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15 Mar 2010 : Column 696

Mark Pritchard rose-

Bill Rammell: If the hon. Gentleman wants a further discussion about this-I will give way briefly to him-I would be happy to meet him.

Mark Pritchard: I am grateful for the Minister of State, but it is important for my constituents and people throughout the west midlands to have something on the record this evening, so that they can at least sleep in their beds without fearing the loss of their jobs. Is it not the case that, as a result of the delay in drawing down our troops from Germany, there will be a five-year gap? The Minister suggests that people will not lose their jobs, but he will know that several hundred people are not in scope to relocate to Wales under the defence training review programme, so if they are not relocating, what jobs will they have?

Bill Rammell: I reiterate to the hon. Gentleman what I have just said: there is no intention to mothball the site. The Army will assume ownership, following the vacation, in 2015. I am more than happy to talk to him in more detail about how this will go forward.

My hon. Friend the Member for Glasgow, South-West (Mr. Davidson) is a consistent, coherent and dogged advocate of his constituents in support of the carriers. I think that he was right to highlight the revealing testiness of the response from the Conservatives when they said that they would examine the break clauses of the contract on day one of a Conservative Government. That is in contrast to the actions we have taken in placing the orders and cutting the steel. Given the alacrity and enthusiasm with which the Conservative party is committed to going significantly beyond any savings that we have put forward in the way of cuts in public expenditure, the Conservatives have a real job of persuasion to do.

Finally, the hon. Member for Westbury (Dr. Murrison) wound up for the Opposition. There was one issue on which I strongly agreed with him-the need to get away from the tribalism of the services. I wholly share his concern in that regard but I will take no lectures from Conservative Members on service accommodation, which has been a problem for decades. We have struggled for 13 years to manage what we inherited from the last Conservative Government, particularly their scandalous PFI scheme, which defies any logic in terms of value for money.

Overall, we have had a good debate. We should recognise that there is more that unites us on defence than divides us. Where we can, we need to make common cause, particularly in respect of our mission in Afghanistan. Our armed forces deserve nothing less.

Question put and agreed to.



Regional Spatial Strategy (Irchester)

9.29 pm

Mr. Peter Bone (Wellingborough) (Con): With your permission, Madam Deputy Speaker, I would like to present a petition organised by Tony Skipper. He is one of those publicly spirited members of the community
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who goes out and gets things done. He organised this petition, which has hundreds of signatures.

The petition states:

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Stroke Services (North Yorkshire)

Motion made, and Question proposed, That this House do now adjourn. -(Kerry McCarthy.)

9.31 pm

Mr. Phil Willis (Harrogate and Knaresborough) (LD): May I, with your indulgence, Mr. Deputy Speaker, say how sad I was to hear of the death of Ashok Kumar, the Member for Middlesbrough, South and East Cleveland? He was a man whom the whole House respected enormously for his knowledge of science and for the support that he gave to an area that I know well. My first school as a head teacher was in his constituency, and I have many friends in the area who think of him as a very special Member of Parliament. He combined his duties as a constituency MP with his role in the House, particularly his chairing of the Parliamentary Office of Science and Technology. He held together a disparate group of people in POST and produced some remarkable pieces of work, which Members of this House and the public at large have found incredibly useful in trying to understand some of the big science issues. He will be greatly missed as somebody who graced this House with dignity, and we will hold him in great affection.

I suspect that this is the last time that I will have the opportunity, before I retire, to make a speech in the House. It is therefore with a little sadness that I speak tonight, but it is pleasing that Back-Bench MPs can raise on behalf of their constituents issues that have a broader appeal than some of the more parochial issues that dominate the House. It is therefore important that I can raise with the Minister this evening the subject of services for stroke victims.

As someone who was fortunate enough to recover from a small stroke in 2007, this debate is important to me personally. However, it is also important to the estimated 6 million people in the United Kingdom who are coping with the after-effects of strokes. This is a major, massive issue: in the course of this short debate of half an hour or so, six people in the United Kingdom will have a stroke, which will add six to the 150,000 people nationwide every year who suffer from a stroke or mini-stroke. In a year's time, 40 to 50 per cent. of those who have had a stroke this year will be reliant on somebody else for their day-to-day activities, and nearly one in three will be clinically depressed.

Many stroke victims suffer ongoing physical, psychological, sensory and social complications, often for the rest of their lives. I suspect that Members in all parts of the House know people-members of their families or communities-whose lives have been devastated in this way. Stroke destroys lives. Not only is it a major killer; it is currently estimated that 900,000 people in the United Kingdom are living with its after-effects-not to mention their families, friends and carers, who are also profoundly affected.

Without the remarkable efforts of the Stroke Association, many people and their families would struggle to cope, let alone begin to recover. I want to record my thanks to all who work for, raise resources for and support the association. Its excellent manifesto for 2010-2015 contains clear, lucid and achievable proposals of ways in which a Government of any persuasion can continue to improve stroke care in the future. I hope the Minister will tell us whether she has received that document and whether
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the Government will adopt any of its key proposals, which are very much in line with their own stroke policy documents.

The Stroke Association depends on inspirational individuals who deliver support to victims and their families-people like Jenny Jones, in my constituency. Jenny pioneered and runs the association's family and carer support service in Harrogate and Craven. So far, the service has helped more than 350 stroke survivors and their families since its inception in 2008. Jenny Jones has personally been responsible for improving the lives of hundreds of people, and-for her and many like her-I want to register my deepest thanks on behalf of all whom she has supported.

To be fair, the Government also deserve recognition for the progress made recently in the delivery of stroke services. As the Minister will know, in 2005 the National Audit Office published a ground-breaking report exposing the lack of priority given to stroke services in the United Kingdom, and the unnecessary suffering that it was causing to stroke survivors throughout the country. As a result, the 2007 national stroke strategy for England was produced, and was widely welcomed by both survivors and those working in the sector.

The fact that the national stroke strategy came with an additional £105 million from central Government, to be funded over three years, was particularly positive. Strategies without resources are pretty useless. I know that those funds have made an enormous difference to the lives of stroke survivors throughout the United Kingdom. I thank the Minister-and her predecessor, who did a great deal of work in this regard-for making it happen.

One thing was particularly rewarding. All too often money is spent on initiatives that do not make any difference, but, as the Minister knows, when the NAO revisited the issue it concluded that a considerable amount of progress had been made, and that has been endorsed by the Stroke Association in particular. It has been argued, however, that improvements in the acute care delivered in the immediate aftermath of a stroke have not been matched by provisions for long-term community care.

The National Audit Office was right: there has been an improvement in the recognition of stroke. It has been helped by the excellent media campaign that has been running over the past year. Posters have been put up in appropriate places, particularly near sports grounds. We know that people may have strokes when they become excited. Access to specialist stroke services in our hospitals and hugely effective physiotherapy services have also made a real difference. All the evidence suggests that if people who have had strokes are taken into most general hospitals very quickly, they are likely to receive pretty good attention.

Long-term community care, however, remains problematic. I want to concentrate on that problem this evening, and to highlight the challenges in my part of the country. In 2008, North Yorkshire county council allocated funding for the Stroke Association's family and carer support service in Harrogate and Craven. This was the first provision of any kind in North Yorkshire, and the county council should be congratulated on its foresight in creating such a service. I have put that
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on the record. When the national stroke service funding was allocated in 2008, the pioneering work that occurred in Harrogate was replicated across North Yorkshire using the Harrogate model, providing invaluable care and support for thousands more people. That is laudable. However, as Harrogate and Craven already had a service, it was not allocated any national stroke strategy support. Last year North Yorkshire county council announced that it would not be renewing the funding for the Harrogate service when its initial contract runs out this month, presenting a real threat that the pioneering service in the county would close.

I raised this issue with the Prime Minister last month at Prime Minister's questions. I did not receive a very constructive response, but the local support for the campaign to keep the community service open has been absolutely phenomenal. As an example, I launched a Facebook group on this subject last week ahead of this debate, and 365 members have joined the group in a week. These are real issues affecting real people. It would be useful to reiterate a few of the messages that I have received since starting the campaign; these are from the last week.

One constituent messaged me this morning to say:

A local nurse wrote to say:

Finally, we received a heartbreaking letter in my office two weeks ago from a young woman who explained:

Let me be clear; there is no doubt about the value of this service to my local community. Thanks to our campaign-particularly the work of Claire Kelley, my assistant in Harrogate-and to the strength of local stroke survivors and their families and carers who have joined us in this, North Yorkshire county council is now back at the negotiating table with the Stroke Association to discuss the short-term extension of the funding for this service. Again, to be fair, I would like to register my thanks to the officers of the county council for their willingness to reconsider their decision, but my ongoing concern remains that the long-term future of the Harrogate stroke service remains in jeopardy.

These are difficult times for all councils across the country but when one considers that the cost of this provision is just £35,000 a year, compared with £400,000 spent on the county council's self-serving local authority newspaper, it is hard to believe that even in these hard times, funds cannot be found for something that makes such a huge difference to the lives of so many people. Vulnerable stroke survivors, their families and carers should not have to launch a large-scale campaign to preserve a basic standard of provision that, on my understanding, was promised under the national stroke strategy and is being largely funded by the Government. Indeed, the Government's own strategy published in 2007 stated:

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It goes on to say that

That is the Government's own strategy, so that is what should be happening. The strategy does not say that these services will be available only after vulnerable people kick up a fuss and get their MP involved, questions are asked of the Prime Minister, and a debate is held in the House of Commons. It says that these services should be available immediately to all who need them for as long as they need them.

Sadly, this problem is not confined to Harrogate. In fact, the biggest concern I have is that the Harrogate example may be an omen of the state of things to come. The national stroke strategy funding is due to come to an end in a year's time, at the end of March 2011. What will happen to these services once the funding dries up? The Government do not seem to be actively seeking reassurance from local authorities that they intend to continue these services beyond March 2010, despite the fact that the 2010 National Audit Office report recommended that they do so.

In fact, when pressed on this in the recent Public Accounts Committee hearing on stroke on 24 February, the NHS chief executive, Sir David Nicholson, said that there would be no extension of the ring-fenced funding for local authorities, commenting:

that is, after the period of funding ends.

Frankly, an "expectation" or assumption is not good enough. As the example of Harrogate and Craven shows, not all local authorities understand the need for community stroke services, and not all of them will decide to continue to fund these provisions once the additional funds dry up. The Stroke Association estimates that 50 to 60 such services across the country may be under threat of closure by this time next year unless something is done.

I therefore have four questions for the Minister, and I would be grateful if she would do her best to answer them as fully as possible, to provide some peace of mind for the survivors of strokes who rely on these services. First, what assurances can the Minister give that stroke support services, developed by local authorities in response to the Government national stroke strategy, will be sustained beyond 2010-11, and what action do the Government plan to take to ensure that these services are sustained? That is fundamental.

Secondly, what plans do the Government have to monitor and evaluate the use of ring-fenced funds by local authorities, to ensure that they have been effectively allocated to stroke-specific services, and not diverted elsewhere? Thirdly, will the Government consider extending the period of the ring-fenced funding for local authorities from three to five years, to allow for sufficient development and continuation of community stroke support services? Finally, will the Department of Health take action to improve the research-based evidence and guidance on the costs and benefits of clinical and other support for
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long-term stroke care? That is a fundamental issue too, because if we do not support stroke victims in the community and get them reasonably or fully rehabilitated, the costs to the NHS and the nation are extensive-yet we have no real evidence to support that assertion.

It is clear to me that the Government have done some very positive work in improving both acute and community stroke provision throughout the country, and many local authorities have responded positively; some, like North Yorkshire, have responded proactively. However, the Government have been naive as well, by assuming that local authorities, such as Conservative-controlled North Yorkshire, will not only recognise this work but use their overstretched budgets to continue to fund it. They are in a bind-I recognise that-but we should not take community stroke services for granted. They are absolutely essential for stroke victims and their families.

I despair that an incoming Government, desperate to slash public spending, will not recognise the importance of these community-based services. I therefore hope that the Minister will put down a marker tonight that, in the event of a Labour Government being returned to office after the general election, this matter will continue to be a high priority, so that these vulnerable people will continue to get the support that they need.

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