Skip to main content

Defibrillators in Public Areas

Volume 619: debated on Monday 16 January 2017

Motion made, and Question proposed, That this House do now adjourn.—(Graham Stuart.)

Defibrillators save lives. That is the truth that drives the work of the Oliver King Foundation, a charity that campaigns to ensure that defibrillators are available in public places and that people are trained to use them. Every year, ambulance services in the UK treat about 30,000 people for a non-hospital cardiac arrest, but fewer than 10% of them survive—fewer than one in 10. Of the average 82 people who suffer cardiac arrest outside hospital every day in the UK, just eight live.

Cardio pulmonary resuscitation is often championed as the best way to treat cardiac arrest before the emergency services arrive. Indeed, in some cases it can double the likelihood of survival. But even then the chances of resuscitation are still as low as 20%, and that is only in some cases. Clearly CPR alone is not enough.

A little over a year ago, on 7 December 2015, my 28-year-old son had a cardiac arrest. He is one of the few lucky ones who got to hospital in time and survived. He has his own defibrillator, but does the hon. Lady agree that, in conjunction with defibrillator training, it is incredibly important that people are trained in CPR? In my son’s case, his girlfriend was trained in CPR and saw him through the process until the paramedics arrived.

The hon. Gentleman has had a frightening experience in his family, and also learnt the incredible importance of not only having defibrillators available, but having people who know how to use them. I could hardly better his family’s example of how important that is.

A study by the British Heart Foundation found that for every single minute without defibrillation, chances of survival fall by between 7% and 10%. The Care Quality Commission sets a response target of eight minutes for emergency ambulance services, but we know that ambulances cannot possibly arrive within that time in every case. Even if they did, the chances of survival without immediate defibrillation and CPR will have already plummeted to 20% or lower. Access to a defibrillator can therefore make a huge difference. If cardiac arrest is recognised, basic first aid is given, 999 is called and CPR is applied, in combination with rapid and effective defibrillation, the chances of survival can exceed 50%. In fact, in some cases it can be as high as 80%. However, immediate action is vital. A defibrillator must be at hand for those survival rates to be realised.

Three people who know that better than most are my constituents Mark, Joanne and Ben King. In 2011, Mark and Joanne King lost their son Oliver, and Ben lost his brother. Oliver tragically died following a sudden cardiac arrest while racing in, and winning, a school swimming competition. He was just 12 years old. He had a hidden heart condition, and without access to a defibrillator at school his chances of survival on that day were dramatically reduced. Had he lived, this Saturday would have been his 18th birthday.

I never met Oliver, but I have been struck by talking to those who knew him well. He was clearly a very happy and popular boy, judging by the tributes that poured in from those who knew him following the shock of that terrible day. He was known as a big character at King David High School. His teachers recall his “uncompromising zest for life” and how he was loved and respected by boys and girls and teachers alike. His best friend David recalls Oliver’s charm and how it was deployed on more than one occasion to get them out of a tricky situation. This year is particularly difficult for David, as he will be celebrating the milestone of turning 18 without his best friend.

Everyone mentions Oliver’s love of football—he was a staunch Evertonian. His family and friends all recall his great talent and potential on the pitch. One of his teachers describes him as

“a sportsman at heart and a natural at whatever he turned his hand to”.

Above all, Oliver was caring, loving and incredibly close to his family:

“family was everything to Oliver.”

It goes without saying that Oliver’s death left many who knew and loved him with a great sense of loss. His family and friends are sadly not alone in going through this terrible ordeal. As well as the thousands of people who die every year following sudden cardiac arrest, there are thousands more who are now faced with the agonising reality of living without their loved one.

I pay tribute to the hon. Lady for bringing this important subject to the House and for her good fortune in having, potentially, three and a half hours in which to debate it. She has given an emotional case of somebody for whom, for the sake of a relatively simple and inexpensive bit of kit, the outcome might have been different. Does she agree that public buildings—certainly places such as schools—should automatically be fitted with a defibrillator?

Will the hon. Lady pay tribute to Sompting Big Local in my constituency, which has a lottery grant for the enhancement of the village? Its first priority was to install four defibrillators in every corner of the village, including one outside the local pharmacy, because it saw it as a worthwhile thing to do. Many other people have imaginatively used things such as redundant telephone boxes by replacing them with defibrillators as an obvious help point for local people. Should not we just be doing those things automatically?

I agree very much with the hon. Gentleman. He has set out an example from his constituency. Around the country, there are many ways in which communities are starting to ensure that they have access to defibrillators so that, if needed, they are there. I welcome that. We should try to ensure that defibrillators are available throughout our land—up and down, north and south, and east and west. What happened to Oliver is not as rare as we might hope. In the UK, some 270 young people tragically die every year of sudden cardiac arrest while at school. That furthers the hon. Gentleman’s point that having defibrillators routinely available in schools seems to be a no-brainer.

In 2012, Oliver’s parents, Mark and Joanne, set up the Oliver King Foundation in memory of their son. It aims to raise awareness of the conditions that lead to sudden cardiac arrest, which is vital as the family did not know that Oliver had any condition that might have led to what happened. If they had known, probably with the diagnosis of a simple electrocardiogram test, they may well have been able to take steps that could have avoided what happened. Other aims of the foundation are to purchase and place defibrillators in schools and sports centres, to train staff how to use them and to hold screening events to enable simple, painless ECG testing to help diagnose such conditions and ensure that what happened to Oliver does not happen to the children of other families.

Mark and Joanne have done an incredible job. Their aim is simple: to ensure that no more families have to go through what they did, knowing that the death of a son, daughter, mother, father or friend may have been prevented. They campaign tirelessly and effectively to ensure that every school in the country is equipped with an automated external defibrillator. They have the support of more than 200 hon. and right hon. Members of this House, across parties.

Automated external defibrillators are specifically designed for use by non-medically trained people. They are remarkable, life-saving machines that are not difficult to use. The machine will apply an electrical pulse only when it detects an irregular heart rate and it talks the user through the process, step by step. However, at about £1,200, AEDs are not cheap and, even if provided, some people are often afraid of using them. As a result, many schools and high-risk public areas in the UK are still not equipped with them. As a direct result of the work of the Oliver King Foundation, more than 800 schools and public places now have this life-saving kit and people who are confident to use it. In Liverpool, Oliver’s home city, not a single school is now without one thanks to the work of the foundation and Liverpool City Council.

The foundation has also managed to train 15,000 people around the country in how to use an AED, thus making sure that in sudden difficult circumstances the confidence is there to use this life-saving kit. As a direct result, 11 lives have been saved that would otherwise have been lost, including an elderly gentleman who suffered a heart attack at his local gym. Thanks to the staff’s quick thinking and use of the gym’s defibrillator, he was sat up and talking by the time the emergency services arrived. In Woolton in my constituency, where Oliver used to live, an AED provided by the foundation was deployed three times this December alone. If the defibrillator is available and training is provided, people will use one: it is as simple as that.

However, we cannot and should not be reliant on charities to do all the heavy lifting and work in this policy area. In November, the hon. Member for Lewes (Maria Caulfield) introduced the Defibrillators (Availability) Bill under the 10-minute rule procedure, with the purpose being to

“increase the rates of survival rates from non-hospital cardiac arrests across the UK”.

Its objective is basically to do for the nation what the OK Foundation has done for Liverpool and is continuing to do in its work in other places: providing defibrillators in public places and training people to use them.

I am not sure whether the hon. Lady is aware of the impact that these defibrillators have in cardiac ambulances. When I qualified, an ambulance just picked someone up and took them to a hospital, but the big, boxy ambulances have more equipment in them than was in a casualty unit in those days. Even in professional hands, this technology has transformed out-of-hospital cardiac arrest.

I thank the hon. Lady for that very useful information, from her own experience as a doctor. It is important that the availability of this kit is widened across our society in order to save lives.

Current legislation surrounding public access to defibrillators is practically non-existent. Last year, the Government produced a guide for schools recommending the purchase of AEDs. While I welcome that move to highlight the issue, the Government should do more. Will the Minister undertake to meet Mark and Joanne and the OK Foundation to discuss a realistic programme of providing AEDs in public places and training for people such that they feel confident to use them? Will he facilitate a meeting with the Prime Minister? I know that the OK Foundation would welcome an opportunity to argue its case at the highest possible level of Government.

I thank the hon. Lady for raising such an important issue in this Adjournment debate. I, too, pay tribute to the Oliver King Foundation for all its hard work. This is one of those rare occasions when there is cross-party agreement. We agree on the need for these defibrillators, but the Bill that will come here for its Second Reading on 27 January is unlikely to make progress simply because of its nature as a ten-minute rule Bill. Does she agree that it would be good if the Government adopted the Bill, because this procedure does save lives, it is relatively cheap to introduce, and it would make a difference to young people? As she eloquently explained, 12 young lives are lost each week through these incidents.

I congratulate the hon. Lady on bringing forward her Bill. Yes, it was done under the 10-minute rule procedure, but it is now there, and I echo her call for the Government to adopt it. As she realistically observed, the only reason it may not progress in this Session is that there is no time given its position on the list for private Member’s Bill Fridays. The Government could transform that in an instant by taking on board aspects of the Bill—or the whole Bill, preferably—and putting them into some of their own legislation. The Minister might have something to say about that.

I congratulate my hon. Friend on the eloquent and forceful speech she is making. She has already paid tribute to the King family. May I add my tribute to them for their great dignity and the constructive way in which they have taken the issue forward? I agree with the hon. Member for Lewes (Maria Caulfield) that the ten-minute rule Bill has virtually no chance of getting on to the statute book, but the Government could, if they had a mind to, adopt it and turn it into a Government Bill. Of course, if it is defective in any way, it could be amended, but nevertheless the spirit of it could be carried forward.

My right hon. Friend is completely correct on both those things. I know that he knows the King family, as many of us on Merseyside do. Many colleagues from across the House have met either the family or the campaigners associated with the Oliver King Foundation, which does a stunning job of getting across its campaigning efforts and its ask to Members across the House.

Losing Oliver was devastating for Mark, Joanne and Ben, and for Oliver’s friends and his local community. Who knows what he would have been capable of achieving, had he lived? It would have been something remarkable, I have no doubt, given the way in which he had started off in life.

I would like to finish by saying how much I admire the positive and successful way in which Oliver King’s family and friends have channelled their grief into ensuring that no other family has to endure what they did. They have done such good work in Liverpool and elsewhere, and they are moving on to other places to start installing AEDs in schools, sports centres and other public places. Only the Government can help them to achieve their goal nationwide, and I very much hope that the Minister, in his reply, will want to take the opportunity to announce a Government initiative to make that dream a reality. I think it would be a fitting tribute to Oliver King.

I commend the hon. Member for Garston and Halewood (Maria Eagle) for her excellent and thorough speech. I want to make only a few points. I absolutely agree that this is such a vital matter that it is for the Government to take some initiative. Although charities—including, as I have learned, the Oliver King Foundation—do amazing work, the matter is so important that it must be overseen by the Government.

In my constituency, thanks to the British Heart Foundation, we have some amazing kits for CPR work. I have had great fun going round businesses that have taken up my offer of hiring out those kits for nothing. They do the training in their lunchtime or before work, and in 20 minutes they are confident about doing CPR, thanks to the excellent “Mini Anne” resus kits, as we call them. That is fabulous.

Another Member mentioned defibrillators in red phone boxes, which is the work of the Community HeartBeat Trust. I do not know about others, but when I am travelling around I now notice when there is a defibrillator in a red phone box. It is a wonderful initiative, and, again, it is being done by a charity.

One of my concerns is about a situation I have encountered in my constituency. After one business had enthusiastically taken up my offer of use of the CPR kit, I said to those in charge of it, “You are in my central town of Twickenham. Would you consider having a publicly accessible defibrillator?” They looked into it, but they were put off not just by the initial up-front cost—as the hon. Member for Garston and Halewood said, it is realistically £1,000-plus—but by the maintenance costs and responsibility. If a defibrillator is used once, it has to be reset and checked, and there is some money involved in maintenance. I think it was the idea of having the responsibility for such vital equipment that put off my local business.

Public Health England or clinical commissioning groups could map the location of publicly accessible defibrillators and encourage schools, sports facilities and stadiums to have them. In London, we have the community toilet scheme, but we do not have an equivalent community defibrillator scheme whereby everybody would know where the nearest defibrillator was and somebody would be responsible for maintenance. That is all that would be required.

The great thing is that Members on both sides of the House—and I commend my hon. Friend the Member for Lewes (Maria Caulfield)—are all thinking the same way, and there is an appetite among charities and the public for this, but I believe that now is the time for the Government to lead.

The hon. Member for Garston and Halewood (Maria Eagle) started her excellent speech by saying that defibrillators save lives. We accept that; there is no question but that that is the case. Before I respond to the points that she and my hon. Friend the Member for Twickenham (Dr Mathias) made, I want to add my congratulations to the Oliver King Foundation on its work, and to the family on turning a terrible tragedy into something positive. We have heard about what has been achieved in Liverpool, as well as more widely.

One of the asks of the hon. Member for Garston and Halewood was that I meet her and the family to talk about how to take this matter forward. I confirm that I would be very happy to do so. Indeed, the sports Minister, my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), who is with me on the Front Bench today, also feels passionately about this matter, which was in the sport strategy that was published about a year ago. I am happy to set up such a meeting. I am not in a position to set out tonight the Government’s view if the private Member’s Bill does not go through, but if the hon. Member for Garston and Halewood organises the meeting, I would be happy for it to be more widely attended by interested Members.

I think the hon. Member for Lewes (Maria Caulfield) accepts, as I certainly do, that although a ten-minute rule Bill might have been a good way to raise the issue, it is not a suitable vehicle for taking this forward. The request is that the Minister and the Department look at the Bill as it stands, and that, if it needs to be amended or redrafted, they suggest ways of doing so, or even take it on themselves. The Government should bring a measure forward, rather than leaving this to a legislative vehicle that simply will not work.

As I have said, I am not in a position to say tonight what the Government will do in respect of the Bill. I am willing to say that we will meet and talk about it after this debate. As I will come on to say, there is a question about the extent to which defibrillators should be mandatory, as was raised in relation to schools, versus dealing with this through guidelines and other forms of help. I will try to make some of those points later.

The hon. Member for Garston and Halewood made the point that the survival rate of people who have an out-of-hospital cardiac arrest is in the order of about 10%. It varies a little by ambulance service—it can be between 7% and 12%—and if we could get all ambulance services up to 12%, that in itself would save many lives. There is no question but that if defibrillators were available in time, the figure would be at least doubled and perhaps increased by more than that. We also accept the figure from the British Heart Foundation, which I think she cited, that every minute of delay reduces the probability of success by something like 10%.

We need to achieve two things: we need to create more access to defibrillators; and, as my hon. Friend the Member for Calder Valley (Craig Whittaker), who is not now in the Chamber, said in relation to the incident in his family, we also need to increase training and CPR awareness. I recall doing CPR training and being taken through all this two years ago in a church hall in Warrington. It really did not take very long, and I hope I can still remember how to do it. Using these things must be done in parallel with other training. I understand that some defibrillators work fairly easily without too much training, but experience of and ability in CPR buys time, which is what we need to achieve.

I will talk about what the Government are doing in relation to public places, schools, the workplace more generally and, as I have mentioned, sports. I will also take a few minutes at the end of my speech—I do not think that we will be here until 10 o’clock—to talk about screening, which was mentioned as something we ought to consider.

Since 2007, ambulance trusts have had responsibility for the defibrillators around the country. That is because they are where 999 calls go, and they ought to know where the nearest defibrillator is when they get one. If there is a code or the defibrillator is locked, they are responsible for that. In addition, the British Heart Foundation in England—this is also happening in Scotland—is trying to create a database of the defibrillators that we believe are out there. The BHF thinks that there are something like 14,000 defibrillators. Unfortunately, for historical reasons that have grown up over time, there could be maintenance issues with some of them. We need to bring all that up to date, and the BHF is leading the charge on that.

In the past two years, the Government have allocated £1 million per annum for defibrillators in public places. That money is for England only and has led to some success. We had 700 new defibrillators last year as well as the cabinets that go with them, in addition to a range of CPR training, and we expect the same thing to happen this year. That represents an appreciable increase in the number of defibrillators. As I have said, we are doing that because we believe that defibrillators save lives, as does the training around them.

The Member for Garston and Halewood talked about schools. She rightly said that schools have been issued with guidance saying that we expect them to consider the installation of defibrillators, but it is also true to say that not every school has a defibrillator. The hon. Lady also talked about defibrillators costing in excess of £1,000. The scheme that we have put in place for schools uses NHS Supply Chain, which means that they can source a defibrillator for something like £435, which is clearly better than £1,000. I accept that that still comes out of a school’s budget, but nevertheless a great number of schools are taking that up. Schools can also apply to the British Heart Foundation scheme that we talked about earlier, provided that the defibrillator is publicly accessible, which in many cases it would be. However, I accept that we have not mandated such provision, as the Bill asks us to—I will talk about that a little later.

There are workplace health and safety aspects that every employer must consider. We have put in place a requirement that, from 1 January this year, everybody in a workplace who is first aid-accredited—obviously health and safety regulations require that there are such people—must have defibrillation training and be in a position to use those facilities. That is now happening, and it includes everybody who will have to do a first aid refresher course.

As I mentioned, sport is a priority area. Sports governing bodies will have formal responsibility, and many sports are taking this forward. We know of the incidents that have occurred. I think it was Fabrice Muamba during a Tottenham game who was saved by a combination of a defibrillator and a doctor in the crowd who knew CPR, and rugby league and rugby union are also involved. The Football Association has made available a £1.2 million grant to buy 1,300 defibrillators for use at football grounds up and down the country—and not just at the very large grounds. I am involved at Warrington Town football club, and we will be getting a defibrillator under that scheme as well. All FA-accredited coaches will also have to be CPR trained.

I know from the sports Minister that the sport strategy has made defibrillators in sports a priority. She has nominated Baroness Grey-Thompson to take this forward, in terms of putting a duty of care on the various governing bodies. It is an area of priority.

It is also important to understand more about sudden cardiac arrest and to make progress through research. The Government have provided funds through the National Institute of Health Research particularly to deal with the genetic aspects of the condition, given that it has a generic element. Work on gene discovery is also going on at the Oxford Biomedical Research Centre. I am not saying that we are close to a solution or a clear way forward, but this is a research priority. If we understood the genetics better, it would help us to do screening better, so let me move on to screening.

There is a school of thought that screening for children’s genetic predisposition to heart problems could make a difference. In 2015, the UK’s screening authority, the screening committee, considered screening people between the ages of 12 and 39. It did not support that, however, and I believe that that position is consistent with that of every other country in Europe. We have looked into this, and my understanding is that no other country carries out such screening. A number of reasons have been given: it is difficult to get clarity about the numbers of people who would be affected; there is concern that even if screening were to identify people with a potential weakness, there is no consensus on how that should be managed; and, finally, there is a significant concern about the efficacy of a test, especially regarding the number of false negatives and false positives, which it was felt could do more harm than good. If peer-reviewed evidence came forward, based on the findings of places that had conducted screening work, the matter would be reconsidered, but without that, it will not be looked at again until 2018. That leaves us with the issue of how to make more progress on the number of defibrillators available. Perhaps the difference between the hon. Lady’s remarks and my response is not whether it is a good thing to make progress on defibrillators, but whether the Government should mandate putting defibrillators in every school and sports facility.

I understand the Minister’s concern about whether this should be mandated. However, these days we would never operate a school without a smoke alarm or fire extinguishers, and we would not put children on a school bus without seat belts. For me, defibrillators are as essential a piece of safety equipment as any of those things.

I accept that. As I say, the guidelines are clear: any school can make use of the NHS Supply Chain facility to put in a defibrillator for £400 or so.

The Minister talked about screening, which my hon. Friend the Member for Garston and Halewood (Maria Eagle) also mentioned. Although I understand the conclusions and the advice that has already been given, to ensure that there is no confusion, is it not appropriate that if somebody has already been affected, screening should be available to their family, particularly their siblings?

I accept that. Also, a number of sports governing bodies offer screening for people who participate in their sports, but of course that is not the national screening of all 12 to 39-year-olds, which was the issue that was looked at.

Let me finish by reiterating my willingness to meet the hon. Member for Garston and Halewood, other Members and people from the Oliver King Foundation.

I conveyed a request for the Prime Minister to meet the Oliver King Foundation and Oliver’s parents. Could the Minister help me to facilitate that?

I can do many things, but I cannot answer for the Prime Minister. I think I am right in saying that those people met the Secretary of State a couple of years ago. Perhaps when we meet, however, they can start at the bottom end of the food chain before working their way upwards.

When the Government invest in any aspect of health, whether it be cancer drugs or access to GPs, efficacy and cost-effectiveness must be evaluated. The National Institute for Health and Care Excellence uses the criterion “quality-adjusted life years”. Investment in defibrillators must be judged against investment in other necessities, such as cancer drugs, but it is clear from what has been said in a debate that has attracted interest on both sides of the House and the border that defibrillators save money as we start to save lives. The Government accept that, and I want us to make progress in this regard.

Question put and agreed to.

House adjourned.