael
Bacon, Mr. Richard
Baker, Norman
Barker, Gregory
Baron, Mr. John
Barrett, John
Beith, rh Mr. Alan
Bellingham, Mr. Henry
Bercow, John
Blunt, Mr. Crispin
Bone, Mr. Peter
Boswell, Mr. Tim
Bottomley, Peter
Brazier, Mr. Julian
Breed, Mr. Colin
Brokenshire, James
Brooke, Annette
Browne, Mr. Jeremy
Browning, Angela
Bruce, rh Malcolm
Burns, Mr. Simon
Burrowes, Mr. David
Butterfill, Sir John
Cable, Dr. Vincent
Cameron, rh Mr. David
Campbell, rh Sir Menzies
Carmichael, Mr. Alistair
Carswell, Mr. Douglas
Cash, Mr. William
Chope, Mr. Christopher
Clappison, Mr. James
Clark, Greg
Clarke, rh Mr. Kenneth
Clifton-Brown, Mr. Geoffrey
Cox, Mr. Geoffrey
Crabb, Mr. Stephen
Davey, Mr. Edward
Davies, Philip
Davis, rh David (Haltemprice and Howden)
Djanogly, Mr. Jonathan
Dorrell, rh Mr. Stephen
Duddridge, James
Duncan, Alan
Duncan Smith, rh Mr. Iain
Dunne, Mr. Philip
Ellwood, Mr. Tobias
Evans, Mr. Nigel
Evennett, Mr. David
Fallon, Mr. Michael
Farron, Tim
Featherstone, Lynne
Field, Mr. Mark
Foster, Mr. Don

Francois, Mr. Mark
Gale, Mr. Roger
Garnier, Mr. Edward
Gauke, Mr. David
George, Andrew
Gibb, Mr. Nick
Gidley, Sandra
Gillan, Mrs. Cheryl
Goodman, Mr. Paul
Gove, Michael
Gray, Mr. James
Grayling, Chris
Green, Damian
Greening, Justine
Greenway, Mr. John
Grieve, Mr. Dominic
Hague, rh Mr. William
Hancock, Mr. Mike
Harper, Mr. Mark
Harris, Dr. Evan
Harvey, Nick
Hayes, Mr. John
Heath, Mr. David
Heathcoat-Amory, rh Mr. David
Hemming, John
Hendry, Charles
Herbert, Nick
Hoban, Mr. Mark
Hogg, rh Mr. Douglas
Hollobone, Mr. Philip
Holloway, Mr. Adam
Holmes, Paul
Horam, Mr. John
Horwood, Martin
Howarth, David
Hughes, Simon
Huhne, Chris
Hunt, Mr. Jeremy
Hurd, Mr. Nick
Jack, rh Mr. Michael
Johnson, Mr. Boris
Jones, Mr. David
Key, Robert
Kirkbride, Miss Julie
Knight, rh Mr. Greg
Kramer, Susan
Lait, Mrs. Jacqui
Lancaster, Mr. Mark
Lansley, Mr. Andrew
Laws, Mr. David
Letwin, rh Mr. Oliver
Lewis, Dr. Julian
Liddell-Grainger, Mr. Ian
Lidington, Mr. David
Llwyd, Mr. Elfyn
Loughton, Tim
Mackay, rh Mr. Andrew
Maclean, rh David
Main, Anne
Malins, Mr. Humfrey
Maples, Mr. John
May, rh Mrs. Theresa
McIntosh, Miss Anne
McLoughlin, rh Mr. Patrick
Mercer, Patrick
Miller, Mrs. Maria
Milton, Anne
Mitchell, Mr. Andrew
Moore, Mr. Michael
Mulholland, Greg
Mundell, David
Murrison, Dr. Andrew
Neill, Robert
O'Brien, Mr. Stephen
Oaten, Mr. Mark
Öpik, Lembit
Osborne, Mr. George
Paice, Mr. James
Pelling, Mr. Andrew
Penning, Mike
Penrose, John
Pickles, Mr. Eric
Price, Adam
Prisk, Mr. Mark
Pritchard, Mark
Pugh, Dr. John
Randall, Mr. John
Reid, Mr. Alan
Rifkind, rh Sir Malcolm
Robathan, Mr. Andrew
Robertson, Hugh
Robertson, Mr. Laurence
Rosindell, Andrew
Ruffley, Mr. David
Russell, Bob
Sanders, Mr. Adrian
Scott, Mr. Lee
Selous, Andrew
Shapps, Grant
Shepherd, Mr. Richard
Simpson, David
Simpson, Mr. Keith
Smith, Sir Robert
Soames, Mr. Nicholas
Spicer, Sir Michael
Spink, Bob
Spring, Mr. Richard
Steen, Mr. Anthony
Streeter, Mr. Gary
Stuart, Mr. Graham
Swayne, Mr. Desmond
Swire, Mr. Hugo
Syms, Mr. Robert
Tapsell, Sir Peter
Taylor, Mr. Ian
Teather, Sarah
Thurso, John
Tredinnick, David
Turner, Mr. Andrew
Tyrie, Mr. Andrew
Viggers, Peter
Villiers, Mrs. Theresa
Watkinson, Angela
Webb, Steve
Whittingdale, Mr. John
Wiggin, Bill
Willetts, Mr. David
Williams, Mark
Williams, Mr. Roger
Williams, Stephen
Willis, Mr. Phil
Willott, Jenny
Wilshire, Mr. David
Wilson, Mr. Rob
Winterton, Ann
Winterton, Sir Nicholas
Wright, Jeremy
Yeo, Mr. Tim
Young, rh Sir George
Younger-Ross, Richard
Tellers for the Ayes:

Michael Fabricant and
Mr. Richard Benyon

NOES


Abbott, Ms Diane
Ainger, Nick
Alexander, rh Mr. Douglas
Allen, Mr. Graham
Anderson, Janet
Austin, John
Bailey, Mr. Adrian
Baird, Vera
Balls, rh Ed
Banks, Gordon
Barlow, Ms Celia
Barron, rh Mr. Kevin
Bayley, Hugh
Beckett, rh Margaret
Begg, Miss Anne
Bell, Sir Stuart
Benn, rh Hilary
Benton, Mr. Joe
Betts, Mr. Clive
Blackman, Liz
Blackman-Woods, Dr. Roberta
Blears, rh Hazel
Blizzard, Mr. Bob
Blunkett, rh Mr. David
Borrow, Mr. David S.
Bradshaw, Mr. Ben
Brennan, Kevin
Brown, Lyn
Brown, rh Mr. Nicholas
Brown, Mr. Russell
Browne, rh Des
Bryant, Chris
Buck, Ms Karen
Burden, Richard
Burgon, Colin
Burnham, rh Andy
Butler, Ms Dawn
Byers, rh Mr. Stephen
Byrne, Mr. Liam
Caborn, rh Mr. Richard
Cairns, David
Campbell, Mr. Alan
Caton, Mr. Martin
Cawsey, Mr. Ian
Challen, Colin
Chapman, Ben
Chaytor, Mr. David
Clapham, Mr. Michael
Clark, Paul
Clarke, rh Mr. Charles
Clarke, rh Mr. Tom
Clelland, Mr. David
Clwyd, rh Ann
Coaker, Mr. Vernon
Coffey, Ann
Cohen, Harry
Connarty, Michael
Cook, Frank
Cooper, Rosie
Cooper, Yvette
Corbyn, Jeremy
Cousins, Jim
Creagh, Mary
Cruddas, Jon
Cunningham, Mr. Jim
Curtis-Thomas, Mrs. Claire
Darling, rh Mr. Alistair
David, Mr. Wayne
Davidson, Mr. Ian
Davies, Mr. Dai
Davies, Mr. Quentin
Dean, Mrs. Janet
Denham, rh Mr. John
Devine, Mr. Jim
Dismore, Mr. Andrew
Dobbin, Jim
Dobson, rh Frank
Donohoe, Mr. Brian H.
Doran, Mr. Frank
Drew, Mr. David
Dunwoody, Mrs. Gwyneth
Durkan, Mark
Eagle, Angela
Eagle, Maria
Efford, Clive
Ellman, Mrs. Louise
Engel, Natascha
Ennis, Jeff
Etherington, Bill
Field, rh Mr. Frank
Fisher, Mark
Fitzpatrick, Jim
Flello, Mr. Robert
Flint, Caroline
Flynn, Paul
Follett, Barbara
Foster, Mr. Michael (Worcester)
Foster, Michael Jabez (Hastings and Rye)
Francis, Dr. Hywel
Gardiner, Barry
George, rh Mr. Bruce
Gerrard, Mr. Neil
Gibson, Dr. Ian
Gilroy, Linda
Goggins, Paul
Goodman, Helen
Griffith, Nia
Griffiths, Nigel
Grogan, Mr. John
Gwynne, Andrew
Hain, rh Mr. Peter
Hall, Mr. Mike
Hanson, rh Mr. David
Harman, rh Ms Harriet
Harris, Mr. Tom
Healey, John
Henderson, Mr. Doug
Hendrick, Mr. Mark
Heppell, Mr. John
Hesford, Stephen
Hewitt, rh Ms Patricia
Heyes, David
Hill, rh Keith
Hillier, Meg
Hodge, rh Margaret
Hodgson, Mrs. Sharon
Hoey, Kate
Hood, Mr. Jim
Hoon, rh Mr. Geoffrey
Hope, Phil
Hopkins, Kelvin
Howarth, rh Mr. George
Howells, Dr. Kim
Hoyle, Mr. Lindsay
Hughes, rh Beverley
Humble, Mrs. Joan
Hutton, rh Mr. John
Iddon, Dr. Brian
Irranca-Davies, Huw
James, Mrs. Siân C.

Jenkins, Mr. Brian
Johnson, rh Alan
Jones, Helen
Jones, Lynne
Jones, Mr. Martyn
Jowell, rh Tessa
Joyce, Mr. Eric
Kaufman, rh Sir Gerald
Keeble, Ms Sally
Keeley, Barbara
Keen, Alan
Keen, Ann
Kelly, rh Ruth
Kennedy, rh Jane
Khan, Mr. Sadiq
Kidney, Mr. David
Kilfoyle, Mr. Peter
Knight, Jim
Kumar, Dr. Ashok
Ladyman, Dr. Stephen
Lammy, Mr. David
Laxton, Mr. Bob
Lazarowicz, Mark
Lepper, David
Levitt, Tom
Lewis, Mr. Ivan
Linton, Martin
Lloyd, Tony
Love, Mr. Andrew
Lucas, Ian
MacShane, rh Mr. Denis
Mactaggart, Fiona
Mahmood, Mr. Khalid
Mallaber, Judy
Mann, John
Marris, Rob
Marsden, Mr. Gordon
Marshall, Mr. David
Martlew, Mr. Eric
McAvoy, rh Mr. Thomas
McCafferty, Chris
McCarthy, Kerry
McCarthy-Fry, Sarah
McCartney, rh Mr. Ian
McDonagh, Siobhain
McDonnell, John
McFadden, Mr. Pat
McFall, rh John
McGovern, Mr. Jim
McIsaac, Shona
McKechin, Ann
McKenna, Rosemary
McNulty, Mr. Tony
Meacher, rh Mr. Michael
Meale, Mr. Alan
Merron, Gillian
Michael, rh Alun
Milburn, rh Mr. Alan
Miliband, rh Edward
Miller, Andrew
Mitchell, Mr. Austin
Moffat, Anne
Moffatt, Laura
Moon, Mrs. Madeleine
Moran, Margaret
Morden, Jessica
Morley, rh Mr. Elliot
Mountford, Kali
Mullin, Mr. Chris
Munn, Meg
Murphy, Mr. Jim
Murphy, rh Mr. Paul
Naysmith, Dr. Doug
Norris, Dan
O'Brien, Mr. Mike
O'Hara, Mr. Edward
Olner, Mr. Bill
Owen, Albert
Palmer, Dr. Nick
Pearson, Ian
Plaskitt, Mr. James
Pound, Stephen
Prentice, Bridget
Prentice, Mr. Gordon
Prescott, rh Mr. John
Primarolo, rh Dawn
Prosser, Gwyn
Purnell, rh James
Rammell, Bill
Raynsford, rh Mr. Nick
Reed, Mr. Andy
Reed, Mr. Jamie
Reid, rh John
Riordan, Mrs. Linda
Robertson, John
Robinson, Mr. Geoffrey
Rooney, Mr. Terry
Roy, Mr. Frank
Ruane, Chris
Ruddock, Joan
Russell, Christine
Salter, Martin
Seabeck, Alison
Shaw, Jonathan
Sheridan, Jim
Simpson, Alan
Singh, Mr. Marsha
Skinner, Mr. Dennis
Slaughter, Mr. Andy
Smith, rh Mr. Andrew
Smith, Ms Angela C. (Sheffield, Hillsborough)
Smith, Angela E. (Basildon)
Smith, Geraldine
Smith, rh Jacqui
Snelgrove, Anne
Soulsby, Sir Peter
Southworth, Helen
Spellar, rh Mr. John
Starkey, Dr. Phyllis
Stoate, Dr. Howard
Strang, rh Dr. Gavin
Straw, rh Mr. Jack
Stringer, Graham
Stuart, Ms Gisela
Sutcliffe, Mr. Gerry
Tami, Mark
Taylor, Ms Dari
Taylor, David
Taylor, Dr. Richard
Thomas, Mr. Gareth
Thornberry, Emily
Timms, rh Mr. Stephen
Tipping, Paddy
Todd, Mr. Mark
Touhig, rh Mr. Don
Trickett, Jon
Truswell, Mr. Paul
Turner, Dr. Desmond
Turner, Mr. Neil
Twigg, Derek
Vaz, rh Keith
Vis, Dr. Rudi
Walley, Joan

Waltho, Lynda
Ward, Claire
Wareing, Mr. Robert N.
Watts, Mr. Dave
Whitehead, Dr. Alan
Wicks, Malcolm
Williams, rh Mr. Alan
Williams, Mrs. Betty
Wills, Mr. Michael
Winnick, Mr. David
Winterton, rh Ms Rosie
Wood, Mike
Woolas, Mr. Phil
Wright, David
Wright, Mr. Iain
Wright, Dr. Tony
Tellers for the Noes:

Ms Diana R. Johnson and
Tony Cunningham
Question accordingly negatived.
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