 The final item of business is a member's business debate on motion number 12093 in the name of Margaret Mitchell and Chess Heart and Stroke Scotland's outstanding support for survivors. This debate will be concluded without any questions being put and in light those members who wish to take part in the debate, please press the request of squeak buttons now and i hynny wedi datblygu ti'n hyrwod tynnu yn ystod. Mae'n trwy gyda'r ysgol squat, dweud tynnu'n dwylo, o ddyn nhw. Yn credu, ddyn nhw i gyd ddim yn rwyf am i ddechrau'r cael ei ddechrau applied gyfnodsgol iawn i'r oedud hynny. Mae'n amsgol i'r gweithio'r gweithio'r gyfnodionol yn y ddechrau'r ysgol. Ieithalu i ddechrau i gyd y gallan roedd gyda'r gweithio'r gweithio'r gweithio, I began to understand the varied issues associated with strokes which survivors face. I discovered for example that those who have had a stroke often then experience hidden conditions. These will be different for each individual, but tiredness, memory loss, a lack of ability to concentrate and communication difficulties are common. Given this, stroke survivors support groups such as the ones provided by the charity Chest, Heart and Stroke Scotland, CHSS for short, play an immensely important role. Those groups provide the opportunity for survivors to meet, and it can then be a tremendous relief for a survivor to know that they are not alone and that someone else understands how they feel and what they are experiencing. The charity also helps stroke survivors to understand and come to terms with new physical and other limitations, which can be a product of the stroke. CHSS, community stroke groups, are self-managed, so though linked to CHSS, this allows them the flexibility to reflect local interests and diversity. Those groups help their members to take part in activities in their local community. In fact, when I heard about all the Coatbridge members' activities, including ab-sailing, I felt a definite couch potato by comparison. The charity's community stroke services are provided in partnership with the NHS, which in turn helps to establish a link between community services and speech language and physiotherapy. It is absolutely essential that stroke survivors have access to these services as soon as possible after having a stroke. The CHSS, 110 different communication support services across Scotland, can offer either one-to-one or group support, which helps to rebuild survivors' communication skills and often daunting and formidable tasks. Despite that, the sad and unpalatable truth is that adequate physiotherapy and speech therapy are in far too many cases not available, and survivors talk of different levels of provision across health board areas. That anecdotal evidence was confirmed by an FOI request that I lodged with health boards and local authorities, which revealed either different levels of provision or, more worryingly, still a complete inability to specify exactly what provision was available. Minister, surely that lack of adequate provision is something that could be tackled and should be tackled as a priority? It makes sense in terms of preventative spend, but the difference that it can make to the quality of life to survivors—their spouses and families whose lives are also turned upside down—is beyond measure. Here, the NHS offers invaluable support to the family members who virtually overnight can find themselves cast in the new, stressful and intense role of carers of stroke survivors. That is an aspect that is often overlooked, as I heard in graphic, compelling and deeply disturbing detail yesterday when I met with some South Lanarkshire carers stroke survivors. The common thread was the lack of support available from the social work department, especially if the stroke survivor was not hospitalised for any length of time and or they owned their own home. The same story was repeated about how the survivors and their carers were left to flounder callously told to make the arrangements to source and commission the necessary adaptations which they then had to pay for to allow the survivor to live in the familiar and comforting sanctuary of their own home. That is at a time when stress levels for those carers is off the scale, especially if they are not just coping with the new, demanding role but are also facing financial difficulties from loss of employment, which could mean that their home has to be sold. At the same time, the hidden conditions such as extreme tiredness has a knock-on effect for survivors just attempting to do routine tasks such as accessing a large supermarket and being forced to park several hundred metres from the entrance. Walking the distance might be possible but slow and laborious to the point of not being feasible given the extreme tiredness and exhaustion that can often suddenly set in for stroke survivors. Imagine the humiliation of a stroke survivor, a blue badge applicant who was asked to attend the mother wall, not land at shark, and so hecked HQ for assessment. On presenting, he was met by an occupational therapist and told to follow her to her room. She then proceeded to set off at a pace around the circular lobby. The survivor protested he couldn't keep up and needed to rest. This was ignored and he sold your don to find himself back where he started. Apparently, their assessment had been completed and he was refused a blue badge. I don't believe for a second that any politician would condone this degrading treatment. Certainly, when I made the director aware of what had taken place, he was appalled and confirmed that a proper reassessment would be carried out. However, the callousness and dehumanising behaviour on the part of some local government officials, including social workers, usually far down the chain of command, must be addressed and checks and balances put in place to ensure that stroke victims get a fair hearing. On a more positive note, the awareness-raising acronym FAST is designed to help the public to recognise that someone may be having a stroke. The F stands for face. If one side of the face is drooping, it is a possible symptom. A stands for arms and the test to see is whether they can lift both their arms. S stands for speech. If slurred then together with the above signs, then T means time to call 999. Early treatment and recognition of a stroke occurring where blood supply to the part of the brain is being cut off is clearly crucial to minimising long-term damage. However, too many of the survivors at CHSS report that GPs are not picking up the signs that indicate that a patient is either at risk of a stroke or having a minor stroke, which can lead to a more severe stroke. Although the FAST campaign is excellent, much more needs to be done to train GPs to recognise other stroke symptoms, which can include high cholesterol, high blood pressure and or diabetes. To put the scale of the problem in perspective, in Scotland today, every 45 minutes someone will have a stroke. It could be anyone at any time. That is why the issues raised tonight in this debate are so important and, if addressed, could make a monumental difference to the lives of survivors and their carers who deserve this Parliament's support. I therefore look forward to the minister's response. Now, I call on Dennis Robertson to be followed by Malcolm Chisholm. Thank you, Presiding Officer. I can start with an apology to Margaret Mitchell and to the other members that I will have to leave early as I have another engagement. I am grateful to Margaret Mitchell for bringing this debate to the chamber. As the convener of the cross-party group on heart disease and stroke, I am very much aware of the story that Margaret Mitchell has presented to the chamber this evening. The Cheshart Stroke Scotland is the co-secretariat for the cross-party group. Often, we hear of stories of survivors at the cross-party group, all with their own individual stories. However, a lot has happened and a lot of good work is going on. Indeed, the cross-party group was instrumental in taking forward the stroke charter. It was first moved by Helen Eadie. When Helen Eadie died, I undertook to take that charter forward with the subgroup of the committee. A charter that has been supported by the Cabinet Secretary for Health, Alex Neil, before he moved over to his other portfolio. During the time that the charter was being put forward, it was more to do with acknowledging that intervention after a person has a stroke needs to be quick. It needs to be at the time and at the location that the person requires this important rehabilitation. Quick intervention could prevent the person's stroke from becoming that bit worse. Margaret Mitchell gave us one of two stories there, which are too often, Presiding Officer, the stories that we have heard at the cross-party group. People being wrongly assessed—I used the term wrongly assessed for things like a blue badge, for instance—because the full impact of the stroke is not taken into cognisance during that assessment. That is the fault of the assessment process and not understanding the impact or the full impact that a stroke may have on an individual and certainly the ability of that individual to carry out the tasks that they had undertaken before. In my previous work in the north-east services, I came across many people who had a visual impairment as a result of stroke. To understand the haeminopia that that incurs is very difficult initially for the patient and certainly their families and carers. With the right support and understanding, the person can learn to live with that degree of sight loss as they understand it and become they can adjust to that with the right instruction and support. Too often, we do not get the right information, we do not often get the right support at the time of need. This is not just frustrating for the patient, the sufferer or the survivor, as we talk about, but for their families and friends. In Margaret Mitchell's absolutely right, it can have a devastating impact on a person's not just mental health, but their ability perhaps to go back to employment, their ability to perhaps do simple tasks, perhaps just to go out on their own and come back feeling refreshed from maybe a walk. Because quite often that initial walk that they used to enjoy for leisure is one that is arduous and tiring and gets to the point that they may not wish to do it anymore. Chest, heart and stroke with the peer support, the invaluable peer support that it gives is immeasurable. Because knowing that someone else has survived, knowing that someone else has adjusted, knowing that someone else has moved on is inspirational for many. We need to be aware that it is just not charities like Chest, Heart and Stroke. We all have a responsibility and that includes our general practitioners and our clinicians. Once again, I thank Margaret Mitchell for bringing this debate to the chamber and I sincerely hope that, indeed, the minister is listening. I thank you very much. I now call on Malcolm Chisholm to be followed by Dave Thompson. Presiding Officer, I would like to congratulate Margaret Mitchell for bringing this important debate to the chamber and also, like her, welcome the young stroke survivors to the Parliament today. I think that the key to improving the quality of health and, indeed, social care services is listening to the experience of those who have had to use those services. Clearly, Margaret Mitchell has done that and drawn to the attention of the minister on many important issues that need to be addressed. However, when I read the motion, I felt that what I wanted to do was emphasise the importance in general terms of the voluntary health sector for health, and in particular, obviously, in the context of today's motion, the work of Chest, Heart and Stroke Scotland. Obviously, we are working across cardiovascular disease as well, but concentrating today on their stroke services and looking up some information, I was told that there are 37 communication support services in south-east Scotland alone. Obviously, I do not have direct knowledge of Lanarkshire. 1,333 people affected by speech and language difficulties after stroke benefited from their communication support services, which, of course, are the centrepiece of the motion today. To be honest, I did not know the scale of support that was given to stroke survivors by Chest, Heart and Stroke Scotland, and I certainly think that we should pay tribute to their work. However, of course, it is not just in that particular area that they are active for stroke. They also have, and again I am looking at my own area, south-east of Scotland, seven stroke specialist services through stroke nurses. They run a stroke training programme for professionals in Lothian and I know elsewhere, and they have given research funding. For example, at the western general hospital, there is a research project that is supported by Chest, Heart and Stroke Scotland to better understand the relationship between different measures of blood pressure and different types of stroke. Over and above that, they have an advice line in information and personal support grants to some people who are survivors of stroke. I think that the key thing that I want to do is to pay tribute to their work and looking to their strategy ahead. I know that they have plans over the next two or three years to involve service users in the planning and design of services, even more than they do at present, and to further develop training for specialist staff. They, of course, have been very involved in the public recognising strokes, and they have developed a campaign pack and disseminated that through the health service. Clearly, the public recognising the symptoms of stroke is very important, as well as GP awareness, as is highlighted by Margaret Mitchell. Just in the last minute, I think that I would like to give, I suppose, the more positive developments that have taken place, because Margaret Mitchell quite rightly highlighted all the actions that need to be taken still in relation to physiotherapy, speech and language therapy, social care, and the blue badge issue is certainly one that I have come across recently as well. However, I think that we need to recognise that we really, over the years of this Parliament—and, in fact, starting in the three or four years before it—have seen significant advances. For example, there was a 50 per cent reduction in premature mortality from stroke between 1995 and 2010. Over the last 10 years, the number of new cases of cerebral vascular disease is down by 21 per cent, and the stroke improvement plan, which I read before the debate, told us that, in the last year for which we have figures, there was a 10 per cent improvement in delivering key elements of the stroke care bundle. There are lots of issues there about getting to a stroke unit, having it getting an aspirin if it is appropriate, getting thrombolitis if it is appropriate and so on. We should recognise that there has been very consistent progress over the years of this Parliament, particularly in relation to hospital care for people who have had strokes. However, I think that it is quite right that Margaret Mitchell has emphasised what happens after people leave hospital, and there are clearly many issues there that need to be addressed. Many, many thanks. I now call on Dave Thompson, after which we will move to closing speech from the minister. Thank you very much, Presiding Officer. I, too, would like to congratulate Margaret Mitchell on securing this debate and welcome the young stroke survivors to the Parliament. It is a privilege to take part tonight, as I personally have benefited from heart surgery back in 2006, in the middle of my successful 2006-07 election campaign. The repaired mitral valve, which I had done at that time in the single bypass, are still fine, and my cardiologist in Inverness, the excellent Professor Steve Leslie, is very happy with me. I actually have a lot to thank the NHS for, including another major operation just 18 months ago on a bilateral subdural hematoma, which could have left me much worse than I am. I have recovered extremely well, and I am very grateful for that. Of course, the NHS would not function as well without bodies such as Chest Heart and Stroke Scotland. It is also a great privilege for me to be a vice-convener of the cross-party group on heart disease and stroke, which does much good work under the convenership of Dennis Robertson. Of course, chest heart and stroke conditions are wide and varied, which means that the information provided by Chest Heart and Stroke Scotland through its communication support services must be accurate and tailored to suit the individual cases. I have no doubt that we have all in some way been touched by the great work that Chest Heart and Stroke Scotland do, even if we have not been fully aware of the tireless tasks that their volunteers and employees undertake behind the scenes. In that vein, I thought that it would be useful to highlight just some of the campaigns that Chest Heart and Stroke Scotland are involved with right now. Firstly, there are voices Scotland. That is a national network of people affected by Chest Heart and Stroke conditions who want to have their say. Through free workshops and on-going support, people are provided with the knowledge, skills and confidence to work with the health and social care services in order to help to plan new and better services. Then we have Think Fast and Save a Life, a campaign that has been mentioned already that aims to raise awareness of stroke and acknowledges that with more than 12,000 people in Scotland having a stroke every year, it is essential that folk recognise a stroke when it is occurring so that they are able to take the prompt action that is necessary. In addition, there is the Aphasia Alliance campaign that highlights the fact that a third of the estimated 12,500 people who have a stroke in Scotland every year will be left with Aphasia. Aphasia is a condition that affects the language skills of sufferers after they have experienced brain damage. It can affect speech, understanding and reading and writing. For those with breathing problems, we have the COPD awareness campaign, which is important because there are more than 115,000 in Scotland with a diagnosis of chronic obstructive pulmonary disease or COPD. However, it is believed that many more people have COPD but are unaware of it. Many folk relate symptoms of COPD to smoking or ageing and tend not to report their symptoms to their doctors. Early diagnosis would hugely benefit those folk. Finally, there is the PARCS project, which is a person-focused range of activities for people with respiratory, cardiac and stroke conditions. It is a collaborative project looking at different physical activity in a variety of community settings and whether that meets people's needs. Of course, all those campaigns involve hard-working health professionals who are also supported by Chest Heart and Stroke Scotland and many others who get involved. E-learning resources are also available and links to several specific Chest Heart and Stroke related web resources along with national health and social care resources being available. This is very helpful so that people can see at a glance what resources are available in their areas. For all of this, I thank Chest Heart and Stroke Scotland and wish more power to their elbow. Without bodies and charities such as those, our health service would crumble, I have no doubt. Thank you very much indeed to all those who are involved. Many thanks. Now we move to closing speech on Minister Maureen Watt. Minister, seven minutes all thereby. Thank you very much, Presiding Officer. I, too, would like to thank Margaret Mitchell for raising this motion and also congratulate Chest Heart and Stroke Scotland on their contribution to stroke care in Scotland over the last 20 years. I also add my welcome to the young survivors group in the gallery. Stroke remains the third-biggest killer in Scotland and the leading cause of disability, which is why it has been a clinical priority for NHS Scotland since the mid-1990s. Over the years, the stroke community of which CHSS is a key stakeholder have worked together in making excellent progress to deliver the best possible health and social care to people who have had a stroke. However, we will always strive to do more. I am sorry to hear about the situations that Margaret Mitchell described of people who have suffered strokes in North Lanarkshire. It is not acceptable and I am glad that she has and will continue to take up robustly the issues with the chief executive of North Lanarkshire Council. Poor customer care is something that we should not put up with and has to be challenged on every occasion. However, it means that people have to learn that the best possible care and service should be given to those who need it. I am glad that she mentioned adaptations when I was convener of the infrastructure and capital investment committee and housing was part of the remit. I know how important adaptations are in order that people can move sometimes from a hospital setting back to their homes as quickly as possible. However, we have done a lot and this is reflected in the updated stroke improvement plan published in August 2014, which sets out eight priority areas to ensure that in Scotland we continue to strive towards improved prevention, treatment and care of stroke. All those with an interest across all levels and roles have an important part to play. It is by working together, learning together and sharing breast practice that we will deliver improvements. We must also continue to strengthen ways to actively engage with people affected by stroke and learn from them and identify the issues that are important to them. I am proud to say that we supported Chest, Heart and Stroke Scotland through collaborative working and our relationship with the charity extends beyond stroke care and we collaboratively work with them on improving heart disease and respiratory care too. CHSS community support services is a good example of partnership working between CHSS and the NHS. This service offers an important bridge for stroke patients between speech and language therapy and independent activities in the community. It provides stroke survivors young and old with an opportunity to increase confidence and ability to communicate in a variety of social settings. This service is co-ordinated by someone who understands the needs of each individual and can be delivered on a one-to-one basis or in peer support groups. CHSS and NHS Lanarkshire also work in partnership to provide a number of other services, including stroke support nurses, training co-ordinators and financial advice. I think that services are there but perhaps they are not being used in the best way possible or perhaps they are not even known that they do exist. As Malcolm Chisholm said, not every situation is as Margaret Mitchell described. Since 2010, CHSS has run 11 successful fast campaigns raising awareness of strokes symptoms that we support. More recently, in 2013, we provided CHSS funding to co-ordinate the fast campaign with NHS boards and they have developed a toolkit for boards to use locally. The funding also supported the production of a short online video featuring actors from the popular still game series to get the fast message across. The fast campaigns are aimed at both the general public and healthcare professionals, including GPs. CHSS evaluation of those campaigns indicates that recognition of the fast campaign message rose from 32 to 61 per cent and the proportion of patients or relatives who called NHS services for help within 30 minutes of the onset of the symptoms rose from 46 per cent to 62 per cent. I think that that is really encouraging and it shows that we must keep this campaign going so that it reaches even more people. I am glad that Dave Thompson and his contribution highlighted the other campaigns that are run. We recognise the importance of supporting stroke survivors for improved wellbeing and quality of life. That is why the Stroke Improvement Plan sets out two priority areas that focus on rehabilitation and life after stroke. Those priorities take a person-centred approach and ensure multidisciplinary stroke teams offer a range of self-management support. Stroke patients will have an acute therapy assessment, a stroke rehabilitation delivered by a stroke specialist based on the needs of the individual. Personalised and integrated services for adults who have had a stroke will be strengthened further with the implementation of the Social Care Self-Directed Support Scotland Act 2013 and the Public Bodies Joint Working Scotland Act 2014. In conclusion, we are committed to working in partnership with the voluntary sector to support new ways of delivering services. That is an ideal opportunity to publicly acknowledge the good work that has been advanced in partnership with CHSS across a range of long term conditions. We are keen to continue working alongside charities such as Chest Heart Support Scotland to make real improvements to the quality of life of people in Scotland. Finally, I thank David Clark, who has been chief executive of CHSS since 1994 and a member of the Scottish Government's National Advisory Committee for Stroke Citizens Inception over 10 years ago. I would like to wish him an enjoyable retirement when it comes in me. Thank you. That concludes this evening's business. I now close this meeting of Parliament.