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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
make a significant difference not only to the figures but to literally thousands and thousands of peoples 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 yearsyet 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.
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 groups 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 consideredperhaps 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
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 placeand 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 diagnosticssomething 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 Governments 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
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 strokesurvivors, carers and professionalshave 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. Pauls 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:
Stroke clinicians, managers and politicians can feel proud of the advances that have been made over the last ten yearsthere are few other conditions that have progressed as rapidly.
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 patientsthat 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.
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 worldsouth lakelandthe 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.
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