asked Her Majesty's Government:

Whether adequate specialist therapy is available to patients leaving hospital following strokes, in particular speech therapy; and what steps they are taking to ensure that such therapy is available in all areas.

My Lords, all stroke survivors who need it should have access to specialist therapy, including speech and language therapy. The Department of Health is developing a new national strategy for stroke, which will set out the vision for modernising services and delivering the newest treatments for stroke. This will include therapy and other kinds of rehabilitation for stroke patients and survivors.

My Lords, I thank my noble friend for that reply. Is he aware, as I am sure he is, that skilled, specialist rehabilitation has been found in research to make a substantial difference to the quality of life and independence of post-stroke patients? Unfortunately, it is not all that readily available in some areas, as the Stroke Association has told me. Without it, people otherwise able to lead independent and useful lives face what amounts to a form of social exclusion because they are unable to speak and to communicate.

My Lords, my noble friend is right about the importance of therapy. A third of stroke survivors have persistent speech and language issues. I can tell her that there has been an increase in the number of speech therapists working in the NHS and, in a Picker Institute survey of stroke patients carried out in 2005, 69 per cent said that they had been given enough help with speaking difficulties after they had left hospital. That is a good foundation, but I accept that more needs to be done.

My Lords, I was interested to hear the Minister say that more speech therapists are now working in the NHS. While it is certainly true that there are more posts, anecdotal evidence suggests that, when they become vacant, many of them are now being frozen. Can he tell us whether the stroke strategy, when it comes out, will include any data on exactly how many people are providing speech therapy in the NHS?

My Lords, the survey will look at workforce issues. The statistics that I have show that in 1997 around 3,742 whole-time-equivalent speech therapists were working in the NHS. The latest census, which was conducted in 2006, shows that the number is 5,149, which is an increase of over 37 per cent.

My Lords, is my noble friend aware that the stroke group at the Royal Free Hospital in Hampstead, of which I am a member, is being shut down? How many other groups are similarly affected? Does my noble friend agree that ensuring that stroke victims are given effective treatment during their recovery is important? What are the Government going to do about this?

My Lords, I was not aware of the closure of the group that my noble friend referred to, but I am happy to look into it. I accept the premise that as much work as possible needs to be done with people who have suffered a stroke to enable them to recover and get back into full working lives. Great advances have been made over the past few years in specialist stroke services and the work undertaken in rehabilitation. However, more needs to be done and that is what will be covered in the strategy due to be published shortly.

My Lords, is there not a bit of a gap between government policy and what is happening on the ground? In his responses not just on this subject but on many others, the Minister seems just to be reiterating policy. A recent survey showed a dearth of support for stroke patients in, for example, Wales. Can he respond to that?

My Lords, I cannot respond to the situation in Wales, but I can say that the NHS faces specific and serious challenges in giving priority to stroke services. However, the fact is that we have seen a big fall in mortality from stroke in both the under-65s and those aged 65 to 75. Some 97 per cent of hospitals now have stroke units, which is a big improvement on the position a decade ago, and we have seen a large increase in the number of speech therapists. Improvements are being made.

My Lords, I declare an interest as a former chairman of council of the Stroke Association. In his original Answer, the Minister said that specialist services "should" be available. The question is: are they?

My Lords, I pay tribute to the Stroke Association for its incredibly valuable work. Specialist stroke services have been developed, but not every part of the country has them to a sufficient extent. We wish to use the strategy as a way of encouraging the NHS to give appropriate priority to the development of those services.

My Lords, I declare my interests as a former director of the Stroke Association and as a stroke survivor. In my experience, one of the most important therapies is physiotherapy, especially that provided by physiotherapists who are specialists in dealing with stroke victims. There is still clearly a shortage of such specialists. Will the strategy make provision to increase the number of physiotherapists who are stroke specialists?

My Lords, I am not going to anticipate the strategy, but I can assure the noble Lord that workforce issues will be fully considered in it. As with speech therapists, since 1997 we have seen a considerable increase in the number of physiotherapists being employed in the NHS.

My Lords, it is absolutely essential for many patients that they should have a brain scan very quickly after suffering a stroke. I know that that was not the normal practice in this country, although it was in others, but, under the new policy, how long does the Minister estimate it will be before it is routine?

My Lords, the noble Baroness is right to point to the importance of scanning. There has been an increase in the number of scanners and the figures that I have for 2006 show that 59 per cent of patients referred for an emergency CT scan had one within 24 hours, which is up from 51 per cent in 1998. But I accept that there is more to do. The report of Professor Boyle, the national clinical director, published about a year ago, stressed the importance of this and the strategy will contain further details.