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Defibrillators: Public Access

Volume 735: debated on Tuesday 4 July 2023

[Sir Charles Walker in the Chair]

I beg to move,

That this House has considered public access to defibrillators.

It is a pleasure to serve under your chairship, Sir Charles. I am bringing this motion before the House this afternoon to maintain the steady pressure from campaigners and parliamentarians in relation to increasing awareness of and knowledge about defibrillators in two key regards: one, where they are; and two, how to use them. This continues the fine work conducted by Members from across this House, including the members of the all-party parliamentary group on defibrillators, its chair—the hon. Member for Stoke-on-Trent North (Jonathan Gullis) —and the hon. Member for Strangford (Jim Shannon), as well as Members of the other place.

This issue was brought home to me by the experience of my constituent, Bonnie McGhee, who works in the cardiology unit at Queen Elizabeth Hospital. Sadly, Bonnie lost her father to a cardiac arrest, but has since successfully raised funds for a defibrillator in his memory. Access to a defibrillator may have saved his life. The defibrillator that Bonnie funded is in the Clockhouse Community Centre in memory of her father, Jeffrey Anthony Mee. I think of Bonnie and her late father often, and today, they are especially in my thoughts.

In the UK, one person dies every three minutes from a heart or circulatory disease and, every year, 60,000 out-of-hospital cardiac arrests occur. Research by the National Institute for Health and Care Research found that only 8% of people suffering a heart attack outside of hospital will survive. However, the same research found that the odds of survival increase to 32% if a member of the public has access to an automated external defibrillator. If someone has access to a public defibrillator and can administer a life-saving electric shock to the heart to restore its normal rhythm, that will improve the likelihood of survival for anyone who has had a cardiac arrest.

Defibrillators represent an incredible technical advance. They are lightweight, easy to use and designed only to help and not harm the patient. The issue is not about their design but their distribution and public awareness of what they are and how to use them.

I thank the hon. Member for securing this important debate and for her excellent speech. Does she agree that community defibrillator training sessions are vital, and will she join me in thanking people such as Ryan Cawsey of St John Ambulance Cymru and Stephanie Roberts of the Gwalchmai Hotel, who make possible free defibrillator training sessions for Ynys Môn constituents?

I thank the hon. Member for her intervention, and I will come to that really important point about community training. I also thank her and agree with her comments about the charities and organisations that are already doing the groundwork to provide help and ensure that people are adequately trained.

Research from Resuscitation Council UK shows that access to AEDs is not fairly distributed across the income and ethnic distribution of England. In other words, if someone is poor and/or black, they are less likely to have access to a defibrillator, but if someone is affluent and white, they are more likely to have access. The research shows unequal access across England, with fewer in the north-east and more in London. This is a classic example of what Dr Tudor Hart called “inverse care law”, whereby people with the most needs get the least provision, and vice versa. I hope that the Minister can address that point and tell us what the Government are doing to tackle these stark examples of health inequality.

I am grateful to the hon. Member for securing this important debate. I want to mention Lucky2BHere, a charity based on the Isle of Skye that works across Na h-Eileanan an Iar and the highlands. There are now more than 150 defibrillators across the Western Isles—my constituency—which is about the length of Wales. There is one outside my constituency office in Stornoway, which I will come back to in a second. They are outside schools, and can be accessed at all times.

The work is having to be done be volunteers, who see the great need for it. Michelle Macleod, who works in my office, collapsed in 2019 after having run a relay part of a half marathon, and it was with the help of defibrillators that her life was saved. That underscores, on a personal and an office basis, exactly how important those defibrillators are in my constituency. I congratulate the hon. Member on raising this subject, so that there is greater awareness among the public and the Government about what needs to be done.

I thank the hon. Member for making such an important contribution and Lucky2BHere for the work it is doing. I acknowledge his constituent, whose life was saved by this work. Volunteers are doing a lot of work to raise money for defibrillators. I have seen it happen in my constituency recently, where the Friends of Lesnes Abbey and Woods have raised money for defibrillators.

I welcome the Minister’s announcement that £1 million will be available for community defibrillators. I am sure that he will set out how that money will be used and what impact it will have. Otherwise, the money risks being more of a PR exercise than an exercise in serious public health policy.

I commend the hon. Lady for securing the debate. She was very kind to mention me earlier—I brought the Automated External Defibrillators (Public Access) Bill to the House in 2020, as most Members will know. The Government accepted the need to have defibrillators in schools, which was really good.

The person who made that happen was Mark King, whose son Oliver died in March 2011 from a cardiac arrest—he was an outstanding young man who would have gone very far in the world. There have been 4,500 AEDs placed in schools, 70,000 staff have been trained in AED awareness and 47 lives have been saved. Two of the lives saved were in my constituency, because the defibrillators were in place at the right time. I congratulate the hon. Lady on securing the debate, and I look forward to doing even more. Perhaps the Minister can give an indication what the next steps will be.

This is not to blow his trumpet, but I thank the hon. Member for the work he has done on the issue and for the important points that he just highlighted.

Let me go back to my point about the Minister’s announcement of the £1 million that will be available for community defibrillators. I have questions about the timing of the announcement, just a few days ahead of this debate. What will the method of distribution be for the roll-out? I am concerned that Ministers will pitch community groups against one another in a cruel competition to see who wins. The danger is that the winners are either the best organised or have the loudest voices, or else are favoured in the eyes of Ministers. This does happen with schemes of this nature. Resuscitation Council UK warns about

“defibrillators being disproportionately stored in communities that have resources, amplifying the UK’s mismatch between Automated External Defibrillator…density and Out of Hospital Cardiac Arrest incidence. By instead targeting public-access devices in areas of poor health and high OHCA incidence, this initiative could increase the chance of survival in the most high-risk communities.”

There is also the issue of public awareness and knowledge. Each year, there are 60,000 out-of-hospital cardiac arrests in the UK, with less than one in 10 surviving. While immediate CPR and defibrillation can more than double the chances of survival, public access defibrillators are used in less than one in 10 cases. Defibrillators must be located in well-signposted, unlocked and easily accessible places that members of the community can access immediately in an emergency. They must be maintained and ready for use. By the way, the criminal justice system should throw the book at anyone convicted of vandalising public access defibrillators. Few crimes are more mindless than selfishly disabling a defibrillator that might save a stranger’s life. Does the Minister believe that the current range of punishments available to the courts for vandalising a defibrillator is adequate?

As the House will know, there is a national database of locations of defibrillators. It is called The Circuit and is maintained by the British Heart Foundation, NHS, Resuscitation Council UK and St John Ambulance. I pay tribute to each of them for their work, but the database is not complete. The Circuit currently has more than 70,000 defibrillators mapped, but there are estimated to be between 100,000 and 200,000 devices in the UK. This means that emergency services, including the ambulance service, might not be able to direct people to a defibrillator to save someone’s life. Will the Minister explain how that can be acceptable and what the Government are doing to rectify the situation?

The hon. Lady is right to outline the fact that many people do not necessarily know where defibrillators are located, and there is a need to ensure that that happens. Does she agree that one thing that should happen—maybe the Minister can answer this question—is the teaching of CPR, which is crucial to ensuring that people feel confident enough to use the apparatus of a defibrillator? Does she feel that the Minister should take that issue on board as well?

I thank the hon. Member for making such an important point. He literally took the words out of my mouth, because I was going to mention that later. He is right, because there is no point having all these defibrillators if no one knows how to use them. There are some located in my constituency and more widely, and people do not even know about them. I went to my local station recently, and some of the staff did not know that there was a defibrillator in the station. That lack of awareness is quite concerning.

I warmly welcome the Complete The Circuit campaign being run by the Daily Express and the British Heart Foundation. The campaign seeks to have every defibrillator listed. If Google Maps can list every pub and restaurant, which I know we all like, surely we should be able to see every defibrillator on our smartphones. I congratulate the Daily Express and its editor, Gary Jones, for this initiative—I think that is the first time I have ever said that.

I thank the Daily Mirror, which has run a lengthy campaign to install defibrillators in public spaces. Martin Bagot has been the driving force behind the campaign, and I know that people will be interested to know more about the current availability of defibrillators, such as the sorts of public venues that are more likely to have them and the public venues where there is an acute absence of them. Is the Minister aware of any blackspots, particularly in rural areas, where there is a lack of defibrillators? As the hon. Member for Strangford mentioned, if someone can find a defibrillator, will they be able to use it?

There is a strong case for a public information campaign to explain what a defibrillator is and how to use it, which should be supported by workplace training courses and much greater awareness. There are examples of defibrillators from abroad where the information is much clearer and easier to understand. Can the Minister tell us what assessment the Department has made of accessibility for people who cannot read or who do not have English as their first language? Is there a case for reviewing signage and instructions to make defibrillators even more accessible?

Lastly, what about our workplace? According to information released under the Freedom of Information Act 2000, there are 25 defibrillators on the parliamentary estate, including in Central Lobby and Portcullis House—do we know where they are? No. We should be shouting that information from the rooftops; it should not be released through an FOI request. How many right hon. and hon. Members know the whereabouts of those defibrillators? I do not know where the 25 are. How many of our staff know where they are? How many of us have had training in CPR or using defibrillators? This is a classic case of “Physician, heal thyself.” In other words, we in this place should model good behaviour in all things, including access to defibrillators.

There are so many tragic stories from every constituency of lives lost when a defibrillator could have saved them, and I have heard some of them through interventions. Of course, there are many stories in which people have survived because of access to a defibrillator and the quick thinking and swift action of a stranger. That is the ultimate reminder that we are interconnected by shared humanity, that we rely on the kindness of strangers and that, one day, any one of us might need a passer-by to save our lives.

I reassure the hon. Member, as Chair of the Administration Committee as well as Chair of this proceeding, that we will certainly look at her request around defibrillators on the estate. An email is being sent to the Clerk now. I remind Members who want to speak to bob up and down.

I pay tribute to the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), who set out some moving thoughts about the importance of altruism and caring for other people in their moment of need, and about how the Government can perhaps help communities to enable individuals to help other people.

I want to pay particular attention to two aspects of best practice in my constituency and in broader east Devon, and I will close with one ask of the Government. The two examples of great ideas relate to Devon Air Ambulance Trust and Axe Valley Runners club. I met Devon Air Ambulance Trust here in Parliament last winter. The trust let me know that it is running CPR training and training on how to use a defibrillator. It invited me along to Sidmouth rugby club to get some training on CPR and how to use a defibrillator. It was great, because I had not done much of that sort of training since being a Scout as a young lad. It was brilliant to see how much progress has been made in resuscitation and how much more can be achieved these days with technology that we did not have in the 1980s and 1990s.

The Devon Air Ambulance Trust has a “Help with all your Heart” campaign, which seeks the best possible outcomes for patients who suffer a cardiac arrest. Part of the objective is to provide more of the equipment, as well as trying to train people such as myself in how to use it. The trust has put AEDs outside its charity shops on high streets, and it is working with town councils in east Devon to enable better access to AEDs.

The second organisation that is doing great stuff in my part of Devon is Axe Valley Runners club. Earlier this week, as covered by the Midweek Herald newspaper, the club did a “defib dash”. A defib dash is a bit like orienteering, for those who know what that is. The idea is that the runners go off in groups with a map to find a number of defibrillators. They go on various routes, competing against one another, to see who can get back to the beginning having found the most defibrillators. They ran around Seaton, Axmouth, Beer, Colyton and Colyford, covering a big chunk of the Tiverton and Honiton constituency. I pay particular tribute to Heather Simmons, Claire Warner and Sarah and Ronnie Whelan, who deserve credit for that novel and creative idea.

My third and final point is the ask. It would not be necessary for community groups to come up with these fantastic initiatives if there was better understanding of where defibrillators are and how to use them. The hon. Member for Erith and Thamesmead has mentioned the Complete The Circuit campaign being run by the Express. The absence of a complete register of AEDs is a particular issue for rural areas such as my part of Devon. We think that there are 70,000 AEDs on the national register, but our understanding is that there are between 100,000 and 200,000 AEDs in existence. We are, therefore, nowhere near having a good idea of where defibrillators are located. This is an important issue. If someone comes across somebody who has had a cardiac arrest, one of the first things that the ambulance service will do when they call 999 is direct them to the nearest AED. In a rural area such as mine, however, the service might think that the nearest AED is miles away, without knowing that there is one just a few hundred metres away from the incident. As the Express has said, we need to Complete The Circuit. We need a full and proper record of where AEDs are located.

I am a Liberal Democrat and we do not really believe in intervening in matters in which the state need not get involved. In this instance, however, I have been racking my brains for reasons why the Government might not want to legislate or intervene to require community groups to register AEDs on a national database. I have asked the chairman of Sidmouth Town Council and other community groups about the arguments against having a comprehensive register of AEDs, but I have not yet heard a sound argument why we should not require everyone who, through the kindness of their heart, buys an AED to register it so that the ambulance service can direct people to all available AEDs.

In summary, fantastic work is being done outside the House by community groups, but we need a central register and it has to be as comprehensive as possible.

It is a pleasure to serve under your chairship, Sir Charles, and to follow the hon. Member for Tiverton and Honiton (Richard Foord), who made a really interesting speech. I like the idea of a defib dash. I do not know whether we have enough defibrillators in my constituency, but I am certainly going to go away and find out.

I congratulate my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) on securing and leading this important debate and on her great speech. Fewer than one in 10 people survive an out-of-hospital cardiac arrest. Tragically, that means, given that annually in the UK about 30,000 people experience an out-of-hospital cardiac arrest, that only approximately 3,000 of them will survive. In Yorkshire each year, there are approximately 3,300 out-of-hospital cardiac arrests, with a survival rate of only one in 13. Sadly, that means that more than 3,000 people in Yorkshire will not survive a cardiac arrest this year.

There are measures that can improve the chances of survival, including bystander willingness to begin CPR. I have seen that at first hand: my mum, on a number of occasions over the last few decades, has stopped, as a bystander, and she has saved more than one life. As a trained nurse, she had the confidence to do CPR. What is really encouraging is that when research has been done, ordinary members of the public—by “ordinary”, I mean without any medical training—are willing to get involved, but as I will come on to say, they do not always have the skills to do so. That sort of intervention can double or even quadruple the chances of survival.

I am pleased to say that Resuscitation Council UK found that people in Barnsley are more willing than some in other parts of the country to begin CPR if they witness someone having a cardiac arrest. Access to defibrillators and how quickly they are used can also be incredibly effective in improving the chances of survival after a cardiac arrest, with research finding that defibrillation within three to five minutes of collapse improves survival rates from around 50% to 70%. During the public engagement sessions leading up to this debate, the House of Commons research team found that more than half the people asked would feel confident to use a defibrillator without having had training. It is encouraging that 80% of people reported feeling confident to respond to an emergency situation where someone was suffering a cardiac arrest.

Although people are generally willing to help and get involved, they may not always be able to do so. Resuscitation Council UK found that defibrillators are disproportionately more present in affluent areas, where the incident rates of cardiac arrest are typically lower. Of course, no one would begrudge any area for having as many defibrillators available to them as possible, and I am sure that Members from across the House will join me in sending our thanks to those who have fundraised to source a defibrillator for their local community. I would like to take this opportunity to recognise the work of the Hoyland, Milton and Rockingham Ward Alliance in Barnsley, which has funded five new defibrillators for the area, three of which have been installed. That will literally be a lifeline to many in Barnsley East, and I know local people will be incredibly grateful to them.

Not everyone can rely on organisations to provide funding in that way. Less affluent areas face inequality in their cardiac arrest survival prospects, as those who live in more disadvantaged areas are more likely to suffer arrests but less likely to have access to a defibrillator. We need the Government to take urgent action to ensure that defibrillators are suitably distributed across the country, so that people are not at greater risk of dying from cardiac arrest just because of where they live. Last month, my office was pleased to support a parliamentary event by Resuscitation Council UK to highlight this and other issues associated with cardiac arrest survival and follow-up care. We were joined by cardiac arrest survivors and members of the council, who demonstrated how to administer CPR should we ever need to do so. I would like to take this opportunity to put on the record my thanks to them for an informative event.

Defibrillator access and awareness in local communities, particularly in areas such as Barnsley, will save lives, so I am pleased that we are having this debate today. I am keen to hear from the Minister what the Government are doing to improve public access so that as many lives as possible are saved.

It is good to see you in the Chair again, Sir Charles. I congratulate my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) on the way she introduced the debate and the passion she put into it. If we could all be as passionate, we would save more lives, which is wonderful, and I thank her.

Defibrillators save lives and that is why we need to have more of them. Everyone who has spoken in the debate so far has had a story of how a defibrillator has saved someone in their community, and that is because defibrillators save lives. If we know where defibrillators are, how to use them and what to do in medical emergencies, we will save more lives and be more confident in allowing communities to be a part of the healthcare response, especially at a time when our NHS is in crisis. According to the British Heart Foundation, around 3,500 out-of-hospital cardiac arrests happen each year in the south-west of England. In Plymouth alone, 28,000 people struggle with high blood pressure, and 25,000 people in my city live with heart-related conditions. That means we need to ensure that support is available in every one of our communities, should it be required.

Without doubt, the availability of defibrillators would improve cardiac arrest survival rates, and I know this at first hand. In March I held a #MeetLuke public meeting in Compton ward, at which local residents had an opportunity to ask questions to me and local councillors. Our three local councillors—Labour, Conservative and independent—had just been asked an exciting question about cuts to local buses, but the independent councillor struggled to answer. They said they needed some air, and they quickly wanted some water. When they stood up, they fell to the ground having a heart attack. If it had not been for the quick reactions of people in that room, that person would have died. One of the councillors started doing CPR on their fellow councillor, while the other one ran to get the defib, which had been installed in a church opposite to where we were. They called 999 to get the access code to the locked cabinet, and that triggered an emergency response from the ambulance service because a defib had been activated, and a police car was sent as well as an ambulance.

If it had not been for the quick measures and thinking of Labour Councillor Dylan Tippetts and Conservative Councillor Charlotte Carlyle, the independent Councillor Nick Kelly would have died right there. We had help from doctors and first aiders in the room, but if it had not been for the defib, he probably would not have survived. As much as we pride ourselves on having political banter, everyone should be able to go home to their family at the end of the day. When I saw a defibrillator being used right in front of me and how it saved a life, it left not only a harrowing memory, but a responsibility to ensure that there is a defibrillator in every one of our communities.

Councillor Carlyle is working with the local Pearn Charitable Trust to fund more defibrillators in that community, which is admirable. In addition to Compton ward, every other ward in the patch I represent needs defibrillators, and that is especially true of our poorer communities. Richer communities have more access to defibrillators than poorer communities. That is often because of the high upfront cost of a defibrillator, so I welcome the initiative the Minister has outlined to provide funding for communities to bid for a defibrillator. However, I share the concern of my hon. Friend the Member for Erith and Thamesmead about where defibrillators are located. We need to ensure that they go where the need is, not just to where people are good at filling in bids. We are aware from other areas of funding that if someone is a good bid-writer, they are more likely to succeed in the bid. That does not necessarily mean that they have a more worthy cause. I would be grateful if the Minister could set out how his Department is ensuring that the funding goes to where the need is, and not just to where the most successful bids are.

Regarding availability of AEDs and the overall package, it is absolutely important to consider where the risk is. The £1 million funding announced by the Minister is welcome, but it will soon be spent and the great need for AEDs will remain. Where are the deficits? Which areas have a lower concentration and density? They will also be the areas on the map where people are at higher risk of heart disease, and that is why we need to ensure that they have AEDs.

I second the call for defibrillator guardians to register their device with The Circuit. When people dial 999, they will then be able to access a nearby defibrillator and the emergency code to unlock it. It is important that people know about that. I recently visited the O2 store in Drake Circus in Plymouth, which had just installed a defibrillator and trained all staff in how to use it. That is an incredibly welcome move. I would like big corporates to take the initiative and ensure that they are looking after not just their own staff but customers and others nearby.

I challenged local supermarkets in Plymouth on whether they had defibrillators, but not all of them did. The shopping demographic includes people of all ages. For some, leaving the house to push a trolley or carry a basket around a supermarket can be quite intense. We know that cardiac arrests happen when people go shopping. As a basic piece of social responsibility, every single supermarket should have a defibrillator and a sign on the front of the store informing people that it can be used in the event of a problem. What additional conversations is the Minister having with large chains and corporates to ensure that defibrillators are not only registered on The Circuit but visibly signposted?

I echo the call about parliamentary AEDs. There is one outside the office of my hon. Friend the Member for Tooting (Dr Allin-Khan), who will speak in a moment, and my office is situated between hers and that of my hon. Friend the Member for Erith and Thamesmead. That means that I know where the nearest AED to my office is located, but I am not in my office at the moment and I do not know the location of the nearest AED. There is a challenge to onboard people. I like the idea that we should be a beacon of best practice. All staff should be onboarded when they arrive on the parliamentary estate and informed about not only where AEDs are located but how to use them. We are often confused by advice on how to use the staff training allowance provided to us by the Independent Parliamentary Standards Authority, but I think it could be put to good use with first aid training. Following the incident at my public meeting, all my staff will shortly go on a first aid course so that they can feel confident about how to respond in the event of a medical emergency. But that should be a standard for everyone in this place. We should lead by example.

Finally, there needs to be more focus in education and training. If we are faced with someone having a cardiac arrest or a suspected one, knowing what to do in those first few seconds could be the difference between that person surviving or not. As a country, we should aspire to equip each and every one of our citizens with a minimum level of first aid knowledge. Wherever someone is, they should have an understanding about how to provide basic first aid and what to do in the event of an emergency. That training should be repeated throughout their life as a refresher to top up their knowledge, so that wherever someone is, and regardless of whether they have a defibrillator near them, they know what to do in the event of an emergency.

What conversations has the Minister had with the Department for Education to make sure that our young people leave school equipped with first aid? They need to feel confident about operating an AED, especially given that there are places where young people are encouraged not to touch that thing on the wall because it is dangerous. I have heard that said a few times about defibrillators, but we want our young people to know what they should do in the event of an emergency. We should not scare them, but equip them with the knowledge about what should happen.

The defibrillator that saved Nick Kelly’s life in Plymouth was installed only a month before the public meeting. Had the meeting taken place two months previously, as I had originally intended, he would not be alive today. We owe an enormous thanks not only to the organisations, charitable groups and individuals who fundraise and host defibrillators, but to the organisations that pay for the recharging and upkeep, because it is often more prominent to buy a defibrillator in the first place, incurring a high capital cost. It is often less prominent in fundraising to pay to keep it tip-top and in good condition, so that it can be used.

I want to say a special thanks to the congregation and clergy at Emmanuel Church for taking the risk to buy a defibrillator, the benefits of which they have seen almost immediately. I hope that every single church, supermarket, public building and major location in Plymouth takes note of that, buys a defibrillator and puts the maintenance of it in its annual budget. If they do that, we will save more lives and it will help the health service to be able to respond to medical emergencies quicker when they do happen.

I am grateful to the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) for securing today’s important debate on public access to defibrillators, and I congratulate her on the thorough way in which she opened it. It is always a pleasure to take part in debates that are so consensual, and I suspect we are all on the same page, which is nice for a change.

Cardiac arrests strike without warning, and usually outside the confines of a hospital, leaving people in immediate need of medical attention. We have heard from a number of speakers that fewer than one in 10 people survive, which is truly frightening. According to medical professionals, every passing minute without defibrillation reduces a cardiac arrest victim’s chances of survival by a staggering 10%. In such critical moments, defibrillators emerge as vital instruments that are capable of restoring the rhythm of a failing heart, so accessibility and knowledge of where they are located are vital. Incredibly, there is no official centralised database that records the number of defibrillators and their locations.

Thankfully, as we have heard, some organisations have launched their own maps, such as the British Heart Foundation’s Circuit, to improve access to defibrillators. The Circuit is a comprehensive national network of defibrillators, which aims to improve survival rates by mapping the locations of defibrillators across the UK, enabling prompt access during emergencies. There are currently 60,000 defibrillators registered on The Circuit, but it is estimated that tens of thousands remain unknown to the emergency services. Raising awareness about The Circuit and encouraging registration of these devices will enhance their effectiveness in critical situations.

Having the data on one database is really important. Does the hon. Gentleman agree that the data has to be accessible and pulled through to other devices? I just googled “defibrillators near me” on Google Maps, and there really are not any, so we need to make sure not only that the data is stored, but that it is publicly available for people, especially on their handheld devices.

That is a very good point. None of us, myself included, goes anywhere without a mobile device nowadays, so that is the obvious tool of choice.

Timely defibrillation is a cornerstone of improving survival, and Scotland’s out-of-hospital cardiac arrest strategy aims to increase to 20% the rate of incidents where a PAD is applied to the patient before the arrival of the Scottish ambulance service. I encourage groups and organisations with a defibrillator to ensure that it is registered.

Early defibrillation can massively increase someone’s chances of surviving out-of-hospital cardiac arrest, but many defibrillators are never used because the emergency services simply do not know about them. “Scotland’s Out-of-Hospital Cardiac Arrest Report 2019-22” highlights:

“The number of Public Access Defibrillators (PAD) in communities across Scotland that are registered on the national defibrillator network (The Circuit) has more than doubled since 2019”.

That is good, but we need to do better. Currently around 5,000 are registered. Registration on The Circuit makes a PAD device visible to the Scottish Ambulance Service and alerts emergency call handlers that there is a pad near an out-of-hospital cardiac arrest. That makes registration a vital component in that chain of survival.

I am reminded of the Gandhi quote: “You cannot help everyone, but everyone can help someone.” Each of us as an individual can play a crucial role in bridging the gap between cardiac emergencies and lifesaving interventions. The British Heart Foundation’s map of The Circuit offers a valuable resource that allows individuals to check the availability of nearby defibrillators. By using the tool, anyone can quickly identify the nearest defibrillator, which improves response times and potentially saves lives.

Of course, 80% of cardiac arrests occur at home, so it is vital that Governments continue to consider ways to increase engagement at community level. For example, the Scottish Government want bystanders who witness an out-of-hospital cardiac arrest to feel able to take action. To achieve that, Scotland’s out-of-hospital cardiac arrest strategy aims to familiarise a total of 1 million people in Scotland with CPR skills; it works through increased engagement with community organisations such as sports hubs, local businesses and other community groups to raise awareness of and offer opportunities to learn CPR. I had CPR training in the past, but I think I could do with a refresher, as I suspect could many of us who have had the training. It is not done often enough; if an emergency occurred, I am not sure that I would feel as confident as I would have done a month or a couple of months after the training.

As I repeatedly point out in health debates, we cannot escape the fact that health inequality and poverty go hand in hand, and that is the case with out-of-hospital cardiac arrests. Those in the most deprived areas are twice as likely to have an out-of-hospital cardiac arrest and 60% less likely to survive than those in less deprived areas. Deprivation also has a significant effect on the likelihood of receiving bystander CPR. Then there are geographic and demographic issues: around 11% of the population of Scotland live in rural areas; they are 32% less likely to survive or to leave hospital after an out-of-hospital cardiac arrest than those living in urban areas. Over the last seven years, we have started to understand more clearly the association between measures of socioeconomic position and decreased survival rates after such incidents.

Ethnicity can also be a factor in how likely a person is to experience an out-of-hospital cardiac arrest. For example, people from south Asian backgrounds are at up to 50% higher risk of developing coronary heart disease than white Europeans, and coronary heart disease can lead to heart attack or cardiac arrest. In addition, international studies show that women are less likely to have CPR performed on them—a pattern that we also see in the Scottish data. The misconception that breasts make CPR more challenging, fear of doing harm, fear of inappropriate touching and fear of being accused of sexual assault have been given by the public as reasons for that gender discrepancy. It is important that we work to combat those fears and embed the knowledge that CPR is a gender-neutral lifesaving technique. Those health inequalities confirm beyond doubt the importance of prioritising pads in areas of the highest risk first, as a number of other speakers have mentioned.

Availability and accessibility of defibrillators are critical factors in reducing the devastating impact of cardiac arrests. One way of making defibrillators more accessible would be to make them more affordable. Currently, charities and local authorities can claim a VAT exemption when purchasing a defibrillator, but that should be extended to anyone buying the equipment. Quite simply, the UK should follow Ireland’s example and remove the tax. However, raising awareness of initiatives such as The Circuit, encouraging greater community involvement and tackling poverty all remain essential. By embracing those measures and working together, we can create a society in which every individual has a fighting chance against cardiac emergencies, and ultimately save more lives.

It is a pleasure to close for the Opposition with you in the Chair, Sir Charles. I thank my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) for bringing forward this debate. She never ceases to bring the voice of her constituents right to the heart of this place, and today is yet another shining example her doing her community incredibly proud.

It is welcome that there is such unity and consensus on this issue. As we have heard, tremendous progress has been made towards making defibrillators accessible to the public, thanks to the many incredible charities and people who have been working hard to do so. The Community Heartbeat Trust, the Oliver King Foundation and SADS UK are just some of the organisations that are doing brilliant work to provide education and information about automatic external defibrillators, AEDs, and to ensure that more defibrillators are easily accessible in public spaces.

The British Heart Foundation’s Circuit project has ensured that thousands of defibrillators and their locations are registered online, but, as we have heard, that work needs to go further. People who experience the very worst in the heart of their communities need to know that they are able to find and access an AED when they so desperately need it. The Premier League defibrillator fund will provide AEDs to grassroots clubs, which is very welcome and will ensure that lifesaving treatment can be rolled out to even more stadiums.

As we have heard, in the UK one person dies every three minutes from heart or circulatory disease, and 60,000 out-of-hospital cardiac arrests occur every year. Take a minute to think about that. My hon. Friend the Member for Erith and Thamesmead quoted research published by the National Institute for Health and Care Research, which found that just over 8% of people suffering a cardiac arrest outside hospital survive—just 8% of the 60,000 out-of-hospital cardiac arrests. The same research found that the odds of survival increase to 32% if a bystander has access to a public AED, and some studies place that figure even higher. It is simple: AEDs save lives.

According to the British Heart Foundation, the low cardiac arrest survival rate in Britain can be attributed to a lack of access to defibrillators. This critical technology must be accessible to work. With my medical hat on, I will take a moment to explain how it works. CPR works to send the blood around the body to take oxygen to the tissues as a holding measure, but the AED is required to shock the heart and try to restart it again so that it can pump the oxygen around the body. Imagine somebody providing non-stop CPR for hours on end. Not only would that be far too long and the person would be brain dead at the end, but without an AED—without that shock delivered to the heart—CPR is actually pointless.

We must be clear: AEDs are simple, safe and effective. They are portable, have plain instructions and the user cannot give a shock accidentally or hurt somebody. From my professional experience in the emergency department, I know how important quick access to treatment is for patients in cardiac arrest. There can be no doubt that patients who are admitted to hospital after having received prompt treatment with chest compressions or, even more effective, a defibrillator have far improved chances of making a recovery. There is also an economic benefit, because the people whose chances of recovery are worse may spend a long time in an expensive intensive care bed, often not surviving at the end of it. That makes the argument for giving people a better outcome in the first place, which prevents those protracted stays in intensive care and saves money in the long run.

When the heart stops beating, every second counts, and a person’s chance of survival decreases by approximately 10% with every minute that defibrillation is delayed. That speaks to the importance of everyone knowing where the AEDs are. With our NHS in crisis and emergency care at breaking point, lives are being endangered. In December last year, the average ambulance wait for category 1 patients had increased to 10 minutes—the worst performance on record. Those stats make a very clear argument: the painful fact is that people are dying as a result of not being able to get the shock they need from a trained person, whether they arrived in an ambulance or came from an AED in the vicinity.

Category 1 patients are the most serious and life-threatening cases, including cardiac arrest. In a category 1 scenario, every second is the difference between life and death, and longer ambulance waits are costing lives. Sadly, after 13 years of Conservative governance, patients can no longer rely on an ambulance arriving in time. At the end of last year, one in 10 urgent cases waited over 11 hours for an ambulance. How can we in all conscience say to people who lost loved ones in such cases that their loss could not have been avoided, when we know full well that it could have been?

Last year, the Government committed to funding a defibrillator in every state-funded school in England by the end of the academic year. As the academic year is nearing its end, will the Minister outline what progress has been made on that commitment? The Government also committed last year to £1 million of funding to provide an estimated 1,000 public access defibrillators across communities in England. I note that the Department re-announced that policy just last week, so has there not been any progress on that commitment? Will he update us on how the application process is progressing and whether any PADs have been installed, and if they have, in which communities? It is crucial that they are placed in communities where the need is greatest to tackle growing health inequalities, which we have heard about extensively today.

It is really important that health inequalities are not allowed to widen any further through a lack of access to equipment that could save lives. That has to go hand in hand with training people in how to use them. I would be interested to know what work the Department is doing to encourage uptake in the communities that are most in need. While many of us will agree that public access to defibrillators will be a fantastic step towards saving lives, we must not forget that our country also deserves a well-funded, well-resourced and well-supported NHS. It is heartening that there is widespread, cross-party support for publicly accessible AEDs. I hope that the Government will build on the support from across the House and do what is needed to ensure that access is available.

I remind the Minister that if he takes up the full time he must leave two minutes for the mover of the motion to wind up.

It is a pleasure to serve under your chairmanship, Sir Charles. I assure you that, although I will try to address as many of the points and themes raised during this very constructive debate as possible, I do not intend to take the full time available to me.

I congratulate the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) on securing a hugely important debate, and I thank all hon. Members for their contributions. Although I did not agree with all the points made by the Labour Front Bencher, the hon. Member for Tooting (Dr Allin-Khan), I thoroughly agree that there is considerable consensus. What has been displayed is Parliament working at its best, with all hon. Members raising constituency cases and rightly campaigning for greater access to and awareness of defibrillators in their communities and across our country. I put on record my condolences to those who have lost loved ones due to sudden death caused by an undiagnosed heart issue.

As has been said, defibrillators provide vital treatment, with the latest research showing that the use of such devices within three to five minutes of a cardiac arrest increases the chance of survival by over 40%. It is therefore crucial that we have enough defibrillators in public spaces to provide life-saving interventions when needed. I join the hon. Member for Erith and Thamesmead in paying tribute to and thanking the APPG and its members for all their work in this area. She mentioned the need for steady pressure, and I think that she is absolutely right to use that phrase. It is vital that we keep that steady pressure up, not just on the Department or the NHS but on organisations up and down the country, to ensure that we have as much access to these vital AEDs as possible.

The hon. Member for Erith and Thamesmead set out very articulately and eloquently the compelling case for access to and awareness of defibrillators, and I think that she did her constituents and the House a huge service today. I would also like to thank the charities, businesses, clubs and societies that go out and fundraise for AEDs; they are doing their communities a huge service too. Investing in devices and treatments that can prevent the most serious cardiac arrythmias is a priority for the Government. The hon. Lady also rightly raised the issue of inequality. That certainly preys on my mind when considering many aspects of health. She made a very powerful case, and I hope to address that point in my contribution.

As the hon. Member for Tooting mentioned, in December the Government announced a £1 million fund to design a grant scheme for the expansion of publicly accessible AEDs in the community. That fund was designed to provide an estimated 1,000 new defibrillators in spaces across the country. Whether at a town hall, a post office or a favourite green space outside the local Co-op, having access to AEDs in easy-to-reach areas, as we know and as has been very articulately set out this afternoon, can be a lifeline that keeps loved ones with us.

The fund builds on work by the Government, the NHS and stakeholders to improve survival from out-of-hospital cardiac arrests via the use of defibrillators and cardiopulmonary resuscitation—from now on I will use “CPR”, as I do not have the health expertise of the hon. Member for Tooting. The Department of Health and Social Care will invest the funding through an independent partner—I think this directly answers the question from the hon. Member for Erith and Thamesmead—which will be selected from the Government’s Crown Commercial Service list of approved suppliers. Successful applicants will then be asked to demonstrate that the defibrillators will be placed in areas where they are most needed.

To address the hon. Lady’s point about inequality, although Ministers will have no involvement in deciding where defibrillators are sited—it would be totally inappropriate for them to have that kind of involvement— I understand her concerns. It is inevitable to some extent that where an item of medtech is purchased by local communities, there will be a higher prevalence in more affluent areas, where it is easier to fundraise. Where there is Government funding available, it is important that wherever possible we use it to redress the balance in favour of areas that find it more difficult to fundraise. We must ensure that we target areas where there is a shortage of AEDs and do not just top up provision in areas where coverage is already good. I will certainly speak with the Minister for Social Care to see what more we can do to involve local Members of Parliament and interested groups, including the APPG, with the selected partner, to ensure that we get that right, because the hon. Member for Erith and Thamesmead has made a compelling case.

That is really good news to hear. Something that I also want to suggest to the Minister, which I think is really important, is about mapping areas of high need, because one of my concerns is that I am seeing community organisations fundraise for defibrillators, unaware that that fund has been available since late last year. I appreciate that these things take time and it is important that we get it right—we are not just flashing money around anyhow—but will review mechanisms be put in place to ensure that over time the funding is going to the right areas and that the right individuals are receiving the benefits of it?

I thank the hon. Lady for her intervention. She is absolutely right. It is important that whenever we spend Government money—taxpayer-funded money—in this way, there is a proper evaluation process. Having said that, although looking back and asking if we got it right is key, the most important thing for me is to get it right first time. We do that by ensuring that there are clear criteria.

The hon. Lady is also right that we have to map and look at not just areas where people do not have access to AEDs, but areas of social deprivation and areas with a higher prevalence of cardiovascular disease or higher footfall. Those are all factors that we absolutely need to consider when designing the criteria that the independent third-party provider would scope. I am keen to work with the hon. Lady and the APPG to ensure that we are getting that right.

Alongside that—and this is the reason why the number of AEDs that will be available through the fund is an estimate—there is a plan to ask for the match funding that some organisations receive. I am conscious that some areas will be able to do that but others will struggle, which is why it can be full or partial. Potentially, however, that could double the number of AEDs available. Some communities might be able to make only a small contribution, but others could match-fund it entirely. It is important that we set criteria that make it available as widely as possible to communities, especially those less affluent areas where fundraising is difficult.

That is really good. Another thing to highlight is that, as we see in data from The Circuit, not everyone is registering their defibrillators. Is the Minister coming to the point about organisations ensuring that when they receive the funding, they register it as well?

Absolutely. The hon. Lady pre-empts me: I am coming on to The Circuit, because that point has been made by nearly all hon. Members, but I will first conclude my remarks about the fund.

Successful applicants will be encouraged to train or facilitate CPR training in the local community. That is an important element. To expedite the distribution of funding, and in readiness for the appointment of our partner organisation—this touches on the hon. Lady’s question—on 28 June the Department published an invitation for those organisations that wish to bid for an AED to submit an expression of interest.

My hon. Friend the Minister for Social Care wrote to all hon. Members informing them of the AED expression of interest and setting out how organisations can register their interest. It is incumbent on all Members of Parliament to ensure that community groups, organisations and local authorities across our constituencies spread the message loud and clear so that we get as many expressions of interest as possible. I urge any organisation that may benefit from a defibrillator, whether it is a sports club, a local theatre or a community hall, to register and have that opportunity. It is also important that we encourage local councillors to get involved.

The hon. Member for Erith and Thamesmead asked specifically about the Department for Education. I was Schools Minister at the time the decision was made and signed off. On 17 July, the Department for Education announced that it would provide defibrillators to schools in England that do not already have access to one. That is expected to be completed by the end of the 2022-23 academic year. The scheme, of which I am very proud, is the largest distribution of defibrillators to be rolled out across England to date. It will provide more than 20,000 devices, backed by £19 million of funding.

The end of the academic year is in two weeks’ time, on 17 July. May I ask for an update on the progress to meet the target?

I have not been the Schools Minister for many months, but I will gladly ensure that the relevant Minister—or I, having accessed that information—gets it to the hon. Lady.

I remember that a key point in the design of the scheme—this touches on a point made by many hon. Members—was that providing an AED, in and of itself, is not enough. Accompanying the roll-out, we wanted to ensure that there were awareness videos about how easy it is to use an AED. We want teachers, as part of their training and in the staffroom, and pupils in assemblies to see how easy an AED is to use. In a rolling way, we hoped to create a new generation of young people who are confident in their use. As AEDs become more prevalent across communities, that can only be a good thing.

I think it was the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) who asked about CPR and first aid training. As a Back Bencher, I campaigned to have first aid included on the curriculum. The Schools Minister at the time was not very happy about that—not because he was against having it on the curriculum, but because the curriculum was already very full—but we did manage to get it included. It is important that we upskill young people so they have the confidence to act in the unlikely but possible event that they encounter someone in cardiac arrest.

The question about vandalism of defibrillators is a fair one. I had not given it any thought, but I will certainly have a conversation with my counterparts in the Home Office and the Ministry of Justice and see if there is any scope to take further action in that area.

Turning to The Circuit, I would certainly like to recognise the incredibly important work that charities do in ensuring that the public have access to defibrillators. The British Heart Foundation, in partnership with Resuscitation Council UK, the Association of Ambulance Chief Executives and of course the national health service, set up The Circuit, which is the national defibrillator network database that provides information on where defibrillators are located.

I heard the point that the hon. Member for Tiverton and Honiton (Richard Foord) made about legislation, which I have some concerns about. At the moment, registration is entirely voluntary, so nobody is forced to register their defibrillator with The Circuit. However, registration enables the emergency services and community first responders to locate the nearest publicly accessible external defibrillator when they are treating someone suffering from an out-of-hospital sudden cardiac arrest. In those crucial moments after a cardiac arrest, we know that locating an AED quickly will help save lives.

That is a question that I had not previously been asked. The danger of legislating in an area like this is that often there are consequences of legislation. One consequence would be that all existing defibrillators were registered as part of The Circuit, and that comes with a tick—that is a merit. However, having created legislation and having worked in Government Departments where legislation has been drafted on numerous occasions, I know that there are invariably and inevitably also negative unintended consequences that need to be considered and thought through.

For example, would registration discourage communities from taking a defibrillator? Would it discourage businesses like the one to which the hon. Member for Plymouth, Sutton and Devonport referred from putting one in their shop? We have to think through that kind of thing. What kind of pressure does it put on those organisations? Would it discourage people? If we are going to create legislation, what are the implications of not registering? Will there be a criminal sanction or a civil one? These are all things we would have to work through, and that is why legislating on something like this is complex. We have to remember that most defibrillators are bought by community groups, although in this particular case the Government support them. We would be placing a legal requirement on them for something that they are purchasing through goodwill, for philanthropic or altruistic reasons.

We have just got to be careful. I am not saying that we should not consider it, but it is not quite as simple as saying, “Let’s legislate,” and thinking that that will address the problem. What we need to do, and are doing, is to encourage as many people as possible to register because of the benefits of registration.

Would those who receive funding from the £1 million fund for the community be required to register with The Circuit? Where there is Government funding, I think we should be encouraging registration. The more people who are aware, the better.

I totally agree. I will check whether registering will be among the conditions for grant funding; I would like to think that it will, and I will work with the Minister for Social Care to ensure that it is. We know that there are many defibrillators that are not on The Circuit, and—short of legislating, which would not be a quick or easy solution—we have to get them on it as quickly as possible. We have to urge as many organisations and individuals as possible to register.

The hon. Lady asked what steps we are taking to promote that. I recently wrote to all local authorities to ask them to check and, if they have not done so already, to consider adding their defibrillators to The Circuit. I also asked them to reach out and share that message with parish councils, town councils, community groups, village halls, businesses and others that may have a defibrillator that is not registered on The Circuit. I am keen to work with local authorities, which have a reach into their communities that neither central Government nor the national charities could possibly have. I also urge all right hon. and hon. Members to encourage those organisations that have a defibrillator to ensure that it is registered. I join hon. Members in paying tribute to and congratulating the Daily Express on its important campaign, which I am happy to support.

I hear what the hon. Lady says about raising more public awareness about AEDs and where they are located, not on just the parliamentary estate but across communities and the country. I will continue to look at what more we can do centrally, but also by working with national and local charities, to raise that awareness.

The hon. Member for Plymouth, Sutton and Devonport asked about businesses. Some organisations—such as the Premier League, which the hon. Member for Erith and Thamesmead referred to—are leading the way, but we want to encourage more to do so. I will give further thought to how we can encourage other businesses to do the same.

The hon. Member for Tiverton and Honiton asked about first aid, and particularly about CPR. Better awareness and education around first aid training is key to improving survival rates from cardiac arrest. I am pleased that NHS England has partnered with St John Ambulance to, in effect, co-ordinate skills development to significantly increase the use of AEDs by individuals in community settings. That includes a national network of community advocates to champion the importance of first aid training. The plan is to reach 60,000 people, which will help to save up to 4,000 lives each year by 2028, empowering local communities to act more quickly to save people’s lives.

Finally, I cannot speak about cardiac arrest without speaking about prevention, which the hon. Member for Plymouth, Sutton and Devonport referred to. The prevention of heart disease is critical to reducing the number of sudden cardiac arrests. I will set out some of the work that NHS England is doing to reduce preventable deaths from heart disease. Currently, £2.3 billion is being spent to increase the number of centres diagnosing heart disease to at least 100 sites by March 2025. NHS England has developed a new fast-track echocardiography training scheme, which has led to 150 additional echocardiographers, with further support available in 2023-24.

The NHS health check programme, which the Secretary of State recently spoke about, is a core component of NHS England’s CVD prevention pathway. Over 15 million people are eligible for a NHS health check every five years. For every 1 million checks delivered, the NHS health check could prevent an estimated 400 heart attacks and strokes. Something like 10.8 million checks have been delivered between 2013 and December 2022, but it is important that we work hard to ensure that more people benefit from that lifesaving service and get a health check. I am keen that we make it easier and more convenient for people to do so.

I hope that today I have demonstrated the Government’s commitment to increasing the number of AEDs in our local communities. I am keen to see how we can turbocharge that and work with businesses and local communities to go much further. We can all agree that this agenda really matters. Once again, I thank the hon. Member for Erith and Thamesmead for highlighting this vital issue. I look forward to working with her to bring about the change in this area that we all want to see.

I thank the Minister for his remarks about what can be done. This debate was very much about a collaborative approach. Indeed, it is one of the rare debates that I have attended where there has been much consensus.

I thank hon. Members for sharing their experiences, particularly the hon. Member for Tiverton and Honiton (Richard Foord), who also shared some best practices on defibrillators. I am not familiar with the defibrillator dash, but it is something that we can all look into. I thank my hon. Friend the Member for Barnsley East (Stephanie Peacock) for her comments about the community groups fundraising for defibrillators in her constituency, and my hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard), who talked about the importance of corporates, the work that they have done in Plymouth and what can be done in supermarkets.

I thank the Minister for saying that he will consider what engagement and what encouraging conversations there can be with businesses. I am a bit concerned about the £1 million fund, in terms of inequality and little groups being missed out, particularly because we know that the groups that know how to do slick bids are the ones that are very good at getting the money. I am feeling a bit reassured by the Minister that the Government are looking at work to ensure that it is distributed equally, but I think a review needs to be done to make sure that nobody is left behind. It would also be good to get some clarification about whether those receiving funding are being required—

They are? That is good to hear.

May I take this opportunity to thank you, Sir Charles, for saying that you will look at defibrillators in Parliament in your role as Chair of the Administration Committee? I am very impressed that you have taken that on board straightaway. I also want to thank the organisations and charities that have been driving this campaign for their excellent work and briefings.

I thank Bonnie for campaigning on this issue in memory of her dad. I want every citizen, no matter where they live or what they do, to know about defibrillators, where they are and how to use them. I want us all to know how to use one, just as surely as we know how to use a cashpoint. I have had training in how to use a defibrillator—it is so easy to use. I also welcome what the Minister says about the Government’s work in schools and particularly about starting with very young people. I remember receiving first aid at school, so it is good to start this from a really young age.

All these things are possible with the political will to make them happen. I know we will keep up the fight on this issue. I thank everybody for their contributions to this debate.

Question put and agreed to.


That this House has considered public access to defibrillators.

Sitting suspended.