The Health, Wellbeing and Local Government Committee's Report on Stroke Services (Peter Black and South Wales West Liberal Democrats)

The Health, Wellbeing and Local Government Committee's Report on Stroke Services

June 23, 2010 12:00 AM
By Peter Black in Plenary

Peter Black: I concur with Joyce Watson's final words about the provision of services for victims of stroke around Wales, which is patchy, to say the least. One issue that came up in the committee's report was that the level of treatment and service that you could expect after having a stroke, both immediately and the aftercare, differed according to where you lived in Wales. That is unacceptable, and I note from the Minister's acceptance of the vast majority of the committee's recommendations-she has accepted all our recommendations, but not all in full-that she also finds that unacceptable. I hope that we will be able to take forward some changes as a result of this review, although I acknowledge that some are already in train, to improve that situation, so that, when patients do have a stroke, they are able to go to a dedicated stroke unit, no matter how that is defined-and there will be differences in how a stroke unit is defined and what it should look like-where they will receive any necessary treatment immediately to alleviate the symptoms of stroke at units that are open seven days a week, 24 hours a day. Following such treatment, they should then be able to get appropriate rehabilitation to allow them to live as regular a life as possible.

The issue that Joyce alluded to concerning therapy is crucial in this regard. Joyce referred to the provision of speech and language therapy, which is lacking. As speech and language therapists and the royal college said in a briefing paper that they sent to Members, a third of the 11,000 people every year who have a stroke in Wales are left with a communication disability-aphasia. Between 30 and 43 per cent of those affected will remain severely affected in the long term. We need to get the workforce planning in place to ensure that we have an adequate number of speech and language therapists, and we must ensure that the funding is in place for them to deliver the treatment. This needs to be done to ensure that people who have suffered a stroke are able to recover their speech and language faculties to the best of their ability, and are not left behind because of some failing in the service.

Turning to general therapy and occupational therapy in particular, the College of Occupational Therapists has drawn our attention to the fact that almost no funding is available for specialist higher education courses on stroke. Many therapists find they are not allowed to study these courses unless they are prepared to pay for them themselves. To overcome the situation, therapists have developed an all-Wales occupational therapy clinical network to support best practice in stroke services, but they receive no investment or formal support for the network, although it provides in-service training and shared learning and support for those who are not able to secure the time or funding needed to undertake the necessary specialist training. These professionals are trying to put things right themselves. It seems to me that if we are to have a comprehensive service for stroke victims, we need to ensure that the funding is in place.

The committee Chair's point about a stroke register was well made. Some of the most compelling evidence that the committee received demonstrated the importance of having information about how many people suffer strokes and where, as well as the importance of monitoring that information. I noted in the Minister's response to the report, as did the Chair, the reference to allowing that to grow almost organically, but I wonder whether that will be adequate, given the differences in IT provision across Wales, and the fact that we have been relying on such organic growth for some time in the hope that provision would improve, but we have not actually achieved the results that this review shows we need. Perhaps we need a bit more central direction in this regard, too.

The committee has produced a comprehensive report with some important recommendations. I welcome the fact that the Minister has accepted all the recommendations, although some only in part. The key issue for us now is to ensure that acceptance is turned into action, and that a proper action plan is put in place as soon as possible, so that the committee can monitor how the recommendations are being put into effect and can ensure that they are being delivered.

Peter Black and South Wales West Liberal Democrats