World Stroke Day

Caroline Johnson Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for Twickenham (Munira Wilson) on securing this important debate.

Strokes are life-threatening medical emergencies that affect more than 100,000 people in the UK every year, taking over 38,000 lives and leaving many survivors with life-changing disabilities. A study in The Lancet Healthy Longevity estimated their annual cost to be £8 billion, comprising public spending on care and lost economic productivity. The number of cases is rising—in England, stroke admissions increased by 28% from 2005 to 2024—and, as the Stroke Association has said, demographic reality makes it all the more urgent for the Government to take action today to improve stroke care and reduce modifiable risk factors. As we have heard, when stroke care is delayed, the typical victim loses 1.9 million neurones for each minute they are untreated. Of course, delay is measured not just in brain cells, but in lost independence, lost potential and, all too often, lost lives.

The Government cannot just acknowledge the challenge; they must act. The previous Government designated stroke as a national priority area in the 2019 NHS long-term plan, with several commitments to improve prevention, treatment and care. We set out to increase the proportion of people receiving clot-removing thrombectomy to end their stroke, improve post-hospital stroke rehab models for patients, and enhance the Sentinel Stroke National Audit Programme. That important work was led by a network of 20 integrated stroke delivery networks, which were established in 2021, with a national service model setting out best practice. The previous Government also invested more than £57 million in mechanical thrombectomy, and by the end of 2023, 24 centres were open and delivering mechanical thrombectomy across England. Do the Government have a delivery plan to create more of those centres, or do they think there are enough?

Prior to the general election, the previous Government began work on a major conditions strategy to improve the prevention, diagnosis and treatment of six major conditions, including stroke, but rather than see it through, this Labour Government chose to take an axe to progress, pausing the scheme in August 2024 and, a year later, announcing a service framework for cardiovascular diseases in the 10-year plan. Have the Government incorporated the strategy’s findings in the 10-year plan? The plan mentions stroke just twice, and only in the context of smoking and obesity.

I am pleased that the Government have shown an interest in reducing modifiable risk factors. Prevention is always better than cure. Those categorised as obese face an elevated risk of stroke—64% higher than those of healthy weight—and one in five children leaves primary school obese. We spoke about obesity in this morning’s debate, but I did not get answers to most of my questions. I appreciate that the Minister is covering for someone this afternoon, but will he undertake to get answers not just to the questions asked in this debate, but to those asked in this morning’s?

I am encouraged to see Ministers showing an interest in furthering the previous Government’s work to tackle smoking, a habit to which one in four strokes is directly attributable, but it seems to be taking quite a long time. Just yesterday, health leaders warned that more than 120,000 young people have started smoking since the Tobacco and Vapes Bill was introduced. Will the Minister assure us that the Government will prioritise the Bill and pass it without delay?

High blood pressure remains the single biggest risk factor for strokes, and it is generally asymptomatic, which is why it is so important that tests are carried out in locations that are convenient for people. Last year, community pharmacies in England delivered more than 140,000 blood pressure checks and diagnosed nearly 11,000 cases of hypertension. As the Government complete the latest round of pharmacy negotiations, will the Minister commit to expanding that service further, so that pharmacies can detect more cases and prevent more strokes?

The Government’s delay to the NHS workforce plan is particularly concerning. We need enough doctors to train to perform thrombectomy and care for patients, and enough physios, occupational therapists, nurses, speech therapists and so on to support rehabilitation. After the Government cancelled the major conditions strategy last summer, their 10-year plan promised a service framework, as I said. Given that they have now delayed the workforce plan, the cancer plan, the neonatal and maternity plan and the HIV plan, will the Minister assure the House that they will not also delay the service framework for cardiovascular disease? We need action and not just words, so will the Minister explain what the Government have done materially to improve early stroke diagnosis since they came to office?

Stroke care is not only about medical interventions. For many survivors, recovery starts when they return home and have to re-learn to walk, speak and carry out daily tasks, so access to physiotherapy, occupational therapy, speech and language therapy and other support is vital. How do the Government plan to improve that provision, and what are they doing to provide psychological support to the families of stroke victims and victims themselves, especially in cases where there is a change of personality or emotional disturbance?

Prevention is better than cure. Work on smoking, obesity and high blood pressure are important. In the event of a stroke, every minute counts. Every minute the Government spend perfecting plans instead of putting things into action is a minute of suffering that could have been spared.

--- Later in debate ---

[Dr Ahmed]

My hon. Friend must have read my mind. As I was saying, our plan is only for England. Hon. Friends have already articulated the fact that in Scotland, despite the best efforts of clinicians in Glasgow, Edinburgh and Dundee, there has not been the ability—or the intent from the Scottish Government—to bring forward a proper 24/7 stroke thrombectomy service. That means that the time of day that Scottish patients have a stroke determines the outcome. They are literally being dealt a roulette wheel of care: 20th-century care out of hours and 21st-century care within office hours. It is simply unacceptable, and the UK Government stand ready to assist the Scottish Government in any way, shape or form they require to make sure that access to the highest quality of care is as available to patients in Scotland as it is to those in England.

[Dr Caroline Johnson]

I am grateful to the Minister for answering the question and talking about universal services being available from next year. Can he confirm whether they will be 24/7 and what he means by “universal”? If someone is living in a rural area, what is the greatest distance or time they should expect to travel to get to their local thrombectomy centre?

[Dr Ahmed]

What I mean by “universal” is indeed 24/7. As the hon. Member well knows, there are always challenges in delivering stroke care and heart attack care to rural communities. She, as a clinician, knows that we try our best, through the ambulance service and other forms of repatriation, to try to make sure there is equitable access wherever we can achieve it.

I thank my hon. Friend the Member for Stratford and Bow again for her kind words about the very small part that I played in her husband’s diagnosis. I am glad that he continues to do so well. I want to pay tribute to some of the charities involved in this space, because they have been instrumental in the innovation in stroke care over the past 20 to 30 years. I thank the Stroke Association, Different Strokes and Chest, Heart and Stroke Scotland for the incredible work that they do, including in my own constituency.

As the fourth largest cause of death for adults, stroke has a devastating impact on patients, families and the wider community. About one third of people who suffer a stroke will be left with some form of long-term disability. This is an important inequalities issue, as has already been discussed in this debate. Cardiovascular disease hits hardest in the most deprived parts of our country, including in parts of my own constituency, where people are more likely to smoke and less likely to have access to decent food and open green spaces. This Government were elected on a manifesto to tackle the biggest killers, including cardiovascular disease, and our health mission is committed to reducing deaths from heart disease and strokes by a quarter in the next 10 years.

I want to set out our reforms to the NHS, especially those which are part of our 10-year health plan, which will drive down rates of disease while helping people to live well for longer. Many Members in this Chamber are familiar with our three shifts: moving more care into the community, advancing the cause of digital health, and prioritising prevention over treatment.

On prevention, as much as I love my job as a surgeon I am still rooting for the public health Minister to put me out of business. She is taking forward strong preventive measures in her brief, through our Tobacco and Vapes Bill and by beefing up the NHS health check, which is England’s flagship cardiovascular prevention programme. That programme helps to target the abnormalities common to heart disease, to stroke, sometimes to diabetes and to kidney disease, and in many cases even to dementia through behavioural and clinical interventions. Each year, the programme engages 1.3 million people, preventing around 500 heart attacks or strokes. To improve access and engagement, we are developing the NHS health check online so that people can use it at home. That is being piloted by three local authorities until December.

We have already begun trialling more than 130,000 lifesaving heart health checks in the workspace—in offices, shop floors and commercial areas—all across the country. That will also help to reduce the risk of stroke. The hon. Member for Sleaford and North Hykeham asked about community pharmacy. Community pharmacy can and will continue to provide free blood pressure check services for anyone over the age of 40.

On rehabilitation, the stroke quality improvement for rehabilitation programme has increased the percentage of patients discharged from hospital to community stroke services from just under 66% when this Government took office to almost 70%. There is much more to be done, of course, but I believe that we are moving in the right direction.

As hon. Members are aware, the NHS fell behind in the last 14 years—certainly behind the private sector—in using digital technology. That was an appalling inequity, so let me come to our shift from analogue to digital. Half of all people who experience a stroke in England are now recovering thanks to revolutionary scanners that mean patients can avoid the risk of serious disability. The world-first technology that is coming online will analyse CT scans of stroke patients arriving in hospital, identifying them within 60 seconds. That means that the average time between a patient arriving at a hospital and starting life-saving and life-changing treatment is shortened from 140 minutes to only 79, resulting in less disability and a greater quality of life. I am pleased to update the House that since the roll-out last summer, the tool has been used to interpret the brain scans of more than 60,000 patients.

This Government believe that working people have the right to expect the same level of rehabilitative services as the wealthy. That is why we are so gladdened by the new state-of-the-art rehab gym hub at Montagu hospital in Doncaster, which is a perfect example of the best of the NHS that we wish to bring to the rest of the NHS. The suite relies on robotic therapies, which are otherwise provided only in private healthcare. The machines combine robotics with gamified, interactive activities to enhance both physical and cognitive recovery following a stroke—an example of what the seamless integration of physiotherapy and investment in digital health can achieve for stroke patients.

We are also forging partnerships with medtech companies to deliver the next generation of healthcare for patients. Reneural, which has partnered with Hillingdon Hospitals NHS foundation trust, is bringing virtual reality stroke rehabilitation to patients, and enabling therapists to remotely deliver and monitor stroke rehabilitation. Our shift from analogue to digital is supporting both in-hospital and community-based therapy, and, in many ways, allowing equality between rural and urban communities.

I am not saying that everything is perfect—far from it—or that there will not be bumps along the way. However, in a few short months, we have improved the outcomes of more than 60,000 patients, which is a testament to the actions of this Government. Through focus, and by delivering on the promises of digital and bringing the best of the NHS to the rest of the NHS, we can, and we will, do better for stroke patients and their loved ones.