Before we begin, I am required to read out some advice from Mr Speaker. I remind Members that they are expected to wear face coverings when they are not speaking in the debate. That is in line with current Government guidance and that of the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done at the testing centre in the House or at home. Please also give each other and members of staff space when seated and when entering and leaving the room.
That this House has considered public access to Automatic External Defibrillators.
I am pleased to see many hon. Members from all political parties in the Chamber. I will also say, because I mean it, that I am especially pleased to see the Minister in her place and I look forward to her response. She understands the importance of the debate. Each hon. Member who speaks will illustrate the strength of the need for the Government and—dare I say it—civil servants to understand the importance of the debate. If they understand it, and if the Government press the issue, the general public will be glad to see it happening.
It is a pleasure to have this debate before the Second Reading of the Automated External Defibrillators (Public Access) Bill on 10 December. I thank the Backbench Business Committee for granting my application. The intention is to deliver public access to AEDs across the whole United Kingdom. All MPs will have at least one person in their constituency who has been saved by an AED.
I am grateful to the hon. Member for Sedgefield (Paul Howell) who co-sponsored the debate and supported me in making it happen. I appreciate his co-operation, partnership and friendship. He made representations to the Committee alongside me and shared his own experience, which he will tell us about shortly. He has referred to the dedicated work of his constituent Councillor David Sutton-Lloyd, who advocates and lobbies with him about the importance of awareness and public availability of these lifesaving devices.
In my constituency, Councillor Mo Razzaq has been championing the cause and has fought hard to improve provision, which has led to a community defibrillator installation outside Strachan Craft Butchers in Blantyre. Does the hon. Gentleman agree that locally elected representatives can be instrumental to the cause?
I appreciate the hon. Lady’s intervention about the importance of councillors, which I will return to, such as the friend of the hon. Member for Sedgefield. Communities lead on such matters.
There are many defibrillators across great parts of the United Kingdom of Great Britain and Northern Ireland, but the Bill legislates so that everyone must have one in place. There is no cost to the Government; the Bill just puts in place the necessity to do it, rather than saying that it must come from community activities or otherwise.
To give an example from my constituency, in Newtownards some of the shop owners got together and spent £1,000 on a defibrillator, which is available on the high street in the middle of town. Every school in Northern Ireland has a defibrillator. As I will say later, I had a meeting with the former Secretary of State for Education about this issue, and he was committed to it in that role.
I am deeply encouraged by and thankful for the amount of support for the Bill on both sides of the House. I thank hon. Members present for contacting me to offer their support and for suggesting that I hold a debate before Second Reading. The purpose of the debate is to raise awareness and to build the campaign outside the House. We are all able to point to many cases. It is a fundamental aspect of our democracy that Members are able to scrutinise and debate proposed legislation. This debate offers Members the chance to do just that. I have worked with the Minister and look forward to continuing that work to bring this important piece of legislation forward—to bring this ideal into reality. If we can do that, and deliver across the United Kingdom, I will be more than pleased.
Since the Bill’s First Reading, I have been overwhelmed by the amount of support. Support has come from across the House—from all sides, from all parties—which is a reflection that it is welcomed across society. I thank all Members who wrote to the Secretary of State for Health and Social Care urging him to engage on this issue. I was able to meet the Secretary of State to discuss the Bill and he demonstrated his sincere support, which we appreciate. The members of the public and people in industry who have contacted me—I have held meetings with as many as possible over the past few months—are the driving community spirit behind this Bill. The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) referred to that community spirit. It drives us as constituency MPs.
This is an incredibly important debate. Does the hon. Gentleman agree that AEDs should be put on public buildings? Those buildings are not open 24/7 and the AEDs should be accessible to the public 24 hours a day, so they should be on the outside of the building. Does he also agree that if every child in school had one hour’s training in CPR every year, we would have far fewer deaths? A combination of those two measures would save many more lives.
I do agree, and I think there would be a positive consensus in the House on that. I will give an example later of how an AED in a school saved a life in my constituency. I have two examples to illustrate the point.
I have seen over the past year how we have begun to address the importance of CPR training, to which the hon. Lady referred, and AED availability. I agree with her. The AED in Newtownards is in the street, but it could have been in the shop, which closes at six o’clock, so from 6 pm to 9 the next morning it would not have been available. The hon. Lady is right about what should be done.
The right hon. Member for South Staffordshire (Gavin Williamson) backed the campaign, in his former role as Secretary of State for Education, to see all schools equipped with defibrillators. I believe that has been accomplished. I was encouraged by that, as we are trying to do it back home as well. However, it is not just about primary schools; it is about having AEDs available in streets, shopping centres, Government and local government buildings, and leisure centres. The Bill says that they should be available, but it does not put a cost factor on it. To make this happen is a win-win for the Minister and the Government.
I will explain where the campaign came from. The Minister will remember that we met Mark King, of the Oliver King Foundation, whose 12-year-old son Oliver died of cardiac arrest during a school swimming lesson in 2011. I was incredibly moved, as I know the Minister was, by Mark’s experience. I was motivated too by his commitment to installing AEDs as far and wide across the community as possible. I know that he will be watching the debate today, and it will be a poignant one for him. Throughout this journey, I have stayed in touch with the foundation. I want to remind Members that this Bill was inspired by a young fella called Oliver King—a 12-year-old—and that we bring this debate to the Chamber in the hope of ensuring that Oliver’s legacy continues.
Following cardiac arrest, for each minute that passes the chances of survival fall by a massive 20%. Outside urban areas, and certainly in very rural locations, ambulance call-out times are often much longer than a matter of minutes. Does the hon. Member agree that provision needs to be prioritised in rural areas?
I certainly do. Living in a rural area as I do, I know the hon. Lady is absolutely right. I would hope and expect that to be the case. I want to give others the opportunity to speak and will make my closing comments now.
Let us remember why we are here today. We are here because there are currently over 30,000 out-of-hospital cardiac arrests in the United Kingdom each year. Of those people, only one out of 10 will survive. I put it to the Minister, the Government and civil servants that I want—indeed, I think we all want—the other nine to survive as well. How can they survive? They can survive if we have access to AEDs in the places where people are, including in rural places. That is why we must push this forward.
What value do we put on a life? A typical defibrillator for the community can cost £800. The Library notes refer to the cost being between £600 and £2,500. However, across Northern Ireland, with the efforts of all the charities and groups I have mentioned, the defibrillators are already in place. I have also mentioned the efforts of organisations such as the Premier League and the Education Ministers here in Westminster and back home in Northern Ireland, and I suspect the same is true in Scotland and Wales as well. That is why, when the legislation is introduced, it will be to encourage those who have not yet gone to that extra stage to make sure that there are defibrillators. That is why this debate is incredibly important. If the cost is £600 or, as it is in Northern Ireland, £800, that is a small price for the Government and the private sector to pay potentially to save lives.
Is it not right that every leisure centre should have a defibrillator? Is it not right that there should be one in the centre of every town? Is it not right that defibrillators should be available and accessible in restaurants, and outside buildings for times when people are out and about, including to visit pubs and restaurants at night time?
The debate can last until 3 o’clock. I am obliged to call the Front Benchers no later than 2.27 pm and the guideline limits are: 10 minutes for the Scottish National party; 10 minutes for Her Majesty’s Opposition; 10 minutes for the Minister; and then Jim Shannon will have three minutes at the end to sum up the debate. So, until 2.27 pm, we are in Back-Bench time. Four distinguished Back Benchers are seeking to catch my eye and we will start with Rob Roberts.
Thank you, Mr Hollobone, for calling me to speak and it is a pleasure to serve under your chairmanship.
I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate on such an important matter; as he says, it is a matter of life and death. I have no doubt that this issue will draw agreement from all political parties, and such is the nature of the hon. Gentleman that he is one of the few Members who could rightly be called “my hon. Friend” by Members from all parties in the House.
It is vital that there is greater access to defibrillators in local communities across the whole of the UK. To save myself tripping over the word “defibrillators” for the next five minutes, I will shorten it to “defibs” from this point onwards.
Every year in Wales, around 6,000 people suffer from cardiac arrest. About half of those incidents occur outside hospitals, with just one in 20 of the people affected surviving. The National Institute for Health Research has found that survival outcomes for people experiencing out-of-hospital cardiac arrest are greatly improved when bystanders use a defib.
When we consider that, as the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) said in an intervention, someone’s chance of surviving cardiac arrest decreases by at least 10% to 15% with every passing minute, it is vital that everyone in the community not only knows where the nearest defib is located but—most crucially—has the knowledge and confidence to use it.
I understand how important it is to improve the teaching of these lifesaving skills having campaigned with the family and friends of Janene Maguire, a loving mother of three who unexpectedly passed away of a cardiac arrest in February 2000. Sadly, and almost amazingly, nearly two decades later one of Janene’s daughters also suffered from a sudden cardiac arrest. Fortunately, she was with her friend, who saved her life by performing CPR until a paramedic arrived.
Thank you, Mr Hollobone. I am very honoured to be a replacement for Mr Thomson— I do not know how able, but I will do my best.
I am very grateful to have the opportunity to contribute to this vital debate. I too pay tribute to the hon. Member for Strangford (Jim Shannon), who has been championing this cause for a considerable time and therefore is an expert on it, as he showed with his opening speech. I confess that, in contrast, I am comparatively new to the issue. Like many others, I had my interest in it sparked by the lifesaving treatment of Christian Eriksen at this summer’s Euros, to which the hon. Member referred, and by subsequent conversations with constituents. I have been able to start some productive local conversations with the two local authorities that serve my constituents and with the British Heart Foundation. I am keen to learn more, and already have learned quite a lot more in the course of the debate.
In launching a small local campaign to help raise awareness of cardiac arrest and how to respond, and to try to increase access to lifesaving CPR training and defibrillators, we opted to call it Every Second Counts. That is not remotely original, but it reflects the fact that, as hon. Members have noted, when it comes to surviving a cardiac arrest, every moment really does matter.
The numbers are stark when it comes to survival rates for the 30,000 out-of-hospital cardiac arrests that people suffer each year in the UK—just one in 10, as we have heard. However, if we think about that from a different perspective, it means that we have the opportunity here to save hundreds—thousands—of lives if we get the response right. The basic components of a successful strategy seem uncontroversial, as we have already heard. We need to ensure that people can recognise what a cardiac arrest looks like so that they can take appropriate action. We need to ensure that they know to call 999 and can perform CPR. We also need them to use a defibrillator if one is available.
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I thank the Minister for her invaluable contribution. I thank Tom, Sandra and Daniel from Stryker, Matthew Spencer from Healthcomms Consulting, Greg Quinn from BD, Sarah French from SADS UK, Gabriel Phillips of APCO Worldwide, Iain Lawrence from Aero Healthcare UK, Sudden Cardiac Arrest UK, as well as the Arrhythmia Alliance, the Community Heartbeat Trust and British Heart Foundation Northern Ireland. I suspect most of those bodies have already contacted the Minister, as well as her local community and other community groups.
I have been interviewed by university students about the Bill. This demonstrates the concern and interest of a wide cross-section of society about the need for public access to AEDs. I am very grateful for their interest and for broadening my knowledge. No matter what age I am, I will always learn. Today I learn more, and the next day more again. I have an open and active mind, and I want to respond and to learn things that we can use in this House for the benefit of everyone. They taught me about the consequences of a lack of awareness of and training in cardiopulmonary resuscitation, which added to my knowledge and understanding of sudden cardiac arrest.
There is momentum growing, not only from The Mirror, which has its own campaign. I turned on the Denmark match at the Euros and did not realise what had happened. I was trying to figure out what was happening on screen, as I had missed the first 30 minutes or so of the match. I thought somebody had got hit on the head by a bottle thrown from the crowd or something. The Danish team were all around Christian Eriksen, and I realised that he had had a heart attack. That day, an AED saved his life, because it was there. The Premier League has donated 2,000 AEDs or thereabouts, aiming for them to filter down to some of the junior clubs. There is definitely a growing momentum out there.
I want the debate today to be marked by hope and commitment, but also by respectful demand. We should all support this issue. I am in no doubt as to the wishes of people in the community with regard to the proposed legislation, its importance and the need to have it in place now.
I am encouraged that in Northern Ireland, the Education (Curriculum) (CPR and AED) Bill has reached its second stage. This is not about politics; it is about the issue. That is the way I see things. I am a political person, of course, but what drives me is asking what is the right way to do things—that is important. One of my colleagues who is not of my party, Colin McGrath MLA, has brought the Bill to the Northern Ireland Assembly. We have worked together; he was keen to know what I was doing and I was keen to assist him back home in the Assembly. He has expressed his best wishes for the Bill, because it is just as important for children to acquire the CPR and AED skills that the hon. Member for Mid Derbyshire referred to, as it is for adults. It is good to see a devolved Administration talking, taking this on and encouraging others to follow suit.
I believe in acts and not just words. Very shortly, the hon. Member for High Peak (Robert Largan) and I will be doing an AED instruction session in the House, when we are able to. I am not sure when that will be, but we are hoping to do it this side of Christmas—the idea is to have a date that coincides with the Bill’s Second Reading on 10 December. It will be with David Higginbottom of Driver First Assist. My staff and I back home will also be taking part in a CPR and AED training session in the office in Newtownards led by Mrs Pauline Waring, superintendent of the St John Ambulance Dufferin Cadet Unit in Bangor. She, along with many other volunteer leaders, does incredible work with St John cadets by training them in first aid and lifesaving skills. It is always good to remember that the St John Ambulance is voluntarily staffed and funded by its own efforts; I encourage Members to engage with their local St John Ambulance if they can.
The hon. Member for Sedgefield, in his representation to the Committee for this debate, raised the very important point that many people are afraid of AEDs. They should not be, and that is why the training is important. Right away, people ask, “Will I know what to do?”. They will know what to do, because it is quite simple. I am not being smart by saying that; the instructions are really easy—they are easy for children to use as well, if that is necessary. People will learn that AEDs and CPR cannot do any harm; they can only do good. That is the motivation. I refer again to my message of hope for this debate, because anything that equips and inspires our young—anyone, in fact—to do good for the community carries the spirit of hope.
I want to raise some important facts about AEDs and CPR because they are two of the links in the “chain of survival” referred to in the UK Resuscitation Council’s updated guidelines. The third link is targeted temperature management. I want to touch on TTM here because I have been made aware of how this impacts on the recovery process. While the focus of this debate is on promoting the prevalence and availability of AEDs in public spaces and buildings, it remains essential that we consider the whole “chain of survival” once a person has experienced a cardiac arrest and been resuscitated.
In my constituency of Strangford one Saturday afternoon at a football match, one of the supporters collapsed at the side of the pitch. I spoke about this at the debate on the ten-minute rule Bill in February. What saved that man was the fact that the club had a defibrillator at all its matches. That is characteristic of all football matches in my region. People were able to resuscitate that man and he is alive today because the Portavogie football team and one of its staff members were able to get him back. He is alive today and can still attend football matches.
I want to give another example, but I am conscious of the time and other Members want to speak. A father was outside a school after leaving his children there. Unfortunately, he then had a heart attack. The children were inside and did not know what was happening to their daddy. The school had a defibrillator and, again, access to an AED saved that man’s life—he is alive today. Not only is he alive; he is able to continue taking his children to school.
I have given two examples, and I know that other Members will have lots of their own. It is hard not to get enthused about this issue, because of the clear benefits. I have referred to Christian Eriksen who collapsed at the football match. I acknowledge and praise the hard work and unfailing efforts of the Minister, who proposed legislation in 2016 and 2019. Her support is needed if we are to get this done.
In May 2021, the Italian Government passed legislation requiring all offices open to the public with more than 15 employees, transport hubs, railway stations, airports, sports centres and educational establishments—schools, universities and all those places—to have public access to AEDs. In France, a Bill was passed in 2018 requiring almost all buildings where people gather to have access to an AED, including restaurants and shopping centres. It went a stage further by including holiday centres, places of worship, covered car parks and even mountain refuges. In Singapore, AEDs are carried in taxis.
In this House, we are at an important stage. We have more AEDs per head than across the whole of the country—that is not a criticism, Mr Hollobone. I am not saying we should not have them, but I would like to see that replicated everywhere else.
There is a campaign called The Circuit, which registers all community AEDs. The sale of AEDs rose significantly after the Euros incident, and when AEDs are registered on a central database, emergency call handlers can direct callers to the nearest AED. The objective of this Bill is to have an AED within three minutes of everyone. That is what the hon. Member for Rutherglen and Hamilton West wants to have; indeed, I think it is what we all want to have.
The Bill does not cost the Government anything. I have said it three times now; forgive me for saying it three times, but I want to emphasise it and say why it is important. Here is a Bill that delivers across the whole of the United Kingdom of Great Britain and Northern Ireland. This Bill will save lives, which is why it is important.
I say to my hon. Friends—all the Members here are my hon. Friends; to be truthful, on this issue all Members are probably hon. Friends whether they are in the Chamber or outside it—that this proposed legislation is neither to the left nor the right of politics. It is about what is right and what is wrong. It is about our whole society and equipping it with the means to save lives. Can there be a more civilised or caring thing to do? If words could make the difference—I will use a quotation, but before I do so I will say one other thing.
Today, this House can support the campaign to deliver AEDs, at no cost to the Government. AEDs save lives. That is the purpose of the Bill—it is to save lives. It is about those nine out of 10 who die every year because the AEDs were not available. It is as simple as that. It is about saving lives. For me, that is the crux of it.
I say that life and death are in the hands of the Minister and her Government, and they would seem to be in the hands of civil servants too. So what action will those hands—the hands of Ministers, the Government and civil servants—take in the coming days when the Bill comes back to the House on 10 December?
I will close with very poignant words. I know that the Minister knows that they refer to wee Oliver King. His dad said, and I have never forgotten it:
“Had the swimming pool had an AED, my son, Oliver, would still be here today.”
That is what we are here for.
The experience of that family in my constituency highlighted to me the importance of improving awareness and knowledge of both CPR and defibs. I am pleased to say that, as a result of our campaigning, the Welsh Government committed to including these lifesaving skills in the school curriculum in Wales, as they are in the curriculum in England. I hope that equipping young people with the knowledge to save lives will ensure that the survival rate for out-of-hospital cardiac arrests is greatly improved.
Despite the success of having added to the curriculum in Wales, the campaign to improve lifesaving skills and access to lifesaving equipment is far from over. Access to defibs and the knowledge of how to use them still needs to be greatly improved. As part of my commitment to improving these skills, I will continue to work with the Welsh charity Calon Hearts to organise a number of CPR events in my constituency in the new year. Participants will be able to learn the skills and gain the confidence to apply them, ensuring that people from all backgrounds have that knowledge, so that they too are able to save lives.
Although the Resuscitation Council has provided guidance for adult basic life support, which advises on how CPR and defibrillation should be administered during a sudden cardiac arrest, the vast majority of people still do not have that knowledge and are unable to use it when needed. Currently there are 5,423 public access defibs registered with the Welsh ambulance service, but the British Heart Foundation estimates that there are thousands more defibs that the trust has no record of. With that in mind, there is an obvious but important question to ask: what is the point of increasing the number of public access defibs if people do not know where they are or how to use them?
There seems to be a simple solution to the issue. Why not create a comprehensive, UK-wide database, on an app that can be downloaded to smartphones, including all defibs and their precise locations, and simple, easy-to-follow instructions on how to use them? It seems as though that would be a relatively simple database to establish and maintain. It should not be beyond the wit of man to put something in place along those lines. There are currently a number of different defib databases covering different areas of the UK, so it is certainly a feasible idea. Much of the data is already there, and just needs to be amalgamated in one comprehensive database. If all NHS systems in the UK worked together with organisations such as The Circuit, the national defibrillator network, it could easily be achieved, and would undoubtedly help to save many more lives.
The Welsh Government, to their credit, have recently committed £500,000 to improve community access to defibs. I encourage them to collaborate with the UK Government, and indeed the Scottish and Northern Irish devolved Administrations, to ensure that public access to defibs and the knowledge of how to use them is improved across the UK, and that it is mandatory for all defib providers to register every new device on the database.
When someone goes into cardiac arrest, every second counts. I want to ensure that as many tragic and unnecessary deaths can be avoided as possible, by equipping the general public with as much knowledge and as many skills as possible.
Access to defibrillators is a vital component of the chain of survival. How do we improve accessibility, because currently, as we have heard, only a small percentage of out-of-hospital cardiac arrests receive bystander defibrillation? It is important that there is a greater understanding of when and how to use defibrillators. We must get across the message that they are easy to use so that people do not hesitate for fear of doing it wrong. I look forward to taking part in the training that the hon. Member for Strangford is going to put on for us.
We need to get defibrillators across the country registered on The Circuit so that when we call 999 we can be directed to the nearest accessible defibrillator. We all know that early defibrillation can massively increase someone’s chances of surviving an out-of-hospital cardiac arrest, but many defibrillators are never used because the emergency services simply do not know about them. The Circuit, an initiative by the British Heart Foundation, could prove an important step forward, and we all have a role in raising awareness in our constituencies.
A lot of good work is being done across the UK. We have heard about that already today. We all need to learn from each other, but we can also learn from good practice and what works by looking at examples from abroad. Denmark seems to be a model of good practice, which seems appropriate given what happened to Christian Eriksen. A training programme, the placement of 17,000 AEDs in the community and the implementation of a registry of where they are has seen impressive results. Survival rates have tripled largely because the rates of bystander CPR have shot up from 19% to 65%.
The Danes also use a smartphone Heartrunner app to alert responders trained in CPR and the use of defibrillators to any nearby cardiac arrest and the nearest publicly accessible defibrillator. Some 16,000 citizens joined that system in its first two months.
Sweden has seen survival rates double in the last 20 years, partly through mass CPR training—something we have heard about today—and SMS Lifesavers, which seems to be along the same lines as the Danish Heartrunner model.
It is not just about the number of accessible defibrillators, but where they are. It is brilliant to have two installed by voluntary organisations in the same street, but ideally we need to be able to target them where they are most needed, and we need to map that out. Some 80% of out-of-hospital cardiac arrests occur at home, so how do we get as many into areas of concentrated housing as possible? Some public buildings will be ideal for that, with many schools situated in the heart of communities, for example, but other large housing estates might not have such buildings, so how do we deal with that? On the other hand—the hon. Member for Strangford touched on this earlier—our more remote areas have low concentrations of people, but possibly longer to wait for an ambulance, so defibrillators could be all the more vital.
Again looking to Denmark and Sweden as an example, I understand that 200,000 people have access to emergency medical deliveries of defibrillators by drone. Studies in Canada have suggested that that could be a lifesaving option for rural areas. But perhaps we should learn to run before we try to fly. NHS Grampian has had some success in reducing response times to remote areas with teams of trained volunteer responders equipped with AEDs and vehicle locator systems.
On another related issue, I was concerned to read that those in the most deprived areas of the country are almost 20% less likely to receive bystander CPR, so we need to try to understand why that is and how we can address that problem. We need to address these issues to ensure the best response, and we would be wise to look at the type of work that has been undertaken by the resuscitation research group at the University of Edinburgh. I look forward to working with colleagues across the House to make sure that every second counts, and that we do everything we can to save lives.
I thank the hon. Members who supported this debate and express my support for their call to action.