Official Report 845KB pdf
The final item of business is a members’ business debate on motion S7M-00747, in the name of Gary Bouse, on world stroke day 2026. The debate will be concluded without any question being put. I ask members who wish to speak in the debate to press their request-to-speak buttons now.
Motion debated,
That the Parliament notes that 29 October 2026 marks World Stroke Day; recognises that every stroke changes a life in an instant, often leaving survivors, families and carers facing physical, emotional, psychological and financial consequences; understands that the condition is a medical emergency affecting the brain, requiring urgent specialist treatment; acknowledges that it remains Scotland’s third biggest killer and the leading cause of adult disability, with a stroke reportedly occurring every 49 minutes in Scotland and more than 150,000 stroke survivors across the country living with the lasting effects of the condition; understands with concern that around one in four people who experience a stroke are of working age with up to one in three forced to leave employment as a result; recognises that around 11,000 people in Scotland experienced stroke in 2025, including more than 600 in NHS Forth Valley, which serves residents of Falkirk West; notes the view that to improve Scotland’s stroke services, it requires a comprehensive emergency pathway that ensures people with a suspected stroke are taken to the right service, regardless of location, and provided with timely access to thrombolysis that is local to them where clinically appropriate; further notes the view that this requires a 24/7 national thrombectomy service and improved access to specialist post-stroke rehabilitation in order to improve outcomes and quality of life; notes the belief that without these changes, the cost of stroke to Scotland’s health and social care services, which it already considers significant, will continue to rise, and commends the work of Scotland’s stroke clinical community, third sector organisations, including the Stroke Association and Chest Heart & Stroke Scotland, and the campaigning of people with lived experience of stroke, their families and loved ones, including the Bundy family, whose experience, arising from the tragic death of family member, Tony, aged 53 from a Basilar Artery Ischaemic Stroke, has helped inform their calls for action to transform stroke care and recovery services across Scotland.
17:38
It is an honour to bring this debate to Parliament to mark world stroke day, which takes place tomorrow, 29 October.
Stroke care is an issue of great importance to me and to colleagues across the chamber. I want to speak personally this evening because stroke and its impact on individuals and families are issues that are close to my heart, as I am sure that they are close to the hearts of many members and our constituents, who expect us to ensure that their voices are also heard.
Since my election, discussions with colleagues about stroke care have reinforced why it is vital that the Government must continue to make progress towards delivering the right care, at the right time, to those who need it most. Discussing the issue with my fellow Falkirk councillor, James Bundy, it became clear, through his family’s experience following the loss of his father, Anthony, just how important it is to develop 24-hour, seven-day-a-week access to life-saving thrombectomy services.
I have since had meetings with James, as well as Colin Oliver and Michael Foley of the Stroke Association Scotland and Kirsty Morrison and Amy Callaghan of Chest Heart & Stroke Scotland, and I thank them all sincerely for their support in bringing my first members’ business debate in this session of Parliament.
World stroke day is a day that I have always marked personally. Twenty-five years ago, my mother, Janette Anderson Bouse, suffered a massive intracranial haemorrhage at the age of 57. She remained in a coma for 12 days before passing away. Even if she had survived, her prognosis was extremely poor. This issue is deeply personal to me, and that strengthens my determination to help others who are affected by stroke.
Stroke can affect anyone at any age and in different ways. It remains Scotland’s third biggest killer and the leading cause of adult disability. More than 11,000 people in Scotland experienced a stroke in 2025, and more than 150,000 people are living with the long-term effects of a stroke.
Every stroke is a medical emergency. Timely access to specialist stroke care, thrombolysis or thrombectomy can mean the difference between recovery, lifelong disability or death. Mechanical thrombectomy is a standard procedure that is used to remove blockages in arteries. The sooner that it is carried out, the greater the chance of recovery, with treatment within four hours offering the best outcomes. Many countries already provide access to the procedure around the clock, and Scotland should be no different.
Unfortunately, Scotland does not yet have a comprehensive 24/7 thrombectomy service. As a result, patients who suffer a stroke outwith existing service hours can face barriers to accessing timely treatment and might miss the window in which thrombectomy is most effective.
Currently, a weekend service is available only within NHS Lothian, while three other health boards provide a Monday-to-Friday service from 8 am to 8 pm, with last admissions around 5 pm. In 2025, 210 procedures were carried out under the current arrangements. However, stroke does not adhere to working hours and can occur at any time, day or night.
We must continue to examine post-stroke care to ensure that it meets the agreed standards, but Scotland should always aspire to lead in this field.
I take this opportunity to thank the surgeons, nurses and support staff at Ninewells hospital, Edinburgh royal infirmary and the Queen Elizabeth hospital for their skill, dedication and compassion. This debate is not a criticism of the outstanding work that they do; it is about supporting them and improving the system around them.
I was pleased that the commitment to a 24/7 thrombectomy service was a cross-party manifesto pledge before the election, and I note that it has enjoyed broad support across the chamber in recent months. However, this debate is not about repeating support; it is about implementation. I would welcome an update from the Scottish Government on progress, its commitment to delivery and the timescales for bringing the service to operation.
To mark world stroke day, my team and I are hosting a drop-in session for members and staff of the Scottish Parliament, with the support of Chest Heart & Stroke Scotland, Stroke Association Scotland and Councillor James Bundy. Alongside meeting clinicians and seeing a thrombectomy demonstration kit, attendees will have the opportunity to learn more about stroke care and hear first-hand experiences.
I congratulate the member on the content and tone of his speech. Does he agree with James Bundy that we need to have more data about the number of patients who present with symptoms of stroke—even symptoms that are not recognised—outside of normal service hours, so that we can understand what the demand on the service that we all desire to see established in Scotland would be?
I have no doubt that the more data we have, the better. I would never disagree with that. However, as I said, this debate is about implementation and moving the Government forward from a commitment to an actual action. I hope that the member will accept that as a reply.
I will conclude on what I hope is a positive note. With permission, I will share the story of Michael McDonald from Renfrewshire. Michael suffered two strokes in 2023.
Following his first stroke, he received a thrombectomy to remove a blood clot, while a later aneurysm caused a second stroke requiring further surgery. He also received support from Chest Heart & Stroke Scotland during his recovery. Michael said:
“I was given a thrombectomy after my first stroke. I didn’t realise the procedure was only available during limited hours. I was fortunate that the stroke team treated me immediately.
Now knowing the difference thrombectomy can make, I believe it should be available to everyone, regardless of where they live or what time they are admitted to hospital. It is a gamechanger for stroke recovery.
Recovery is tough and lifelong, but it is possible. I want other young stroke survivors to know they can recover, return to work and get back to doing the things they love.”
Thanks to timely treatment and rehabilitation, Michael is now back at work, married to his wife Holly and the proud father of a new baby.
It should be the ambition of the Government, and of Parliament, to ensure that everyone in our communities has access to the best life-saving services available. I look forward to working with colleagues to achieve that goal, honouring those whom we have lost to stroke by ensuring that their experiences help to shape better futures for others.
I ask every member who wishes to speak to please press their request-to-speak button—thank you.
17:46
Meal do naidheachd to my colleague Gary Bouse—congratulations on securing this important debate to mark world stroke day 2026.
There will be few of us in the chamber whose lives have not been touched by stroke, whether it is through the condition affecting a loved one or a close friend, and I thank Gary Bouse for his very personal speech and the emphasis that he put on 24-hour access to thrombectomy.
As his motion recognises,
“every stroke changes a life in an instant, often leaving survivors, families and carers facing physical, emotional, psychological and financial consequences”.
I will focus on one of those life changes. One in every three stroke survivors are affected by aphasia—that is an estimated 40,000 people in Scotland who are affected by the condition. Last year, I had the privilege, as the then Minister for Public Health and Women’s Health, of responding to my former colleague Rona Mackay’s members’ business debate on aphasia. It was the first time that aphasia had been debated in the chamber. There were thoughtful contributions from members across the chamber, and rereading the Official Report of the debate showed me how members in this place can work positively together.
For those who are not aware of aphasia, it is a language disorder that can impact people’s speech production and understanding, reading and writing and their ability to use numbers—all activities of daily life that can be taken for granted. It was attending a meeting of Chest Heart & Stroke Scotland’s aphasia reference group in Scotland that gave me a small insight into the impact of living with the condition. The group provides advice to help guide service development and campaign work to reflect the experiences of individuals who are affected by aphasia. It was a wonderful group of caring and focused people.
One person I met there was Tom Morris. This is what he says about aphasia:
“It is still hard for me to try to think and process what I want to show or tell people. I cannot write, spell, order or work out numbers now.”
I listened to very personal and moving stories about the impact of the condition on the lives of people in the group. We discussed everything, from the importance of doing a daily crossword to the merits of the Bob Dylan film, “A Complete Unknown”; we even reflected on how that seemed such an appropriate film title to discuss in an aphasia group. Through that group of people and Chest Heart & Stroke Scotland, I hope that we can go some way towards ensuring that aphasia is no longer a complete unknown.
I will continue if I may, Presiding Officer—I think that I still have time. I have a constituent who has raised with me some concerns about the level of knowledge in Social Security Scotland about stroke. I have written to the Minister for Mental Wellbeing, Public Health, Sport, Alcohol and Drugs about that, and I have met with Chest Heart & Stroke Scotland. I am clear that the work that Social Security Scotland does is centred on dignity and respect. However, there is always room for improvement, and I hope that the minister might look into the matter to see whether, through training and support, those who do a great job in Social Security Scotland could be equipped to do an even better job for those living with stroke in Scotland.
I thank Chest Heart & Stroke Scotland and the Stroke Association for their invaluable work. I also pay tribute to Dunoon stroke club, north Argyll stroke support group in Oban and all the other groups across Argyll and Bute that support those who are living with stroke. I also thank the individuals and their families who live with aphasia and other results of stroke for sharing stories with me and more widely. Their courage and focus will help us all to challenge the stigma of living with the condition.
I finish with further words from Tom Morris. He says:
“Six years on I am still learning. Every day I try to reboot my brain, practising everything. I try to speak and communicate with the help from my wife and from Chest Heart & Stroke Scotland’s stroke peer support groups, but I am so worried about all the people who are alone with no help—people whom others will just assume are stupid as their voices and thoughts are unprocessed and unheard.”
On world stroke day 2026, we must remember those people and support them, and ensure that they are not complete unknowns.
17:50
It is an honour to speak to members in the chamber on world stroke day. For those listening to me who have a personal experience of stroke, I know that such an event can change everything in an instant, limiting how someone thinks, moves and feels, and marking the beginning of a difficult journey to recovery.
World stroke day is an opportunity to appreciate the carers and health teams who help stroke survivors to recover their independence and hope. One of the key messages that professionals have repeated to me is that when a stroke occurs, timing is all-important. Acting decisively and giving the right treatment can mean a life free from disability.
The window is so narrow that treatments such as thrombectomy or clot-busting drugs can work for around only around four hours after a stroke. If someone is asleep or isolated when they have a stroke, they might miss out. There may be issues with ambulance delays, lack of capacity in stroke units or trouble accessing records and booking scans, but every minute is vital in protecting the brain from damage. It is essential that the national health service is running well. It is disappointing, therefore, to see that less than 60 per cent of stroke patients are getting four basic care needs met, which is well below the target. Just over 200 patients received a thrombectomy in Scotland last year, but stroke charities believe that many more could be eligible.
In its “Stroke Improvement Plan 2023”, the Government committed to providing a 24/7 thrombectomy service to ensure equal access to stroke treatment. Currently, however, it is only patients in the central belt who can access such services out of hours. In Edinburgh, someone will get treatment over the weekend, but someone in the Western Isles might be lucky to get a diagnosis.
I can see that that is part of a bigger story about life after stroke. Whether it is low mood, tiredness or mobility problems, there is a lot for stroke survivors and their families to adjust to. Partners and unpaid carers are often in desperate need of support. We need faster care plans, home adaptations and more specialist care in the community. One in four adults who have a stroke are of working age. For young stroke survivors, returning to work can be difficult and benefits can be hard to access.
There is also the fear of a stroke happening again. To address that, we need strong public health advice. There is not enough public awareness of the risk factors that make stroke more likely. I was delighted to be appointed last week to Michael Marra’s team, as shadow minister for public health. I look forward to the publication of the long-term conditions framework and to seeing what we can do in Scotland to deliver lasting improvements in stroke care, as the condition has robbed so many people of their health. There is so much passion among members across the chamber, and I look forward to seeing what we can achieve together.
17:54
I thank Gary Bouse for bringing the debate to the chamber on the eve of world stroke day, and I pay tribute to the Bundy family, who campaigned so much after the terrible loss of Tony Bundy at the early age of 53.
I also take the opportunity to recognise all those clinicians, nurses and therapists working on stroke, and the Stroke Association and Chest Heart & Stroke Scotland. As Jenni Minto said, very few people have been unaffected by the issue of stroke; either a family member or a close friend has been affected. Indeed, my husband had a transient ischaemic attack some years ago. It was recognised very quickly, I have to say—he was referred quickly to Ninewells hospital in Dundee and got excellent follow-up care. That was tremendous, but his stroke took place during working hours, and fortunately there were no further complications.
I knew someone else in our area who had a stroke. I live in Pitlochry, in a rural area—the difficulties for those in rural areas have been mentioned already. She was about to go wild swimming in the loch, which quite a few of us do nowadays—it has taken off since Covid. Luckily, she was not yet in the water when she began to feel unwell. The condition was recognised by someone who was not a nurse but dealt with the situation so well that I thought that she was. We took the lady to the local general practice—I do not think that we were supposed to do that, but they took her in and got her an ambulance very quickly. That lady made a good recovery and has got back to the wild swimming. That shows the difference that getting quick attention makes—it is a huge game changer.
Being aware of such personal stories, we are all very much committed to seeing stroke care moving on. The motion refers to the notable fact that one in four strokes affect people of working age and up to one in three of those people leave work as a result, so it is clear that the economic aspect is important, too, and we can get a win in that regard.
I knew a woman—I am not sure if this is the same case that I mentioned; she was in her late 30s, I think—who was on the pill and had a stroke, and she was told that that was a factor in increasing risk. Perhaps the minister can tell me if that is still an issue, because I think that it is not well known at all, and if somebody did not feel right, they might not quickly try to check if it might be a stroke.
I agree absolutely with the calls for thrombectomy to be rolled out across the country 24/7—that could be a game changer. I know that the programme for government refers to expanding the service to provide 24/7 access; that is very welcome and is to be commended. However, I make a plea that we should do that faster and think of the money and economic gain that would come with it. I know that the wheels of Government can move slowly in rolling things out, but we might think about how that would help economically as well as how it would help families.
It is disappointing that we are currently behind England in stroke care, but we welcome that roll-out coming forward from the Government. I know that those who work in stroke departments certainly do their level best, but it is the only critical emergency in Scotland for which round-the-clock access to care is not currently provided. We talk a lot about preventative spend and how difficult it is to prove that that is a gain. In the case of stroke, however, it does not even involve a cross-sector effect—that money would deliver very quickly. We have all seen people, perhaps elderly relatives, who have had a stroke and could perhaps have been helped better, in particular by rehabilitation, as I saw with my aunt. Unfortunately, once people get into care homes, there may not be the staff available there to provide physiotherapy and treat effects such as aphasia, which was mentioned earlier.
We could be getting gains in that area—not quick gains, because we are talking about a big issue, but everyone recognises what a difference that might make. I am sure that we have all thought about which three things we might be terrified of having happen to us—stroke is often one of those things, because it is so devastating so quickly, as Gary Bouse movingly described. We therefore need to think about the specialist rehabilitation workforce and about training the allied health professional workforce to help.
Stroke is one issue in the Government’s plans for which a national pathway would almost certainly help, but we would then have to make sure that there was a way for people to get transport to get them to care fast. On that point, I close by saying that Reform would support the Government in moving that forward. We want a workforce plan, so let us look at that. We also need to think about better public awareness. There is more knowledge about stroke, but young people in particular, and indeed many people, may not know much. For example, it was only recently that we found out that stroke could happen to children and young people. Let us move forward on that work together, and I thank the minister for committing to that.
18:00
I thank my friend Gary Bouse for securing this important debate and for sharing his own moving testimony. I follow him in praising the efforts of James and the rest of the Bundy family off the back of a horrendous tragedy. I think that we all would have forgiven them for simply dealing with their grief and moving on as a family, but instead they fought—not for a short period of time, but for years—to see 24/7 access to thrombectomy. They have taken everyone with them on that journey on a cross-party basis, and I have been hugely grateful to be there for events and talks and to hear the passion with which James and his mum have spoken.
I was pleased to see a commitment in the programme for government—the quicker we can roll that out, the better, so if the minister has any update on timelines for roll-out, that would be greatly appreciated.
Thrombectomy is a genuinely life-saving intervention. I have always been an advocate for the effectiveness of thrombectomy, through the cross-party group on stroke—that is a shameless plug for one of the most effective cross-party groups in this place, if any member wants to come and join us—but a reception that I hosted in the previous session of Parliament really brought that effectiveness home to me. At that reception, there was a young man who had had a stroke. I said hello to him in passing, as people filtered into the garden lobby, and when he was called to speak, I—and other MSPs, I think—could not quite believe that he had had a stroke. He was discharged from hospital in a frighteningly short period of time, with no lasting effects from that stroke, because of how quickly he had had access to thrombectomy.
That access is absolutely transformative, not just for patients themselves but for families, too. As other members have mentioned, stroke is, unfortunately, a condition that not only MSPs across the chamber but people around the country are aware of and have experience of among their own family and friends. Stroke is still the leading cause of disablement for adults in Scotland, and the costs of stroke to the health and social care system are estimated at £2.5 billion.
Some strokes are preventable. I say that not to put blame on patients, because we have to tackle stigma; I would actually put the blame on the environment that we live in. So many things are interconnected with stroke prevention: wider-population health strategies, preventative spend, allowing people to have time to improve their health and wellbeing away from work and ensuring that conditions that can cause an increased risk of stroke are managed as far as possible. The impact on families is huge. Overnight, people are thrown into the role of an unpaid carer, dealing with conditions that they do not understand and which are hugely complex, as well as the lasting health impacts of those conditions.
I know that from a family perspective. As members know very well, we lost my mum nearly six years ago after complications following a stroke. She had atrial fibrillation, putting her at a much higher risk of stroke than the general population, and unfortunately that risk came to pass for us. Before that, my grandpa had had a stroke, which resulted in his having aphasia. Tiredness, the time of day and sometimes even the conversation topic—although I am sure that that was put on at various points—would all affect his speech and his ability to recall words.
I have attended many meetings on aphasia, and one of the stories that has stayed with me involved a member of the stroke voices group. If people have not met with the group, I would hugely recommend doing so. That particular person said that they were worried about getting the bus. They had weakness as a result of their stroke, so they would sit in one of the seats towards the front of the bus that are reserved for people who have disabilities. Outwardly, however, that person looked well and able. When they were challenged by someone getting on the bus as to why they were sitting in one of those seats, their aphasia meant that they simply could not find the words to explain. That experience left them not wanting to leave the house, and not wanting to do something as simple as getting the bus to the shops. That is why we need to keep on challenging the stigma.
I remember the debate that Jenni Minto referenced. It was hugely positive and showed this chamber at its best. I hope that, around stroke, we can continue to do that.
For those who survive their stroke, the rehab teams do an incredible job. I have visited the stroke rehab unit at Wishaw, as well as the research teams at the University of Strathclyde. The rehab teams take that really hard work forward with a level of good humour and fun that often makes it feel nothing like rehab. If anyone has a chance to go and try some of the rehab exercises and machines, they will find that they are not easy—I was frighteningly rubbish at very many of them. We need to have those centres of excellence in more places. I hope that, through some of the public service reform agenda, we see the percentage of people accessing the stroke care bundle rise, making it easy to share that good practice to benefit everyone across Scotland.
I thank Gary Bouse again for bringing forward the debate, and I thank Chest Heart & Stroke Scotland and the Stroke Association for always being incredible at their continued work and making the stories human for us to be able to tell them. Finally, I commend the cross-party group on stroke to the chamber.
18:05
I congratulate Gary Bouse on the debate. I thank him for making it happen and for his speech.
Anthony Bundy has been mentioned a few times tonight. He was 53 years old when he died following a stroke. His family describe a 17-hour wait from the first emergency call to thrombectomy, while the opportunity to prevent devastating brain damage was slipping away. The campaign that many have spoken of tonight has changed so much for Anthony’s wife, Selena, and his son, James, since Anthony’s death.
I know the family personally. James worked in my parliamentary office. He has been a friend of mine for many years and is a wonderful fellow. I have supported the campaign from the very beginning, after witnessing both the devastating consequences of delayed thrombectomy and the profound loss that Anthony’s death has left in their lives. Since his father’s death, James has married and, as many here know, has welcomed twins into the world, and he has launched his own business, which I am particularly proud of—milestones that he clearly wishes that he could have shared with his dad. I am certain that everyone who has met the Bundys has been moved by their story, their determination and their demand for equal access to life-saving treatment, whatever the hour or day.
When I spoke to James after the First Minister recognised the Bundy family’s campaign during the programme for government statement, James welcomed the words but, in typical fashion, he was not ready to declare any kind of victory. Victory, as defined by James and his mum, would be the universal roll-out of 24/7 thrombectomy in Scotland, creating a Scotland that gives everyone a chance.
To deliver 24/7 thrombectomy, we must first understand the shortcomings in our current provision. That is why I intervened earlier on Gary Bouse to ask him about the importance of our knowing how many eligible patients present themselves outside of service hours and what delays they face, and I am glad that Gary Bouse accepted that we need more data. I ask the minister to ensure that those figures are recorded in the Scottish stroke improvement programme annual report, so that they can inform planning and help us to measure progress towards the universal 24/7 thrombectomy service, which must be the ultimate goal.
Another aspect of Anthony’s story that I must mention is that his initial symptoms fell outside the FAST—face, arm, speech, time—criteria for recognising a stroke. The significant adverse event review into Anthony’s death, which was shared with me by the Bundy family, states that the use of FAST delayed Anthony’s diagnosis.
If everyone deserves a chance of receiving thrombectomy, everyone must have a fair chance of prompt diagnosis. Therefore, I ask the minister to review the effectiveness of stroke-recognition tools, including whether approaches such as BE FAST—balance, eyes, face, arm, speech, time—could improve recognition and diagnosis in Scottish hospitals. Gary Bouse will know that Forth Valley royal hospital is pioneering that work now.
The commitment to 24/7 thrombectomy provision in the programme for government was long overdue, but a commitment on its own will not save lives—action will. Again, I ask the minister to set out the delivery plan, the timetable, the funding and the measures by which Parliament will judge progress. Scotland cannot afford another commitment without a clear path to delivery.
To conclude, James Bundy told me of the many lessons that his father had taught him growing up, but now Anthony leaves the Parliament a lesson that we must never forget. A stroke does not wait for office hours, and nor should the care that could save a life. I end my speech with James’s words. He says:
“No family should wonder whether a different time or day might have changed their loved one’s future. My dad deserved that chance. So does everyone in Scotland.”
In memory of Anthony Bundy, let this be the session of Parliament that delivers a Scotland that gives everyone a chance.
18:11
That was a fine speech from Stephen Kerr, and I associate myself with the comments from James Bundy. I thank Gary Bouse for bringing the debate to the chamber and giving us an opportunity to consider these issues tonight. We have heard many exceptional speeches, but I pay tribute to Gillian Mackay in particular for her speech. I did not meet Gillian’s mum, but I met her dad and half of the Mackay clan at the opening of the Scottish Parliament. I can certainly say that her dad and her family are deeply proud of her—she has demonstrated tonight why that is, and I am sure that her mother would be proud, too.
I will start by sharing the experience of one of my constituents, Anne Aitken, who recently contacted me. When she suffered a stroke, she found that the nearest centre for medical intervention was in Dundee, and yet we know that for special intervention work, care needs to be given within four hours. Iris Grunwald, a professor at the University of Dundee, tells us that
“by the time patients reach a specialist centre, there’s often no brain left to save. Every six minutes delay in receiving treatment equates to a 1% lesser chance of a good outcome”.
I do not need to spell out to members the implications that that has for my constituents in the far north.
I am not the first member on the Liberal Democrat benches to raise the issue of rural stroke care in recent months. Only this month, Duncan Dunlop spoke of the experiences of one of his constituents in rural Dumfriesshire, who spent a year in hospital after a stroke because he was not able to receive a care package at home.
Anne Aitken has expressed similar worries about the lack of provision for stroke patients in recovery. Despite living a few miles from Alness, she has experienced a real struggle to access personal carers, social care partnerships or transport to services. I am grateful to Chest Heart & Stroke Scotland for raising the case of Jan Anderson, who is also from Alness. After experiencing a double stroke in 2022, Jan, aged 34, underwent months of rehabilitation and intensive therapy before returning home. Living with vision and mobility issues, fatigue and memory and language difficulties, she has continued her recovery through one-to-one support and peer support from Chest Heart & Stroke Scotland.
The stroke forced Jan to put her career as a musician on hold and left her struggling to come to terms with a very different future from the one that she had planned. Through ongoing work and support from CHSS, she has worked toward small personal goals and continues to rebuild her confidence and independence.
I put on record my thanks to Chest Heart & Stroke Scotland for the support that it provides. That story demonstrates how important it is that we invest in in-patient and out-patient stroke rehabilitation capacity and ensure that it is expanded.
There are a lot of positives to talk about, but we know that stroke care in Scotland lags behind where we want to be. I will put that in some context. At present, stroke services in Scotland are limited to daytime hours; it is only here in Edinburgh that stroke patients in Scotland have access to thrombectomy services seven days a week. In contrast, if one of my constituents was referred to Ninewells hospital in Dundee, they must be on the treatment table and treated before 5 pm, and they would have to hope that it was a weekday. It is vital, therefore, that we take measures to deliver comprehensive access to treatment to tackle one of the biggest killers in Scotland and prevent countless unnecessary deaths.
I therefore welcome calls from the Stroke Association for thrombectomy services to be made available around the clock, as is the case in Northern Ireland—a commitment that the Liberal Democrats made in our manifesto. That would save countless lives and allow considerably more people to make a better recovery closer to home.
We have had commitments from this Government before, and, like others, I welcome the commitment in the programme for government, but we cannot allow that to slide. Therefore, I look forward to the minister setting out a bit more information in terms of detail and timeline.
I will leave the minister and the chamber with this thought from my constituent Anne Aitken. She said:
“How confident or reassured are you that you or a loved one, would receive the best possible medical and aftercare if unlucky enough to suffer a stroke here in the Highlands at an inconvenient time?”
Like her, I believe that more needs to be done.
18:15
I start by congratulating my colleague Gary Bouse on securing his first members’ business debate, which is on an extremely important issue. I also take this opportunity to thank Chest Heart & Stroke Scotland and the Stroke Association for their helpful briefings and for their continuous work to help improve the lives of those who experience strokes.
Just last week, I visited the Clydebank stroke group for one of its weekly sessions, which is run in connection with Chest Heart & Stroke Scotland, and, in East Dunbartonshire, I visited the way ahead stroke group in Bearsden. Those groups are a lifeline to folk in my constituency, which, according to figures, has the highest prevalence rate in the country for key chest, heart and stroke conditions—higher than the NHS Greater Glasgow and Clyde and Scotland-wide averages. Three per cent of the population in West Dunbartonshire have been diagnosed with stroke and TIA, compared with the national average of 2.6 per cent. That is a sobering fact for me, but it is not surprising. We know that there is a strong link between deprivation and health inequalities. That is why I feel that it is vital that we target more resources in areas of deprivation, including Clydebank. As mentioned in the motion, in 2025, around 11,000 people in Scotland experienced stroke, with a stroke reportedly occurring every 49 minutes in Scotland.
During the summer recess, I again met Amy Callaghan, who is the strategic political adviser for Chest Heart & Stroke Scotland, to discuss her work on improving outcomes for people with stroke and other conditions. I am sure that members will remember Amy Callaghan as the former MP for East Dunbartonshire, who suffered a stroke at 28. It is incredibly welcome to see her in this role, bringing immense parliamentary and personal experience to her work in pushing forward the aims of the charity and, in turn, helping those who suffer from these conditions.
During our meeting, we discussed the welcome partnership that the organisation has with the University of Strathclyde in relation to the university’s innovative technology-enhanced rehabilitation gyms, which provide stroke survivors with the chance to expand their rehabilitation options through technology-supported gym equipment. The initiative currently runs in four locations across Scotland, and it is great that further funding has been committed to roll out that model across Scotland.
Having a stroke can change your life in an instant, and it can happen to anyone. That is why it is vital that we help to raise awareness to enable people to notice the signs. I agree with my colleague Gary Bouse and other colleagues who have spoken in the debate that delivery of a 24/7 national thrombectomy service is essential to ensure that everyone can benefit from that crucial treatment, regardless of where or when they have their stroke.
I have also raised that issue with NHS Greater Glasgow and Clyde. The Stroke Association advises that, currently, someone in Clydebank and Milngavie who has a stroke can access thrombectomy services only between 8 am and 5 pm, Monday to Friday. I would welcome the minister addressing the need for a 24/7 service when responding to the debate.
It was welcome to hear the First Minister announce the delivery of heart and lung MOTs, working in partnership with Chest Heart & Stroke Scotland. That is a positive development that focuses on early detection and helps people to make informed life choices to improve their health and reduce their chances of developing serious conditions, including strokes. It focuses on people and communities that are more likely to experience poorer health outcomes and helps to reduce health inequalities. I would welcome the model being extended to my constituency in the future.
We must work together and make sure that people have the best services available to enable them to live well after a stroke.
Due to the number of members who wish to speak in the debate, I am minded to accept a motion without notice, under rule 8.14.3, to extend the debate by up to 30 minutes. I invite Gary Bouse to move the motion without notice.
Motion moved,
That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[Gary Bouse]
Motion agreed to.
18:20
I begin by congratulating Gary Bouse on securing this debate and on his excellent and personal speech and I thank Stroke Scotland and Chest Heart & Stroke for their briefings and their badges—we are all covered in badges this evening.
As Stephen Kerr did, I pay tribute to James Bundy, who worked for me during my first session in Parliament and is a huge credit to his family and to his father Anthony. I know for a fact that he will hate this praise and attention, but I do not think we would be here today without the campaigning by James and his family, so we should mark that.
I also take the opportunity to highlight the case of my own constituent, Derek Grainger, from Musselburgh, who had a stroke in June 2025 that left him with balance problems, memory issues and speech difficulties. He received support from Chest Heart & Stroke Scotland’s stroke nurse service and took part in the charity’s supported self-management programme. He said:
“I got such great support from Chest Heart and Stroke Scotland and from Katie, the stroke nurse. She came to the house within the first few weeks, and she explained everything. It was very reassuring to have someone so knowledgeable to help.”
Following rehabilitation and support, Derek has been able to begin a phased return to work and to re-engage with his local community. He says that the support that he received gave him the strategies he needed to manage life after a stroke, as well as to focus on new goals and get on with life. I believe that is exactly what excellent community rehab should look like.
As a number of members have mentioned, we are in a good place here in Lothian because we have a stroke care service that provides residents with access to thrombectomy through a referral to the east of Scotland hub at Edinburgh royal infirmary. However, as other members have mentioned, that is not a 24-hour service but is available only from Monday to Friday between 8 am and 8 pm, with last admissions at 5 pm. Patients who present at ERI are also the only ones in Scotland who can access thrombectomies at weekends, so the commitment to a 24-hour service is something that we all welcome and the First Minister’s commitment to take that forward is important.
However, I have a number of concerns, because the devil is always in the detail, and I hope the minister will be able to shed some light on those issues. We are about to engage in public service reform and I am concerned that there can be decision inertia within the health service. I have a number of key questions. What does the Government commitment actually mean in practice? Where will we see a firm shift to deliver on a timetable, funding and workforce? I am also concerned about decision to treat, because there will be a need for additional CT and MRI capacity. Every such debate that I have taken part in recently has also included comments on advances in technology and the need for more CT capacity, but we are not seeing that being delivered in the NHS. I would hate to find us here again in years to come, having a debate about people not receiving treatment or about decisions being made not to treat people because of a lack of access to CT and MRI scans. I am putting that on the record today because there is a great opportunity for our country but we must be in a position to deliver that nationally.
I know I am running out of time. I again pay tribute to James Bundy and to all the charities and campaigners who have got us here today, but this is just the start of what must be a huge effort across the NHS to deliver a transformation that will ensure that people who are impacted by a stroke have the best opportunity to survive and to get their lives back on track.
18:25
I am grateful to my colleague Gary Bouse for securing this important debate on world stroke day, and I am pleased to speak in support of the motion.
Like many others, I have personal experience of stroke. My dad had a number of TIAs over a number of years, probably when he was in his mid-60s. He lost his speech and his ability to contact and work with us, and he then suffered from dementia. Therefore, the issue has had a personal impact on our lives, too.
As we all know, every stroke changes a life in an instant. Scotland remains the country in the United Kingdom with the highest rate of stroke. In 2025, about 11,000 people experienced a stroke. It is still our third-biggest killer, and it is the leading cause of complex adult disability. More than 150,000 people across Scotland are still living with the long-term effects of stroke. As we have heard, one in four of those who have a stroke are of working age, and many are forced to leave employment as a result. Behind every figure is a person, a family and a community dealing with sudden and profound change.
The global theme of this year’s world stroke day is “Every Minute Counts”—time is, of course, critical when it comes to it. We must continue to raise public awareness of the FAST signs, so that people call 999 without delay. I listened to Stephen Kerr’s comments on that point, and it will be good to hear what the minister has to say in that regard, because I have heard various comments about that in the past. Rapid recognition and transfer to the right hospital remains the foundation of better outcomes.
As many others have done, I will focus on thrombectomy, which, as we all know, is the procedure that mechanically removes a blood clot from a vessel in the brain. For eligible patients—that is the key point—the procedure can be transformative, because it can dramatically increase the chance of independent living and reduce long-term disability. Evidence shows that the procedure is highly cost effective, as it saves the health and social care system tens of thousands of pounds per patient over time.
Scotland has three regional hubs—the Queen Elizabeth university hospital in Glasgow, the Royal infirmary of Edinburgh and Ninewells hospital in Dundee—which operate a hub-and-spoke model.
In 2025, 210 patients received a thrombectomy—210 patients who could have suffered death or long-term impacts. That represents progress on previous years. I recognise the significant investment that has been made and the dedicated work of clinicians, radiologists, nurses and ambulance staff, particularly the NHS Lothian services that support my constituents in East Lothian Coast and Lammermuirs.
However, it is right to note that we still have further to go. Current rates remain well below the level that would treat the 10 to 15 per cent of patients who could benefit. Too often, access still depends on geography and the time of day. A true 24/7 national thrombectomy service, available regardless of when or where a stroke occurs, is essential if we are to close the gap.
I welcome the Scottish Government’s continued commitment, the additional funding that has been pledged and the ongoing work by Public Services Delivery Scotland on the delivery plan. However, we must maintain the pace and ensure that the workforce pathways and capacity are in place.
Prevention and rehabilitation matter equally. Managing blood pressure, staying active and supporting a healthy lifestyle can prevent many strokes. In the acute phase, specialist rehabilitation services that provide physical, psychological and communication support are vital for quality of life. My daughter-in-law is a physiotherapist, and a lot of her work involves dealing with stroke patients, who are sometimes in their 30s or 40s, over a period of time.
I commend the Stroke Association, Chest Heart & Stroke Scotland, our clinical community and people with lived experience, including the Bundy family, whose campaigning has shone a light on the human cost of delayed access.
This debate is a timely reminder that stroke care is a priority for the Government, so I thank Gary Bouse for securing it. I urge us to make collective efforts so that every patient in Scotland who needs a thrombectomy can receive one promptly and that survivors and their families receive the support that they deserve.
18:29
I congratulate Gary Bouse on bringing this important and timely debate to the chamber.
Given that my contribution comes late in the debate, it is inevitable that colleagues will have already mentioned the statistics, but I make no apology for repeating them, because world stroke day and this debate provide the perfect platform for vital awareness raising. In Scotland, stroke remains our third-biggest killer and the leading cause of adult disability. Last year alone, more than 11,000 people experienced a stroke.
As we heard, someone in Scotland suffers a stroke every 49 minutes. The consequences can be life changing and affect mobility, communication, mental wellbeing, employment, relationships and independence. Yet, despite the scale of the challenge, significant inequalities remain in access to treatment and support. Earlier this year, I raised in the Parliament my concerns about access to thrombectomy services in my constituency of Galloway and West Dumfries. Thrombectomy is, as we know, a highly effective treatment for some stroke patients, but access to it is too often determined by geography and time rather than by clinical need. My constituents do not have immediate access to those services, with the nearest specialist hub located in Glasgow. For someone in Newton Stewart, reaching the Queen Elizabeth university hospital can take at least two hours in good conditions. When dealing with a stroke, those lost hours can have lifelong consequences.
Unfortunately, the challenge is not unique to my constituency, because many people who live in rural and remote parts of Scotland face similar barriers to accessing timely specialist care. That is why I, like others, have consistently called for a fully operational, 24/7 thrombectomy service with national coverage and for a clear plan to deliver it effectively for rural Scotland. I welcome the Government’s commitment to expand provision, but progress must be accelerated, because access to potentially life-changing treatment should never depend on where someone happens to live.
Recently, I had the opportunity to meet Professor Iris Grunwald from the University of Dundee’s image-guided therapy research facility at Ninewells hospital, and to see at first hand some of the remarkable work that is being undertaken to improve stroke outcomes. What impressed me most was the combination of world-leading research and a determination to solve real-world problems. The team is pioneering new approaches to stroke treatment, training clinicians from around the world in developing innovations that could help to bring specialist care closer to patients. What was particularly encouraging was the focus on overcoming the challenges that remote and rural communities face.
From innovative training models to emerging technologies that could transform how thrombectomy is delivered in the future, the work that is taking place in Dundee demonstrates that Scotland has the expertise and ambition to lead the way in stroke care, and we should recognise, support and learn from that success. The question is not whether Scotland has the expertise, because we do; the question is whether the Government is moving quick enough to translate that expertise into better access to treatment for patients.
However, the challenge does not end when a patient leaves hospital. Research by Chest Heart & Stroke Scotland found that 42 per cent of stroke survivors could not access the support that they felt they needed, with almost half saying that their stroke had negatively affected their mental health, and more than a third reporting experiencing loneliness. That is why public awareness remains important. Through the FAST campaign, Chest Heart & Stroke Scotland continues to encourage people to recognise the signs of stroke and to seek emergency treatment without delay, because the sooner treatment is delivered, the greater the chance of survival and recovery.
Prevention must also play a bigger role in our approach. Public Health Scotland projects that cerebrovascular disease, including stroke, will increase by 35 per cent between 2019 and 2044. That growing burden will not only affect individuals and families but place increasing pressure on our health and social care services.
Too often, underlying factors such as high blood pressure, cardiovascular disease and poor respiratory health are identified too late. The recently launched healthy heart and lung checks are therefore a welcome step forward. Delivered through Chest Heart & Stroke Scotland’s health defence hubs, in partnership with the Scottish Government, the checks provide free health assessments and personalised support to help people to better understand and reduce their risk.
We all urge people to learn the signs and risk factors of stroke and to act quickly if they suspect that someone is having one. I also urge the Scottish Government to accelerate the delivery of a fully operational, 24/7 thrombectomy service, ensuring that access to life-saving treatment is determined by clinical need, not postcode. By combining prevention, innovation and timely treatment, we can improve outcomes for stroke patients across every part of Scotland.
18:33
I am very grateful to Gary Bouse for bringing this important debate to the chamber ahead of world stroke day. I congratulate him on securing this meaningful debate for his first ever members’ business debate.
Every stroke changes a life in an instant. It can affect a person’s ability to communicate, to move independently or to return to the life that they knew before. The impact extends beyond the individual to their families, carers and communities. Stroke remains one of Scotland’s leading causes of death and disability, and many people live with its long-term physical, emotional and psychological effects.
Today’s debate is an opportunity to recognise people who are affected by stroke and to reaffirm our commitment to improving stroke care so that everyone in Scotland can access the support that they need.
I will pick up on a number of the issues that were raised around the chamber.
First, I thank members from across the chamber for their very personal anecdotes and powerful advocacy for their constituents, whose voices they have brought to the chamber of their Scottish Parliament tonight. I particularly enjoyed hearing Michael’s story from Gary Bouse, which beautifully brought to life for us all the difference that thrombectomy can make.
I also thank the Bundy family for their powerful advocacy over a number of years in relation to both recognition of stroke symptoms and thrombectomy. I know that they have met with many of my ministerial colleagues, including, most recently, the First Minister. Everyone who has met them has been inspired by their story, and it has renewed our determination to deliver better care. It perhaps is a little bold of me to say, but I hope that, when I meet them, we will be celebrating the universal roll-out of 24/7 access.
I also want to say thank you for the work that is done by Chest Heart & Stroke Scotland and the Stroke Association, both of which have been mentioned. The work that they do is incredible and I am very well aware of the support that they give to individuals affected by stroke. There have been multiple mentions of aphasia in the chamber tonight, and we also appreciate the work that has been done by Chest Heart & Stroke Scotland and the aphasia reference group.
I will take a moment to mention, as Helen McDade did, my thanks to all the health professionals involved in stroke care. While listening to this debate, it struck me just how broad the multidisciplinary team involved in stroke care is. It is a phenomenal and powerful reminder of just how many different professions come together to provide that support. There are lots of specialist nurses and doctors but there are also loads of pharmacists—dare I not mention pharmacists—and allied health professionals, including physios, speech and language therapists, specialist radiographers, occupational therapists and, once people move out into the community, social workers. All of those people work every day to prevent stroke, to treat it and to help people to recover from it.
I welcome this year’s world stroke day campaign and its continued emphasis on the FAST message. Recognising stroke symptoms quickly and acting without delay can save lives and reduce disability. Again, along with other members, I thank Chest Heart & Stroke Scotland for its work to raise awareness and to encourage people to seek help urgently when stroke is suspected.
I look forward to seeing the outputs of the work being done in Forth Valley regarding BE FAST, which was referenced by Stephen Kerr. As I understand it, the evidence base at the moment is not sufficient to support a change in recognition tools. However, that is why the work is so important, because it will build the evidence base and, if a change is needed, a change will come. The Scottish Government has also funded a stroke education package for staff and GP practices, emergency departments and the Scottish Ambulance Service to strengthen stroke recognition and to improve care across the patient pathway.
As many have said this evening, for stroke patients, every minute matters. Timely intervention can make a life-changing difference to outcomes, and I know that there is a strong consensus across party lines on the importance of expanding access to thrombectomy. Delivering a 24/7 thrombectomy service remains a key priority and we have already invested more than £63 million pound to expand access.
As I have updated the chamber on before, Public Services Delivery Scotland has been obtaining the clinical, planning, financial and staffing information from NHS boards that is needed to understand what would be required to make 24/7 thrombectomy available across Scotland.
I ask the minister to respond to the comments I made, which I know have been represented to her by James Bundy himself, about the importance of collecting the data about patients who present outside of normal service hours, including what kind of delays they have experienced and the impact that has had on their outcomes.
Let me reassure the member that the work that Public Services Delivery Scotland is doing is capturing unmet need. We are of course keen to understand that unmet need, because we are trying to build a 24/7 thrombectomy service that works right across Scotland.
I expect that work by Public Services Delivery Scotland to conclude very soon.
I expect Public Services Delivery Scotland to report very soon. After that, we will move at pace to establish a clear delivery plan and timescales for expansion. We plan to publish a national implementation road map by March 2027, and implementation will begin in April 2027. Rural members in particular—of whom I am one—spoke about the complexities of delivering a 24/7 thrombectomy service throughout Scotland, but we are working towards that.
Through the national audit programme, NHS boards are held accountable for their performance against the stroke care standards, which will help to drive continuous improvement. Recent reports show that some progress has been made across several important measures, but I am absolutely clear that improvement is still needed. Through the stroke improvement programme, we continue to work closely with NHS boards to maintain momentum on stroke improvement beyond thrombectomy, with a focus on addressing gaps in performance against the Scottish stroke care standards and implementing the key standards of care in the stroke care bundle.
To maintain momentum and strengthen accountability for improvement, my plan is to convene a round table with accountable leads for stroke services from every NHS board to focus on delivery across the stroke pathway, including implementation of the stroke care bundle and continued improvement for the Scottish stroke care standards. It is vital that we recognise that, while thrombectomy is an important commitment—I am determined to deliver 24/7 access—it is really only suitable for supporting about 10 to15 per cent of people who experience strokes.
It is really important that we get the basics right throughout the country. We want to continue to improve all aspects of stroke care, and every person who experiences a stroke should receive high-quality, evidence-based care, regardless of where they live.
As many members have mentioned, acute treatment is only one part of the stroke pathway. For many people, recovery continues long after people leave hospital, so access to high-quality, person-centred rehabilitation is essential. We recognise the challenges highlighted in the “One in Five” report and have placed rehabilitation right at the heart of our stroke improvement plan. NHS boards are expected to embed rehabilitation within stroke services, including access to psychological and emotional support. To strengthen oversight, questions on rehabilitation will be incorporated into the Scottish stroke care audit to improve national data on access to rehabilitation services. Rehabilitation is also reviewed through annual NHS board assessments, and we are asking all stroke services to offer every patient a formal review six months after their stroke.
As a number of members have mentioned, prevention remains one of the most effective ways to reduce the impact of stroke. Our ambition is to reduce avoidable cardiovascular deaths by 20 per cent over the next 20 years through earlier identification and management of risk factors. Through our cardiovascular disease risk factors programme, which we have rolled out into primary care, more than 120,000 people have received checks, with more than 13,000 people identified as being at increased risk and offered preventative treatment. That is a really powerful intervention. With a further £10 million invested this year, we will continue to expand that programme.
In the previous session, the minister and I had exchanges at committee about prevention, a lot of which sits outside the health portfolio. What conversations is the minister having with other portfolios to try to drive down the incidence of cardiovascular disease?
The Government recognises the holistic approach to health. I have said regularly that about 80 per cent of our health relates to factors outside healthcare; for example, we must not lose sight of action on poverty. However, there are factors that fall under healthcare, such as smoking cessation. We will work together over the next five years to make the strongest effort that we can on that front.
The MOT being rolled out by Chest Heart & Stroke Scotland on healthy heart and lung checks is the next step in early identification and prevention. It will help to identify cardiovascular risk factors earlier and support timely intervention.
I reiterate my thanks to the healthcare professionals working in stroke care, whose dedication improves outcomes every day, and the third sector organisations whose advocacy and support have played such a vital role for stroke survivors and their families. As we mark world stroke day, let us renew our determination to improve stroke care across the whole pathway, build on the progress already made and ensure that everyone affected by stroke receives the care and support that they need to live well after stroke.
Meeting closed at 18:45.
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