Part of the debate – in the Senedd at 5:38 pm on 26 October 2022.
It might well be possible, in a cottage hospital, to deliver the sort of rehabilitation services that you may have in mind, but it isn't going to be possible to deliver clinical excellence unless you've got the critical mass of patients to justify it. It is really, really important that we have stroke units that are available to all our populations within a reasonable driving distance, but there's no doubt that, if you're having a stroke, you need to go to a stroke unit, end of story. That is what the ambulance should be doing—and I'm hoping that the Minister will reassure us that that is what they are doing—because it means that survival is infinitely more likely and the limitations on any disability much more likely.
This is an important debate, and I think it's a good use of World Stroke Day on Saturday to highlight this issue. But I have to say, I'm struggling a little bit in terms of the amount of information that we have been given by the Stroke Association. I was quite concerned when I got the information that my stroke unit for my population in Cardiff and the Vale has an overall score of D. But, when I asked for more information to understand exactly what was going on, I was just referred to the methodology, the alphabet soup; this is not helpful. I need a layperson's description as to what we need to do. And whilst I acknowledge that the physiotherapy services, the speech and language services, occupational therapy, are really good, and the scanning services as well, the key issue is how quickly can you get thrombolysis when you first have a stroke.
That brings us back to the amendment. I'm not convinced, I'm afraid, that recategorising strokes as red, in the same category as immediately-life-threatening calls, is the right approach at this point, because, brutally, if we add stroke to the red list, then in the context of today's stretched services, I fear that that would mean that other people on the red list would die. I don't want to be alarmist about this, but I think—. I acknowledge, however, that the Tories' motion is taking a precautionary approach by suggesting that we refer this to the Health and Social Care Committee to review the benefits of recategorising it, but there's nothing stopping the Health and Social Care Committee from doing that anyway, if they wish to.
I think more important for me is really understanding how the stroke implementation group, which was established in 2013, has been approaching its work to bring all stroke units in Wales up to the standard that is required, and how this stroke implementation board, which was announced in a written statement in September last year, is actually going to change things. Because I don't know anything further about the stroke implementation board. Like Rhun, I've had difficulty finding out about it. I think this is a really important debate, and clearly one that our constituents want us to pay attention to. But, I do think that we need to be clear that in order to have high-quality stroke units, we need to have them not in every district hospital; we need to have stroke units geographically spread out so that the whole population is able to get to one, but it has to be with the justification for the population of that area if you want the quality that everybody is going to want if it's their loved one or their constituent who is having a stroke.
I look forward to hearing the Minister's contributions. I want to hear a little bit more about what Dr Shakeel Ahmad, who is our Wales national clinical lead for stroke, has been doing. I also note that there is a UK conference in Liverpool at the end of November, which I hope some of our Welsh clinicians will be going to, because this is something that is just as important for people the other side of our border. There's been huge improvements in the way that stroke patients are cared for, but, clearly, there's always more to learn.