A stroke is the main cause of disability in Wales and the third most common cause of death, after cancer and heart disease.
While the number of people in Wales dying from a stroke is thankfully falling, the number of people having a stroke is rising and it is widely feared that due to modern lifestyles, Wales may be sitting on a stroke timebomb.
While many people are familiar with the term, unless they or their families have been directly affected by a stroke, it is not always known exactly what the term means or how a stroke is caused. A stroke occurs when part of the brain is deprived of its blood supply and as a consequence, deprived of oxygen. This is usually caused by a blockage or burst blood vessel. A lack of oxygen to brain cells, even for a very short time can damage them irreparably. If the patient receives medical attention immediately, it may be possible to save other brain tissue surrounding the damaged cells and thereby limit the long-term damage.
Access to first class stroke services is therefore vitally important to everyone in Wales, as strokes are not solely confined to the over 65s, as is commonly thought. Stroke services in Wales have been criticised by Dr Tony Rudd, a leading stroke expert, as "scandalously bad", while Edwina Hart herself has admitted that stroke services need to improve. In common with other treatments on the NHS, there has been a strong perception, now backed up with clinical evidence, showing that patients in England have access to nearer, more efficient, and therefore, more effective treatment than patients in Wales.
According to the Stroke Association, being treated in a dedicated stroke unit can double your chances of survival. In England, over 90% of hospitals have a stroke unit, while an audit by the Royal College of Physicians reports that in Wales only 40% of hospitals have a dedicated stroke unit. Only half of these have both acute and rehabilitation beds. Only three hospitals in Wales offer clot-busting drugs to stroke victims. While this is more than a few years ago, it is still not good enough.
In 2007, Edwina Hart pledged an additional £7.5million over three years to improve stroke services. While this money was welcome, there are plenty of measures the Minister could take, which would cost very little, but could make a significant difference to the lives of stroke victims.
There is a lack of information surrounding strokes in Wales. We do not have a stroke register, so all figures for the number of strokes are estimates. An accurate picture of the scale of the problem could allow Wales to better tailor services to the needs of patients. I would also like to see an audit of the number of speech therapists in each LHB, which the Stroke Association has long campaigned for and the Minister has promised to implement. Such information could then be fed in to the Minister's national stroke action plan.
I would like greater support in the community for patients and their families as they try to get back to as normal a life as possible. This was graphically brought home to me recently when I met some constituents at the Assembly. There is also an urgent need to ensure equitable access to clot-busting medicines. An early medical assessment is critical to enhancing survival rates following a stroke and if clot-busting medicines are prescribed, it is essential that patients have access to these as a matter of urgency.
For too long, strokes have been seen as a near terminal condition, yet now many people are living fulfilling lives after a stroke. Action now can help ensure that more stroke victims can seize the opportunities of life.