(11 years, 4 months ago)
Commons ChamberFirst, let me say to the right hon. Gentleman that 25 extra patients a day will have to be absorbed by the three neighbouring hospitals to Trafford, so it is not a large number. We want to make sure that all hospitals, including Wythenshawe, which I have visited—it is a superb hospital—are able to absorb that capacity. It is currently meeting its A and E target. The application that has been made for extra capital grant to help it to expand its A and E department will be treated as a priority.
Safety should always be paramount, but public confidence is also important. As the Secretary of State faces further tough decisions on reconfiguration in the coming years, will he assure me and other Members of this House of two things: that he will be conscious of not applying urban solutions to rural areas; and that where alternative pathways of care can be put in place, that will happen before changes take place?
My hon. Friend makes two important points. I explicitly said that we will not proceed with any of these changes until neighbouring hospitals have been consistently meeting their A and E standards and any necessary changes have been put in place so that we can be sure that they will improve care for patients. That is really important if we are going to maintain confidence.
On my hon. Friend’s point about urban versus rural, part of the underlying reason for these changes is that we need to get more care out of big hospitals, which are often in urban areas, and into the community—into settings near people’s homes. That is very important for rural communities where there are often large concentrations of older people. Today’s decision will mean an additional investment in those community services. As we look at the big changes we need to make in the NHS, we will need to make more decisions that allow more to be invested in out-of-hospital care if we are to prevent the illnesses that ultimately put so much pressure on our A and E departments.
(11 years, 4 months ago)
Commons ChamberI am pleased that services are improving in County Durham; as the hon. Gentleman knows, I have family roots in his part of the world that go back centuries. I am not persuaded of the role of pharmacies, although I am persuaded of the role of pharmacists. I distinguish between the two because I personally think that all GP surgeries should be dispensing drugs. I do not see why the taxpayer should be subsidising pharmacies.
It is no surprise to me that Boots was the biggest ever private equity buy-out in the history of British industry, given that the taxpayer is outside the front door: “Come here for your amoxicillin, and while you’re here you can get your shampoo, conditioner and royal jelly.” I am not convinced about the role of pharmacies in the longer term; pharmacists most certainly have a role and should be included. Community pharmacists should be checking drugs, particularly when patients have polypharmacy—when they have a multitude of medications, another pair of eyes is always appropriate.
To return to the reconfiguration, in my locality we have a number of district general hospitals. Historically, Bracknell itself has been under-served by acute services since it was created in the late ’50s or early ’60s. We have seen services diminish in the area for a variety of reasons and under Governments of both parties, and we are sensitive about that.
Before I was elected as Member of Parliament for Bracknell—I stress that it was before I was elected—I suggested as part of my campaign that we needed to close hospitals in the area and consolidate to improve clinical outcomes. I am not aware that my result at the election was adversely impacted by that. Having worked in the area as a GP for a number of years and looked after 50,000 patients, I guess that people trusted what I was saying, and I recognise that.
I was trying to argue that we could consolidate acute services on a single site and improve community hospital services in appropriate locations around the region. I stress the word “appropriate”, as the problem is often that, for a variety of legacy reasons, hospitals are in inappropriate locations. They are not often on motorways, but on land bequeathed before the war. In my part of the world, the Astor family bequeathed the land for Heatherwood hospital. The local farmer outside Slough bequeathed some land because his daughter was looked after well. People thought, “Okay, we’ll build a hospital in the middle of a farm field nowhere near the population that it seeks to serve.”
There is a legacy problem. There is some need to close and relocate, while in some parts current locations can be enhanced. In my locality, there is the problem with Heatherwood hospital. I must put on the record something bizarre that frustrates me. It is “blue on blue”; if I was in a defence debate, it would be called friendly fire. The Royal Borough of Windsor and Maidenhead has called for a judicial review of the relocation of a minor injuries unit just three miles down the road, would you believe, to Bracknell—an urban centre in a better location and away from a place opposite the Royal Ascot racecourse. That judicial review will delay the move and cost money. I find that baffling and bizarre. It is evidence of the problem that I guess all colleagues of both political colours experience in local politics with regard to health care and trying to change services for the improvement of clinical outcomes, because it is not about cost, although obviously that is a factor, but about improving clinical outcomes. That frustrates me, and I will certainly be dealing with it robustly in local terms. At the moment, it is in the best interests of the general public to have fewer acute hospitals.
My hon. Friend is making an interesting point. Does he agree that in applying solutions such as those he is espousing, we must be careful that we do not apply an urban solution to rural areas? Moving an A and E three miles might be acceptable, but moving it 30 miles would not be acceptable to a lot of us.
My hon. Friend is right: in a rural location the distances become further. I do not know the particular situation in his region, but I would suggest that there are probably location issues with regard to existing hospitals.
Moving neatly on, that is why—yes, you heard it here first: a Conservative calling for a Soviet-style central plan—I have called for a national plan for acute and emergency care. By definition, we cannot have a market interfering in that; we need to look at it in the round and say, “Where would we put these hospitals? Where are the motorways? What is the population density? Where is the rural location? Where is the urban location?” The problem is that if we reconfigure in isolation—I have seen this locally—it has a knock-on effect on other hospital services which then say, “Where are we getting our patients from?”
We should have a national plan that everyone from both parties has bought into. We should have—dare I say it?—a cross-party party committee looking into this. We should take it out of the political exchanges that we all engage in. We know what is going to happen in certain quarters in 2015—it will become a political football. I know that my hon. Friend the Minister is very aware of this. That is dreadful when we are talking about saving lives. Let us try to take this out of party politics. We can have robust exchanges, on principle, about payment, about how services are commissioned or not commissioned, and about whether there should be top-down reorganisation, but the fundamental question of where hospitals—acute and community hospitals—are located should be decided nationally; otherwise we could have perverse decisions whereby some services wither on the vine and we end up with gaps in emergency and acute care across the country. I make a plea for some cross-party activity on this.
Let us put the national health service’s budget into context. This country has debts and liabilities in excess of five times the size of our economy, and the situation is getting worse. Almost 40% of spending is on health and welfare, and it is growing. We know that that will happen; we have heard it this afternoon. Let us be realistic: there is only so much we can afford. I genuinely want a service that is based on clinical need. I genuinely want somebody to arrive at the appropriate location and get the very best care available. I fear that if we continue along this path of denial as regards how the service is paid for and, more important, structured, we will end up with more and more scandals. There are more in the pipeline. The chief executive of Tameside hospital has just resigned.
The public out there want more from us. They want us to make some difficult decisions, for sure, but using evidence, not party politics. I make that plea to everybody. If we can do that, we can structure a service that becomes the envy of the world; it is not that at the moment. However long I end up staying in this House, if that is achieved in the time I have been here, I will retire a happy man.
(11 years, 5 months ago)
Commons ChamberI agree that A and E departments are under huge pressure, and that is why we are taking a lot of measures to deal with them, which is what I am talking about. But I am saying that we have to deal with the root causes, which were things that the shadow Secretary of State’s Government failed to deal with. [Interruption.] Labour Members need to listen. We listened to the shadow Secretary of State’s solutions, which were not really solutions; now I am telling them what we think needs to happen.
We welcome the fact that the Labour party has now seen the light and recognises the need for integration, but Labour Members need to show some humility, because it was the Labour Government who put in place many of the barriers—in particular payment by results mechanisms—that make that so hard to achieve. We are now trying to make integration a reality through the 10 pilots on removing barriers to integration announced by the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), as part of the vulnerable older people’s plan announced to the House last month. Without integration, we will not solve the problem of bed blocking, which is at the heart of the pressures on A and E.
The Secretary of State is right to say that many of the present failures started in the Labour years, particularly the problems with integration. Does he share the concern that I and many of my constituents feel about the 50,000 beds that were lost under Labour Government? We lost the beds, but the intermediate care services and step up, step down facilities were never created to deal with the consequences. That is what is behind a lot of the A and E referrals today.
That is part of the problem with Labour’s approach to the NHS—a top-down approach of closing or downgrading A and E units and making the NHS sort out the problems. We are not doing that.
It is time that Labour took responsibility for the disastrous changes to the GP contract, which contributed to making it so much harder to get a GP appointment and piled further pressure on A and E departments—[Interruption.] No, they need to listen; this is important. The changes in 2004 handed responsibility for providing out-of-hours services to administrators in primary care trusts, at a stroke removing the 24/7 responsibility for patients that until then had always been a core part of being a family doctor. As we heard earlier today, even a former Labour Health Minister regretted those changes, saying before the last election:
“In many ways, GPs got the best deal they ever had from that 2004 contract and since then we have, in a sense, been recovering.”
It is important that Labour Members hear the list of independent voices all saying that we need fundamental change in primary care if we are to deal with pressures on A and E: the College of Emergency Medicine, the Royal College of Physicians, the NHS Alliance, the Family Doctor Association, the head of the Royal College of General Practitioners, who—surprisingly—said something in support of the Government in The Guardian this morning, the Foundation Trust Network and so on. All those voices were ignored by Labour as it put its head in the sand about that disastrous change to the GP contract.
This debate has improved as the Back-Bench contributions have gone on. It started off fairly gracelessly, with an attempt to lay all the blame for the pressures in A and E on this Government. That was pretty shameful. I like and respect the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham), but it was graceless of him to suggest that this is entirely of this Government’s making.
As a number of hon. Members have said, there is a broad range of issues behind the pressures on A and E services. Long before I was elected, I campaigned against some of the changes that made a difference in my own constituency and increased pressure on the NHS. We have heard about bed reductions and the lack of joined-up social and health services. I think there is an issue with GPs and I respect the view of the Health Committee Chairman on that. A lot of residents were confused—this was touched on by the right hon. Member for Exeter (Mr Bradshaw)—about where GPs’ services were and how they could access them after the change in 2004 in particular. I think that that has contributed to people choosing to access other services. I confess that I have absolutely no idea how the out-of-hours service in my area works. I am lucky that I have never had to use it, but a lot of people were incredibly confused by their out-of-hours service after 2004. The right hon. Gentleman also mentioned walk-in centres, but my area did not get one. If we are expected to use the one in Scunthorpe, that is not a sufficient local alternative.
We have also heard about a demographic shift, which is clearly a huge issue, as is population growth. After the failure of health services and all Governments to deal properly with palliative care and end-of-life plans, one of my hospitals in Goole experienced massive reductions in services, largely on the previous Government’s watch. Our mental health ward went and all the town’s mental health beds disappeared, as did medical beds in general. Service after service disappeared. When those mental health services were lost and replaced by apparently intensive home support, we ended up with people in crisis and, as my hon. Friend the Member for Totnes (Dr Wollaston) has said, presenting to A and E and other services.
The failure of social care is a problem, but I remember one of my local authorities—East Riding of Yorkshire—changing the criteria for access to its services many years ago as a result of funding pressures from the previous Government. I wish that Labour councillors at my other council, North Lincolnshire council, had listened to the Secretary of State before they tabled their budget for this year, which proposed removing social care from thousands of my constituents and changing the required criterion from “moderate” to “substantial”. If it had not been for Conservative councillors voting down the Labour budget and instead voting to protect social care, there would have been massive social care cuts in my area. I hope that the right hon. Member for Leigh will relay that to his colleagues in my area.
The failure to have proper intermediate care services has also been mentioned. My local authority is trying to address this through a £3.2 million scheme in my constituency to create a 30-bed unit. Bed blocking has been a massive problem in recent years and we all know about it. Plenty of people come in, but not enough go out the other side. The Labour party has to take some responsibility for that problem, because it has not appeared overnight. The issue has been affected by population growth and a demographic shift.
In the brief time remaining, I concur with the Health Committee Chairman that it would be much better to take the politics out of this debate.
(11 years, 5 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I thank my hon. Friend for his intervention, which clearly outlines exactly what the 111 system should be trying to achieve. Sometimes, when hon. Members ask if I will take an intervention, they are looking over my shoulder to see what I am going to say next. My hon. Friend made exactly the point that I was going to make.
There have been lots of complaints about calls going unanswered and poor advice being given, which reiterates the point made by my hon. Friend. That follows concerns prior to the national roll-out, after pilot schemes showed disastrous results, with tales of patients waiting hours for advice and others being asked to call back later. That situation is quite unsatisfactory and must be addressed. NHS England stated:
“The safety of patients must be our paramount concern”.
So it should be, and if it is not, we want to ask why. It also said:
“NHS England will keep a careful eye on the situation to ensure NHS 111 provides not only a good service to the public, but one which is also safe.”
Examples mentioned by all hon. Members—we have them in front of us—provide information that contradicts that. In Greater Manchester, the 111 service was started and then abandoned. Dr Mary Gibbs, a GP providing out-of-hours cover when the system crashed there, said:
“Calls just weren’t coming through.”
Quite clearly, that is the issue. She stated:
“It was totally inadequate. Patients’ health was put at risk.”
The 111 service tends to be busiest when local surgeries are closed. Dr Laurence Buckman, chairman of the British Medical Association GPs committee, stated:
“We are still receiving reports that patients are facing unacceptably long waits to get through to an NHS 111 operator and suffering from further delays when waiting for calls back with medical advice should they manage to have their call answered… The quality of some of the information being given out appears, from anecdotal sources, to be questionable in some instances.”
The advice that people are being given does not always seem to have been up to scratch and is not of the quality that it should be. He added:
“If any area of the country is failing to meet high standards of care, then its NHS 111 service needs to be suspended.”
This is what the experts in the field are saying. NHS England needs to be more transparent about how the system is functioning across the country.
I met one of my local ambulance service chief executives just last Friday, who told me that, in his experience, the implementation of NHS 111 was going well and was helping to reduce demand on the ambulance service locally—and they were quite happy with the service. Although there have been problems, which the hon. Gentleman is right to highlight, plenty of people have been treated well and professionally by this service, and some health service professionals think that the service is working okay.
I thank the hon. Gentleman for his intervention. I have stated that the focus of the new system was on trying to make it better. Every hon. Member accepts that. The idea behind it is great, if it works. We elected representatives will always get the complaints. Not often do we get the wee card saying, “Thank you very much for what you’ve done for us,” but we always get the ones saying, “It’s not working well.” The hon. Gentleman is right. I accept that there will be many examples throughout the United Kingdom where the system has, perhaps, worked, but equally there are a lot of examples of where it has not worked. That is the point that I am trying to make.
We highlight such issues for a purpose, not to be dogmatic, angry or always to be negative in our comments, but to try to look towards improvement. I always try to think that my comments will be constructive criticism, which can be taken on board to make things better. My idea as an elected representative over the years, as a councillor and a Member of the Legislative Assembly in a previous life, has always been to try make comments in that way.
I am conscious of my position as a Northern Ireland Member of Parliament, because health is a devolved matter and I am ever mindful of the cuts in funding faced by all Departments in an effort to reduce the deficit—every pound spent must be well spent—but, from my perspective, I urge that the Northern Ireland Direct system continue until the kinks are ironed out here. On health, we will follow, as we often do, what happens here on the UK mainland, so, from a Northern Ireland perspective, I want to make sure that the system’s fall downs and problems are ironed out and sorted out before we take on the system—if we take it on.
I have been looking at the system with great interest, because one of my jobs here as MP for Strangford and my party’s health spokesman is to consider the systems across on the mainland. Many of my queries to Ministers here in questions on health and to my Health Minister back in Northern Ireland come from what colleagues say to me and from what these debates bring out. I am interested in seeing how this system works or will work, or does not work. If it does not work, I will convey that to my Minister in Northern Ireland, to ensure that when making a decision there we will look at how it can happen. I will certainly not be urging our Health Minister in Northern Ireland to use his precious funding to implement this scheme as it stands.
It is a pleasure to be called to speak under your chairmanship for what I think is the first time, Mr Robertson. I extend my most sincere thanks to the hon. Member for Thirsk and Malton (Miss McIntosh) for securing this important debate. We have worked closely on a number of issues during my time in Parliament, and she is rightly respected across the House as an independently minded Member. I must express my most sincere sympathies to her, but also my profound thanks for the real courage she has shown in sharing her family’s experiences with us.
It is a mark of the severity of the crisis our A and Es are experiencing that Members of all shades of political persuasion have spoken at some length about their constituents’ experiences. It is no exaggeration to state that members of the public are very concerned about the situation regarding NHS 111. A and E is arguably the most visible part of our NHS, and what happens there is felt throughout the system. From the patient waiting at home for an ambulance to the person waiting on a trolley for a bed, what happens in A and E touches every patient in the NHS.
The crisis in A and E has happened on this Government’s watch. When Labour left office, A and E was performing well, with 98% of patients seen within four hours. However, the number of patients waiting for more than four hours has now doubled, and ambulance queues have doubled too. Let us not forget that the target for the number of patients seen within four hours in A and E has been reduced under this Government, from 98% to 95%. Today’s debate is therefore extremely important, and the Government must finally offer some real solutions to address the crisis they have caused.
I find it incredible that the shadow Minister states that the issue was caused by this Government. A lot of my constituents are having to ring 999 because 50,000 beds were taken out of our hospitals nationally on his party’s watch; wards were closed in my local hospital on his party’s watch. Elderly, vulnerable patients who do not have local hospital beds to go to are now forced to ring 999 to get access to emergency services, so it is pretty shameless of the hon. Gentleman to attempt to politicise the issue.
I have to say I am staggered by the hon. Gentleman’s manufactured indignation. I do not know how long he has been a Member of the House, but he will recall that, between 1997 and 2010, the Labour party took the NHS budget from about £30 billion to £110 billion. However, on every occasion the budget was put before the House of Commons, the Conservative party voted against an increase. He should think again about his manufactured indignation.
I am going to make some progress, because I want to get on to the substantive issues in play.
When Labour first suggested a new NHS 111 service, we were clear—the hon. Gentleman should listen—that it would not replace NHS Direct. Our manifesto in 2010 said:
“A new national 111 telephone number will make nonemergency services far easier for people to access and book.”
The 111 service was planned to help people find an emergency dentist, a late-night pharmacy or an out-of-hours primary care GP. This Government scrapped that and instead pressed ahead with the botched implementation of a system that just could not cope with what it was expected to do. They were warned, but, as usual, they did not listen.
There is no doubt that the 111 service is not fit for purpose. The statistics show it, the examples given by Members today show it and, most importantly, patient testimonies show it. Indeed, the Minister herself acknowledged it in response to the right hon. Member for Mid Sussex (Nicholas Soames) in late May, when she stated:
“We recognise that the service has not been good enough and we are working closely with NHS England to ensure improvement in performance. NHS England have put a number of measures in place already.”—[Official Report, 21 May 2013; Vol. 563, c. 740W.]
I hope the Minister will outline what those measures are and what their effects have been, because the contributions we have heard today suggest they are having a negligible effect.
The implementation of the system has undoubtedly caused serious problems; indeed, in my area, NHS Direct is having to be maintained alongside the 111 service to cope with demand. The Minister must explain in detail how a botched, fragmented implementation was allowed to happen despite there being a significant pilot scheme.
I am not for a moment saying that there are not difficulties and problems in 111. We know there are, but if only the issue were as simple as solving the 111 problems. The out-of-hours service is just one of many factors. [Interruption.] I want to make some progress on this point: 111 is one factor among the failings in relation to the sort of out-of-hours service that people want. We have also had the difficulty of a long, cold winter, which has added pressures—that is something that often happens. Also, there are 1 million more people attending A and E. That is not the fault of the Government. We have not suddenly caused it. It is because of changes—
I will take interventions, but I want to make these points first.
The population is also living considerably longer. That is good and welcome, but there are many frail elderly people with complex illnesses and diseases, so they attend A and E in a way they did not previously. In addition, we suffered under the previous Government from a lack of integration between health and social care. That was one of the things that the Health and Social Care Act 2012 addressed, and will solve. It is about better integration. The hon. Member for Copeland sneers at that.
He laughs at it, Hansard will record. It is not a laughing matter at all. What I was describing is one of the achievements of the Act. I am confident it will deliver.
The Minister is making sensible points. As to manufactured indignation, if that is what it is, mine comes from the fact that I spend 30 to 40 hours a week volunteering in the NHS as a first responder, and I spent 30 hours doing so last weekend.
A big issue that creates pressure in the NHS is the lack of integration between social care and health services, and a lack of proper intermediate care facilities. We do not have the step-up, step-down facilities that we need to deal with the ageing population. That is one of the biggest problems in my area and a reason for increased pressure.
I, too, know that it does no one any favours to make out that someone forcefully and passionately giving a view based on their experience is manufacturing it. I know that that is not true of my hon. Friend, and I thank him for his valuable contribution. He is right.
No; forgive me. The most important thing, though, is that things are improving.
We on the Health Committee were provided with figures yesterday showing that referrals to A and E from NHS 111 were about half the amount of those from NHS Direct, but that there had been an increase in referrals to out-of-hours and GP services. The link between NHS 111 and pressures on A and E is perhaps not proven.
I am grateful for that intervention. I know that the university of Sheffield specifically examined the pilot and found that in most pilot areas, there was no impact. However, we also know that NHS England is monitoring the situation, reviewing the data and analysing all the different, complex problems causing pressure on A and E to ensure that we make the improvements that we want.
My right hon. Friend the Member for Thirsk and Malton—[Interruption.] Well, I am going to make her right hon. for the moment. It will not be put into Hansard, so no one will know; it is just between us. She made an important point about providing for people receiving palliative care, catheter treatment and so on. She said that perhaps they needed a different script. There is much merit in that. Again, I would hope that the commissioning services would put that aspect in the script. She asked specifically about the script. I am reliably informed that it has been written by clinicians at the highest levels, but I also know that there is concern at a senior level about the fact that it takes an average of 20 minutes to go through a prescriptive script.
There is a wider problem here. We live in an age in which it is increasingly difficult to rely on common sense. When somebody rings up and says, “My father is a retired GP. We’ve been here before, and he has all the symptoms of a urinary tract infection,” they should not be asked whether he is still breathing. A large dose of common sense would mean that that question would not be asked, nor would “Is he bleeding?” and so forth. That is the stuff of nonsense.
(11 years, 8 months ago)
Commons ChamberStaffing levels are important, but so are bed numbers. Many of the 41,000 beds lost under the previous Government were in my constituency. Consequently, we have massive pressure on beds, wards on purple alerts and very high mortality rates. Will any inspection regime include an assessment of safe bed levels?
The inspection regime will of course cover such issues as part of its inspection of whether basic standards of care are being met. Yes, of course such issues matter, but there are challenges beyond what an inspection regime can deliver which we will need to address to deal with these issues. In particular, a problem we are wrestling with at the moment is who will take responsibility for the frail elderly when they are discharged from hospital. One reason why they stay in hospital for a long time is because geriatricians are nervous about sending them back into the community. They do not think anyone will take responsibility for them and that is something we have to look at.
(11 years, 8 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
All I can tell the hon. Lady is that if I can use a defibrillator, anyone can use one. We had people come into the House to demonstrate what an AED does. I was under the illusion that it was like something out of an episode of “Casualty”: someone picks up two paddles, says, “Stand back—clear,” and applies the shock to the person through that method. It is not like that. An AED is a small computerised unit that talks someone through the process, so believe me, literally anyone can use one. That will destigmatise the use of these devices for certain people who think that if they do it wrong, they will cause further complications.
I declare an interest as a first responder who on a number of occasions has had to attempt resuscitation. Defibrillators are indeed incredibly easy to use. One of the saddest things is turning up at someone’s house and finding people just standing around, worried or frightened that if they attempt cardiopulmonary resuscitation, they will cause more damage. Actually, the training that is necessary is minimal. I therefore commend not only the e-petition, but the words of the hon. Gentleman up to now. This is something that is very simple. It is so sad to turn up two or three minutes in and find that people have not started CPR, at which point the chance of survival is so much less.
I congratulate the hon. Member for Liverpool, Walton (Steve Rotheram) and everybody who signed the e-petition on securing this debate; 100,000 signatures is an incredible amount to reach. I pay tribute to everybody who signed. It is good to have the Minister and the shadow Secretary of State here. I am happier seeing the shadow Secretary of State here than I was to see him attend a college in Goole recently. As welcome as he is, normally, perhaps he can stay here in future; that would be more beneficial. Alas.[Interruption.] That was a back-handed compliment, by the way.
I also want to pay tribute to the OK Foundation and the British Heart Foundation for the work that they do in raising awareness. It is fantastic to hear about the work that has been undertaken in Liverpool. I do not necessarily agree that where Liverpool leads, the country always follows, or indeed that Liverpool always leads, but on this occasion I pay tribute to what has been achieved on the wrong side of the Pennines.
I intervened on the hon. Member for Liverpool, Walton and talked about the work that I do with the Yorkshire ambulance service as a community first responder. I want to talk about that and how that has got me alive to the issue and really changed my views. It has made me quite passionate. Becoming a first responder has been the thing that I have been most proud of in my life. I am prouder of that than getting elected to this place. Before that, my proudest achievement was passing my driving test on the sixth or seventh occasion. Being a first responder has become the thing that I am most proud of.
I set up a scheme covering Goole, Hook and Airmyn: only three of the 75 communities that I represent, sadly. We did not have a scheme there. We had terrible ambulance response rates. I met the ambulance service and it set me a challenge to do something about it, so we set up a scheme. We have 10 volunteers. My staff in the Goole constituency office have all been trained and they provide cover during the day as first responders. In the evening, members of the community provide cover. We have all become good friends. We are all from different walks of life in the town. They cover evenings and I cover weekends, along with one of my councillors, who lives just round the corner.
I pay tribute to all the volunteers who put themselves forward for first responding in my constituency, both with Yorkshire ambulance service and in the Lincolnshire part of my constituency through LIVES, the Lincolnshire Integrated Voluntary Emergency Service. The volunteers do a fantastic job. They get no publicity for it, which perhaps we as MPs get. They deserve all credit for the lives that they save and the impact that they have. I have seen the impact in my short time doing such work. We set up the scheme about six months ago. We never expected to be as busy in our community as we have ended up being, having attended about 45 calls in our first four months, which is significant.
I want to talk about the training to prove how easy it is. We did our training as first responders over a weekend. It was two full days. The training included oxygen therapy and training for the other types of incidents that we attend. The CPR and defibrillator training took place on the first day. We practised scenarios and it was incredibly simple and easy. It is as simple as the hon. Gentleman said. The defibrillators spoke to us. The first thing they say is, “Tear open packages. Place one pad upper left.” I do not like hearing that now. It strikes fear into me, having had to use them. They talk people through the procedure and the training really is simple. I came away from that training thinking to myself, “How on earth can people not know how to do this?” It is staggering that we require people to be trained in all kinds of other things in their work environment. People have to learn the inside-out of all sorts of health and safety legislation for various jobs, but we do not teach people something as simple as starting chest compressions on somebody. As the hon. Gentleman said in his speech, people fear that they can do more harm than good, but if someone is in cardiac arrest, people can do no more harm than that.
So, we got our scheme up and running and we had our weekend of training. We do ongoing training every month. We have just had a weekend at the Hull York medical school in Hull going through various scenarios to try to enhance our skills, but that is an add-on to the basic training. I thought that we would not get many calls to begin with, but we were very busy. One of the first calls that I attended was a cardiac arrest, which, sadly, was at the furthest point of the three-mile radius that we cover. I got there first, within about six or seven minutes. Even though we had done all our training, I thought that six or seven minutes would be all right. It was a pretty terrifying drive on the way there for my first cardiac arrest.
I turned up in my first responder uniform and all of a sudden everyone was looking at me. However, the training kicks in and straight away I was doing chest compressions, getting the defibrillator up, getting the oxygen going and barking instructions at people to get what was needed from the bag. I thought, “If I can do this, anybody can.” It was the confidence gained from that weekend of training that led to my trying to resuscitate somebody. Unfortunately, it was not successful. I drove away that night, got home and thought about it. It had taken me a few minutes to get there. When I arrived, people were already there. A neighbour had tried to start CPR, but of course that was done through instructions over the telephone. The gentleman was not old and I thought to myself, “If only somebody had been there to start instantly. Why don’t we all know this?” I became passionate about it. Most of our calls tend to be for heart attacks, diabetics and strokes, which can end in a slightly more positive outcome.
The second cardiac arrest that I attended was in a nursing home. A responder from the neighbouring scheme and I were the first people on the scene. On that particular occasion, nursing home staff had not commenced CPR, for whatever reason, and I thought, “Well, why—in nursing homes?” There are so many calls—just on Saturday night, my phone went at 2.30 am about a cardiac arrest at a nursing home in Goole—and they increasingly tend to be from nursing homes. I thought, “Why do we not have a defibrillator in every nursing home?” I notice that the state of Texas passed a law in 2009 to require a defibrillator in every nursing home.
The Minister obviously cannot respond about the curriculum, although I am sure that she will pass such comments on to the relevant Minister, but she could do something about nursing homes. One of my requests is that she simply requires every nursing home, at its own expense—for heaven’s sake, most of them are private organisations—to have on site a defibrillator, which costs less than £1,000, including for the training.
I live two doors away from a nursing home in my village. As a result of reading about what we have been doing locally, the parish council is proactively trying to get a defibrillator in the nursing home for general community use. That is something that we can achieve simply and without great cost to the taxpayer. The same goes for assisted living centres or sheltered housing complexes, where we should require there to be defibrillators.
I have to say—playing a little to the gallery—that, since I started first responding, I have become such an admirer of our ambulance crews and their work. I am playing to the gallery, but of course we are not allowed to refer to people in the Public Gallery. I have seen how busy those guys are. They are constantly called out and they are called out more and more, for which they do not necessarily get credit. They are the true last emergency service: when all else fails, the ambulance service is called on. They sometimes struggle to respond to all the calls in our areas, and there is no doubt that we must do something about that. Demand on our ambulance crews for service is increasing every year, and we must follow through on that with proper resources so that we do not end up with their taking too long to get to a cardiac arrest or other emergencies.
As a result of that work and becoming quite passionate about it, I started to think about the role in schools. The hon. Member for Liverpool, Walton said that 270 young people die of sudden cardiac arrest every year. I worked in government in the United States about 10 or 12 years ago, when we put through the legislature of New Jersey a requirement for a defibrillator to be placed in every school in the state. That happened, and a several other states followed suit, but that was back in 2000, and here we are in 2013, debating this issue in the House—probably for the first time in a long while—with no requirement in this country. Frankly, that seems bonkers to me.
I talked to the East Midlands ambulance service, which covers the other part of my constituency, a few weeks ago after having seen the ITV programme about sudden cardiac arrest and life-saving skills in Norway, and we put in a bid to the local council. Just this morning, my local North Lincolnshire council considered my grant application for defibrillators, and I am told that it has approved the bid to put one in all secondary schools in the north Lincolnshire part of my constituency and in the schools in that of my hon. Friend the Member for Cleethorpes (Martin Vickers). Indeed, it will go further: the council portfolio holder rang me this afternoon to say that it will guarantee a defibrillator in every secondary school, not just those in my constituency and that of my hon. Friend, and that will happen soon.
May I pay tribute to my constituents Robert and Maggie Underwood, who lost their daughter to SADS? They have managed to raise £18,000 to put defibrillators in 15 of my schools in Redditch.
I, too, congratulate my hon. Friend’s constituents. I always think that it is a bit easier for us, as MPs, to bang the drum and to get people behind us, but it is fantastic for residents to do so and to raise such an amount of money, so I pay tribute to them as well. A lot of that is going on around the country, but frankly there needs to be more.
Our bid in north Lincolnshire was also to ask schools to filter training down to young people, as part of the deal of their accepting a defibrillator paid for from the grant, so it does not only relate to use on school sites. I hope that if there is a cardiac arrest—not that I hope for one, but if there is—a young person from north Lincolnshire with that training will be there, so that they can put their training into use, although I would prefer them not to have to do so. The Scunthorpe Telegraph, the local newspaper, rang me today to say that it is quite keen to get behind that and might want to run a campaign about it, so I shall wait to hear more. We can try to use the National Citizen Service to filter down that training.
I congratulate the hon. Gentleman on his excellent speech. He mentioned the Scunthorpe Telegraph, and does he agree that the media have a crucial role? Will he join my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) and me in praising the brilliant work done by the Liverpool Echo with the OK Foundation?
Members of Parliament are never backward in coming forward to praise their local newspapers, not least in the hope that it guarantees them a friendly quote next week, but the hon. Gentleman makes an important point. Newspapers can be part of our going out to challenge—I do not want to say “shame”—businesses. I am a Conservative and I love businesses, but businesses make profits and do so on the back of their workers, to whom they have responsibility. [Interruption.] Well, I think that I am a Conservative. Of course, I am; or just the Brigg and Goole party these days, perhaps. [Interruption.] Well, I am certainly not a Liberal Democrat—no offence to my hon. Friend the Member for Southport (John Pugh)—because my views on Europe count me out.
Newspapers have a responsibility to go to businesses and challenge them, particularly big businesses. I understand that defibrillators would be expensive for smaller ones and those employing only one or two people, but we should ask big businesses, “What are you doing for the welfare of your workers? Where are your defibrillators?” Newspapers such as the Liverpool Echo and the Scunthorpe Telegraph have an important role to play in that.
I am grateful to my hon. Friend, and I congratulate him on his excellent speech, which follows another excellent one. Does he agree that there is a good argument that we can build an Olympic legacy based on the great volunteers who took part in the games by considering whether we can use some of the skills that they helped to bring to the games, and take those skills into the issues of training people and campaigning for defibrillators, which he has identified?
Indeed. My way to address the problem is to have a multi-faceted approach. In many ways, it has to come from the bottom up. We need people in communities to say, “I will be trained and I am happy to filter down that training, and I am even happy to knock on some doors to raise some money to get defibrillators in our communities.” A lot of parish councils have money in the bank, so we should go to them as well. We need a bottom-up approach through volunteers and the Olympic legacy, as the Minister says, but there is also a role for the Government to say to nursing homes and schools, “We want and expect you to provide a defibrillator, which is relatively cheap,” and of course to say the same to businesses. Is it not true corporatism to bring all three of those elements together? As I have said, there is a role for businesses in looking after the welfare of their workers in that way.
Goole high school has a pilot this year in which everyone in year 11 has been funded to go through the National Citizen Service. I have suggested to the head teacher that, as part of the community payback for that, all those young people should be trained in CPR this summer. Therefore, 100 or 200 young people in that community in Goole will leave at the end of the summer having received training, which is 200 more advocates for the whole issue and potentially 200 more life-savers.
Although it is a good idea to provide emergency life-saving skills within the National Citizen Service, does the hon. Gentleman not agree that if we legislated for every school leaver to learn CPR, we would make a huge difference?
I would be quite happy to see that happen. We can leave it to schools to decide how to deliver such learning, but even if we cannot put it in the national curriculum, we should say to schools that they should look to offer such training as an add-on.
I was clearly going to say something about Wisconsin next, as it is written here on a note, but it has gone out of my head. Something jolly good is happening in Wisconsin, which we should look at and perhaps copy if indeed it is a good thing.
Another way to address the matter is through teacher training programmes. Again, that is in the gift of Government and is relatively inexpensive to do. Simply put, we should require teachers, as part of their teacher training, to go through a morning of CPR training.
I end my contribution where I began, by congratulating the hon. Member for Liverpool, Walton on securing the debate. I congratulate, too, all those who have taken part in the debate through the e-petition and who support this campaign. This is a matter of life and death, and a matter where not just minutes but seconds count. We all have a responsibility to do what we can to ensure that we improve the appalling rates of survival for out-of-hospital cardiac arrest in this country.
It is a pleasure to serve under your chairmanship, Mr Amess.
I congratulate my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) on securing this debate. It is a privilege to follow my hon. Friend the Member for West Lancashire (Rosie Cooper) and other Members who have made constructive contributions. Compared with some other debates that I have been involved with in recent weeks and months, the unanimity today is a refreshing change.
I pay tribute not only to my hon. Friend the Member for Liverpool, Walton and the other Members who are in Westminster Hall today, but to the people—more than 110,000 of them—who signed the online petition that was set up by the Oliver King Foundation. Indeed, I pay tribute to the King family, Jake Morrison and all those who have been instrumental in taking forward the campaign. I also thank the Minister for agreeing to meet campaigners; that is very important. It shows the public interest in and the importance of the issues that we are debating today.
As you might be able to tell from my accent, Mr Amess, I am not actually from Merseyside, Liverpool or the north-west.
Well, I am fifth-generation from that area actually, so I have a connection with it. However, I am from the north-east and I know that many colleagues from the north-east and from across the whole country are concerned and share the aims of the OK Foundation, so I hope the Minister will support the campaign to provide defibrillators in all public buildings.
My hon. Friend the Member for Liverpool, Walton referred to the protection that we enjoy here in the Palace of Westminster. I tried to find out precisely how many defibrillators there are in the Palace. There are notices about them at the end of every corridor, including my corridor, and I found that there are actually 16 defibrillators in the Palace. Somebody here obviously knows the importance of early defibrillation in the event of a cardiac arrest, and they are to be complimented for that. The general public should enjoy a similar level of protection.
This is a matter of life and death. As my hon. Friend said, an estimated 60,000 out-of-hospital cardiac arrests occur each year and, incredibly, of the 30,000 cases attended by medical professionals, fewer than one in five of the people affected receive the life-saving intervention they need following a survivable cardiac arrest. I did not realise until I looked at the numbers involved quite how mind-boggling they are. There are nearly 100,000 deaths each year in the UK due to cardiac arrest, which is more than 250 a day, making it one of the UK’s biggest killers.
Hon. Members have already mentioned the British Heart Foundation’s high-profile “Staying Alive” campaign and information film on hands-only CPR. The House will be relieved to know, Mr Amess, that I shall not attempt to sing it or repeat it, but that was a successful campaign. It is reported that in November 28 lives were saved by people who learnt how to administer CPR from the advert headed up the footballer Vinnie Jones, or were inspired by it to take further lessons and coaching, and I imagine that that number is even higher today.
I was surprised by the UK’s record on emergency life-support skills. A British Red Cross survey found that only 7% of people in the UK have first aid skills, compared with 80% of people in Scandinavian countries and a similar figure in Germany. I was surprised, because in the area where I grew up and have always lived, there was quite a strong tradition with the St John Ambulance, and so on, so I expected the figures to be higher, but perhaps it is a function of the society in which we live. That is a major omission and I hope that the Minister takes note of it.
A further survey of public support carried out by the British Heart Foundation found that 73%—almost three quarters—of schoolchildren wanted to learn how to resuscitate someone and give first aid, and more than three quarters of teachers and parents agreed that it would be a good thing to be taught in schools. I hope that the Minister will speak with her counterparts in the Department for Education and press for these life-saving first aid skills to be a core part of the national curriculum, to ensure that all young people leave school equipped with the ability to save a life. That would be really worthwhile.
We know that time matters when cardiac arrest occurs. For every minute that passes following a cardiac arrest and before CPR is administered, the chances of survival are reduced by around 10%. Although CPR can buy more time, defibrillation is the only effective treatment for cardiac arrest caused by ventricular fibrillation, where the heart quivers and stops pumping blood around the body. The British Heart Foundation has found that, for every minute that passes without defibrillation, chances of survival decrease by 14%. We have heard how CPR can improve the chances of survival. We have also heard about research that shows that applying a controlled shock within the first five minutes of collapse provides the best chance of survival. It is therefore essential that defibrillators are readily available, particularly in places where there is higher incidence of cardiac arrest or where it might be difficult for emergency services to arrive quickly.
I applaud the efforts of one of my local newspapers, The Northern Echo, which has been running the “A Chance to Live” campaign in my region, promoting the use of defibrillators in public places, particularly gymnasiums, where there is a greater risk of cardiac arrest occurring both before and after strenuous effort. I am pleased to note—we did a bit of a survey—that all the local authority and council-run gyms in the north-east have defibrillators and staff trained to use them. It has been reported, however, that 80% of private gyms do not have some form of life-saving equipment available; it does not seem to matter whether it is a small gym or one of the larger, more up-market leisure gyms. When challenged about the lack of defibrillators in their gyms, Bannatynes, headquartered in Darlington, issued a statement explaining that they did not have defibrillators because
“they are a specialist piece of medical equipment, which should only be operated by a qualified medical professional.”
I do not know if hon. Members have any contact with Duncan Bannatyne, or if he will get a copy of this debate, but having heard the comprehensive, complete and compelling case advanced by my hon. Friend, it is clear that it is not necessary to have comprehensive training to use a defibrillator. I hope that in the course of this debate we can put to bed this misconception.
As we have heard, modern defibrillators are designed to be used by untrained members of the public; they provide audio and visual instructions to the user and the machines will automatically diagnose the patient and deliver an electric shock only if it is necessary. To provide a medical opinion, as we have the Minister here, in my area in County Durham, Dr Harry Byrne, vice chairman of NHS Darlington clinical commissioning group, has described defibrillators as the
“single greatest advance in out of hospital cardiac assistance since the invention of chest compressions or CPR…You don’t have to be a trained first aider to use one. You just pull it out of the box and follow the instructions step by step. It even tells you what to do”,
as we have heard, from my hon. Friend and the hon. Member for Brigg and Goole (Andrew Percy).
A defibrillator is an essential life-saving piece of equipment and I hope defibrillators will become common, not just in schools, but in workplaces, too. Hon. Members have suggested that they should be in shopping centres and nursing homes. They should be in community buildings as well. Certainly, though, they should be in schools. I agree with my hon. Friend that they should be as common as fire extinguishers and smoke alarms. I hope that the Minister supports these measures and will be proactive in protecting the public and ensuring that everyone, no matter where they live and work, has the best chance of surviving cardiac arrest.
I congratulate my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) on securing this important debate. I also congratulate the OK Foundation, as well as all the other small charities and groups of families and friends of people who have been saved or, sadly, lost their lives, on all the work they do in campaigning and fundraising for defibrillators and for life-saving skills to be taught in schools. I also congratulate charities such as the British Heart Foundation, the Arrhythmia Alliance, the Red Cross and St John Ambulance service for campaigning on the issue.
Each year 150,000 people die in incidents where their lives could be saved if only someone knew what to do, and 30,000 people have a cardiac arrest outside hospital. Many of those people could be saved if bystanders knew what to do, if someone started CPR immediately and if there was a defibrillator available. I want to talk about the chain of survival and the importance of someone starting CPR.
With every minute that passes in a cardiac arrest the chance of survival falls by 10%. CPR increases the chance of survival and prolongs the time a person remains in a shockable condition. If a defibrillator is used to administer a shock the survival rate increases to 50%. On “Casualty” it looks as if CPR makes people suddenly awaken and sit up. Of course, it does not. CPR simply keeps blood and oxygen pumping around the body, which means that the heart can still be shocked back into a rhythm. All the time someone is not breathing, and their heart is not pumping, part of their body and brain is dying. CPR keeps people alive and keeps them going until they can be shocked and can get to hospital.
Teaching emergency life skills in schools and the community is
“a no brainer, it’s just common sense”.
Those are not my words, but the words of Dr Andy Lockey of the Resuscitation Council. He and another 124,665 people have called on the Government to put emergency life support skills in the curriculum for all schools. With just two hours a year we could make every school leaver a life-saver. Those two hours a year could save some of the 150,000 people a year who die in situations where their lives could be saved.
The country looked on in horror just over a year ago, when Fabrice Muamba was playing for Bolton Wanderers against Tottenham and suffered a cardiac arrest. Fabrice was lucky, because he had his cardiac arrest in a public place where there were trained first aiders; because the paramedics were knowledgeable enough to give him immediate CPR on the pitch, so that his brain was saved; and because the medics did not give up, but worked on him for 78 minutes until his heart restarted. Just because he was with people who knew what to do, he survived. Fabrice is campaigning for emergency life support skills to be taught in schools, and for defibrillators to be available in public places. He joined those of us who took the British Heart Foundation’s petition, which was signed by the 124,665 people, to Downing street.
My sister’s friend Malcolm McCormick was also lucky. In April last year he went to school to pick up his grandchildren, and keeled over—effectively dead, not breathing, with his heart not beating. Malcolm was lucky because one of the people waiting to collect their children was a retained firefighter, who gave him CPR; because once a month another firefighter volunteers in the school tuck shop, and it was his Friday to work, so he came out and took control of the situation; and because a defibrillator was available, and he was rushed to a specialist hospital. Malcolm left hospital three days later with very sore ribs; but he was alive, with his brain intact. Four months later he was fit enough to be a games maker at the Paralympics.
Earlier I failed to mention the role of retained firefighters. An initiative by Humberside fire and rescue service is starting this month; retained firefighters in some east Yorkshire communities will respond to the issues that the hon. Lady is outlining. Does she agree that we need a broader debate about what the emergency services do? Perhaps there is a role for members of the fire service. There are some in the fire service who will not allow vehicles with defibrillators fitted to be dispatched or used in relevant situations, although they are standing there while there are no ambulances nearby. We must address that.
I agree that we need to maximise the use of knowledge and equipment in the community. I will talk later about the consortium in Bolton, in which the agencies are working together on getting defibrillators in place, and teaching people ELS.
There are many inspiring stories of people who have saved lives, many of whom are young people. I have talked about them several times in Parliament, but I want now to mention a young woman I met a couple of weeks ago. I was honoured to meet 15-year-old Samantha Hobbs with her parents when she came for a meeting with an Education Minister, which, sadly was cancelled, but can hopefully be rescheduled. One morning last year, Samantha woke to hear her father on the telephone to the emergency services, telling them that he thought her mum was already dead. Samantha did not hesitate. Even though her mum felt cold to the touch, she started CPR. Of course, CPR is very tiring and after a few minutes she was exhausted, so she showed her father what to do and coached him to take over, although he had never had any training. Thanks to Samantha her mum survived and is alive today; she came to Parliament with her daughter. She is alive because Samantha learned life-saving skills at her swimming club. They are campaigning for all children to be taught how to save a life.
I have been working hard to get ELS included in the national curriculum. I even introduced a ten-minute rule Bill to ask the Government to do it, but they are stubbornly resisting that common-sense move; so I am trying to ensure that every young person leaving school in my constituency and throughout Bolton leaves school a life-saver. The work is being done with the North West ambulance service, Bolton Wanderers community trust, Greater Manchester fire and rescue service, Bolton council, the British Heart Foundation and the Arrhythmia Alliance. We are enabling all schools to teach ELS, providing training in the community and campaigning for defibrillators in public places. The campaign has been wonderfully supported by The Bolton News, which has been running a campaign alongside it. We are making progress, but it would be so much better if the Government would take action.
Why cannot defibrillators be made compulsory, like fire extinguishers? Far too many companies and organisations are worried about the consequences of having a defibrillator. No one has ever successfully been sued for attempting to save someone’s life. As so many hon. Members have said, a defibrillator cannot be used on a person unless they are in a shockable condition. It tells the user what to do: where to put the pads and whether a shock can be administered. Companies, businesses and community groups should be far more worried about how they would feel about someone dying, when if they had only invested in a defibrillator and someone had known what to do, they could have saved them.
Will the Minister talk to her colleagues in the Department for Education about making the teaching of ELS compulsory? Will she ensure that health authorities provide teaching of those skills to the public? Will she work with colleagues to legislate for defibrillators in public places? The Government could save 150,000 lives a year. I cannot imagine anything worse than seeing a loved one collapse, and finding out afterwards that I could have saved them if I had known what to do. I have, I hope, made sure that that will not happen to me; I have become a Heartstart tutor. However, we need to give all people the skills, confidence and tools to save lives. As a firefighter in my area said, “When someone’s heart stops, they are dead. You can’t make them any deader, but you could save their life.”
The right hon. Gentleman is absolutely spot on, because we see incredible activity across all four nations of the United Kingdom in the wake of those tragedies. Communities are pulling together, raising funds and donating defibrillators to schools and sports clubs, which brings me to my main point: leadership is now needed at national level to co-ordinate that activity and to bring clarity to the whole situation so that the public know where to find a defibrillator and how to use one. I hope I can persuade the Government to work with Opposition Front Benchers on that. There is no politics involved here; this is about saving lives where we can and doing things to make human progress in this country. Other countries are more focused than we have been, and because of that they are saving more lives.
My feeling is that provision is too random at the moment—it is happening in some places and not in others—and we need clarity on policy at a national level so that we can piggyback on all those local campaigns to make progress. I do not think there is a funding issue, because communities will find the money to put these things in the right places, but we must know where they need to go.
It is crucial to understand that, with the best will in the world, the ambulance service is often unable to make a difference for the people who sadly fall in a busy shopping centre, railway station or sports ground. Why? Because they are unable to get there within the Government target time of eight minutes, which is too late. As my hon. Friend the Member for Bolton West said, it is about that chain of survival; it is about equipping people with the knowledge and the kit at local level to start making a difference so that, when the professionals arrive, there is somebody there to save. That is what we have to do.
If we look at the statistics, 12 young people, as my hon. Friend the Member for Liverpool, Walton said, die from sudden cardiac arrest in the UK every week. We underplay that problem. Until recently, the Department of Health NHS Choices website stated that the figure was 12 young people a year. The figure was corrected after it was pointed out to the Department, but it is important that the problem is not underestimated.
The clinching fact for why we should do more is that across the world, survival rates are very variable. According to the British Heart Foundation, in this country between 2% and 12% of people who suffer a sudden cardiac arrest survive, which is way too low. Elsewhere, in Seattle, as has been said, 50% of people survive, and in Japan, a public access campaign for AEDs has resulted in an immediate increase in rates of survival with minimum neurological impairment for out-of-hospital cardiac arrests.
The evidence is absolutely clear, so what about policy? What did we do while we were in Government? We must be honest. I am not here to say that we did everything right, but we did something. On the back of the focus on heart services, we introduced the national defibrillator programme in the middle of the last decade. It made a modest amount of funds available to purchase defibrillators to give to local organisations. However, I think that a mistake was made. As the programme was wound down, responsibility was passed to ambulance services.
There are two ways of looking at that. On the one hand, ambulance services have been doing brilliant work ever since as they have taken on the responsibility to improve communities’ capacity to respond. It is fantastic to see representatives of the ambulance service here today. I have certainly been impressed by what I have seen in the north-west. The team there is working with communities across the region to build their capacity to respond. The ambulance service has done good work, but national focus on the issue was lost when responsibility was passed down to the ambulance services, and we must acknowledge that.
That brings me to the crux of what I wanted to say, particularly to the Minister. I think that, between us, we can develop a set of simple policy calls that could make a difference and save lives. I will identify three in particular. As hon. Members have said, there is a compelling case for putting emergency life skills on the national curriculum and for making time available, perhaps as part of the personal, social, health and economic education component, to provide training for all young people. No young person should leave school without knowing how to provide CPR and use a defibrillator, because it is not all about defibrillators or CPR—the two together are important. If we train young people in those skills, as my hon. Friend the Member for Bassetlaw said, they will go home and talk to others about them.
I have seen what the British Heart Foundation does in schools. The courses that it delivers for young children are outstanding. It would be easy to add such courses to the national curriculum. My children tell me all the things that they are doing in school: the things that they are learning to make in home economics, and the kings and queens that they know about. It is odd that we do not ensure that every young person in this country leaves school at 16 knowing how to save a life. What more basic skill could we give them during their school years?
On the right hon. Gentleman’s attack on kings and queens, as a former history teacher, I attach importance to learning about them. An easy way to do what he suggests without crowding the curriculum too much would be simply to require all PE teachers to have the training, so that they can disseminate it as part of PE, which is required all the way through school. It would be a simple way to teach it without crowding the curriculum.
That, again, is a good point. Clearly, one size does not fit all. Every area has different needs.
The problem with looking to the ambulance services is that they do not have the money to provide defibrillators to each of their communities. I would also question whether they necessarily know their communities all that intimately, being organisers, as they are, on large, regional scales.
We have discussed areas of responsibility outside those of the Minister’s Department, but will she undertake to look at the situation of nursing homes, particularly in Texas? Will her officials contact the health department in Texas to see what impact there has been as a result of requiring defibrillators in nursing homes? Then we can come to an evidence-based decision on the matter.
My hon. Friend’s point is, again, good and well made. I am glad that we worked out which part of the United States it was that something good could be said about in this respect. I am more than happy to take his point away, as one of the many ideas that hon. Members have suggested in this debate, and see whether we can consider in any way, be it making provision mandatory or issuing guidance to nursing homes and other institutions—[Interruption.] I think my hon. Friend the Member for Brigg and Goole said that he was going to send it to me. I will be interested in anything that ever comes across my desk. I will give it due consideration and pass it on, if necessary, to those who have responsibility for nursing homes in the Department of Health. As I said, it is a good idea.
One could argue that only a limited number of hon. Members have participated in today’s debate. We should stop here for a moment, because all the Members who have spoken have come from the standpoint of having experienced someone—normally a child—dying suddenly from a heart attack. That touches people in a raw way, because it involves a child. Mercifully, out of all the horrors and badness invariably comes something good, which is a point raised by the right hon. Member for Belfast North (Mr Dodds). Hon. Members have raised many examples of the good that has come out of the terrible and tragic loss of a young life.
I have given my reasons for why I do not believe legislation, at the present time, is the answer. I agree with the hon. Lady that a lot of the matter depends on luck. Certain areas seem to offer a better service than others because of some unfortunate tragedy that has befallen them. With the Oliver King Foundation and many other charities that we have heard about today, people have come together and raised money to install defibrillators or to ensure that school children receive the right sort of training.
We heard examples of the work of mayors. The hon. Member for Barrow and Furness (John Woodcock) talked about the work of the mayor in his constituency, and the hon. Member for West Lancashire (Rosie Cooper) spoke about the work that had been done in her constituency by the mayor. She also mentioned the death of a young man and the work that his family has done as a result to ensure that other youngsters did not suffer a similar fate, and that the things that should be in place were there.
Again on legislation, I agree with the Minister’s point that we want a mixed approach to the matter, but if we expect communities to take charge of the matter themselves, we must understand that some communities do not have the capacity to do so. They might not be able to raise money quite as easily as more middle-class and better-off areas can. Some communities might be slightly better organised because they have a parish council speaking for them. We must bear in mind that not every community will have the resources or the individuals who feel confident enough to raise money for such provision.
My hon. Friend’s point is another well made point.
I will return to where this debate started—the subject of sudden adult death syndrome. Starting with screening, often when there has been a case of a sudden cardiac arrest, many people say, “Screening will have a big impact in the future.” As the right hon. Member for Leigh will know, the UK National Screening Committee, an independent expert body that advises Ministers about all aspects of screening, assesses the evidence for screening against a set of internationally recognised criteria. No doubt that is why the right hon. Gentleman listened to and followed its advice, which is that, while screening has a potential to save lives, it is not a foolproof process. The footballer Fabrice Muamba suffered cardiac arrest, and many of us will remember what happened to him at the game. We have heard many people describe the amazing medical assistance that he was given—I cannot remember for how long he was unconscious, but it was an incredibly long time—and that young man has made a remarkable recovery. However, I am told that he had received several screening tests throughout his career.
In 2008, the UK NSC reviewed the evidence for screening for the most common cause of sudden death in those under the age of 30, hypertrophic cardiomyopathy, including looking at athletes and young people who participated in sport. A number of the cases that we have heard today involved, invariably, young men or boys who died while playing sport, notably football. The UK NSC concluded that the evidence did not support the introduction of screening. Sudden cardiac death is a complex condition and is difficult to detect through screening; there is no single test that can detect all the conditions, nor is it possible to say which abnormalities will lead to sudden cardiac death. However, in line with its three-yearly review policy, the UK NSC is again reviewing the evidence. This time the review will go further than only looking at the evidence for screening for HCM and will cover screening for the major causes of sudden cardiac death in young people between the ages of 12 and 39. The review will take into account the most up-to-date international evidence, including evidence from Italy, where screening is currently offered to athletes between the ages of 12 and 35.
There will be an opportunity to participate in the review process later this year, when a copy of the latest review will be open for public consultation on the UK NSC’s website. No doubt, a number of the organisations and charities that we have heard about today will take part in that consultation. I am told that although screening is not routinely available in England, work to prevent premature death from cardiovascular disease is a priority, as it should be.
On 5 March, the cardiovascular disease outcomes strategy—not exactly words that trip off the tongue—was published. It sets out a range of actions to reduce premature mortality for those with, or at risk of, cardiovascular disease. The NHS Commissioning Board will work with the Resuscitation Council, the British Heart Foundation and others to promote the site mapping and registration of defibrillators, and to look at ways of increasing the numbers trained in using them. I pay tribute to the foundation, which a number of hon. Members have mentioned, and rightly so, as we are all grateful for its work in, for example, placing defibrillators in Liverpool primary schools. That is, no doubt, because of the outstanding work of the Oliver King Foundation.
Ambulance trusts have had responsibility for the provision of defibrillators since 2005, and in my view they are best placed to know what is needed in their local area. However, it is important to recognise that defibrillators help only in a minority of cases. The majority of out-of-hospital heart attacks—up to 80%—happen in the home. Bystander CPR doubles survival rates, but it is only attempted in 20% to 30% of cases. It is clear that although defibrillators play an important part, we have to bear in mind, as I said, that 80% of heart attacks, if they do not happen in hospital, happen at home, and I absolutely concede that there is a real need for an increase in the amount of people trained in CPR, because we know that that also plays a hugely important part in ensuring that people who have a heart attack survive it.
When there is a sudden cardiac death, we need to take action to ensure that potentially affected family members are identified and offered counselling and testing to see if they are also at risk. We know that that does not always happen. There are continuing discussions with the chief coroner for England to determine how coroners’ services might help in the identification of potentially affected family members, so that more lives can be saved. The national clinical director for heart disease, Professor Gray, will work with all relevant stakeholders to develop and spread good practice around sudden cardiac death.
In conclusion, I will wait to see the latest recommendation from the UK NSC, following its latest review of evidence. The national clinical director for heart disease will continue to promote good practice and awareness around sudden cardiac death. However, as I have said before—forgive me for repeating myself—I will ensure that I speak to the relevant Minister at the Department for Education about all the arguments that have been advanced today for training in CPR and life-saving techniques to be part of the national curriculum. It is my understanding that that particular part of it is under review, and I will impress on him or her how strongly Members have spoken today.
Again, I thank everybody, especially those who signed the petition, for bringing the debate into this place and, effectively, for shining a spotlight on the matter. I hope that hon. Members will take the issue to their local press, as I am sure they will, and that the national press might also look at it. It is absolutely right that the more we ventilate it, the better the situation will be.
(11 years, 9 months ago)
Commons ChamberThese proposals will go some way to addressing that problem. First, children who reach adulthood— the age of 18—with care costs will continue to receive the support they need without any qualification at all. Adults who become disabled during their working life will have a cap, but it will be a lower one. So we will be able to offer very important support to both those groups.
I welcome this statement as it moves the system on from where it is today. However, for a lot of communities the social care costs are so much more expensive, particularly in rural areas with very elderly populations, and they are more likely to hit that cap more quickly. So can my right hon. Friend assure us that everything will be done to ensure that the cost of care in these more expensive areas is brought down to something more in line with the rest of the country?
(11 years, 10 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I will address that later, but my hon. Friend is right to make that point, because it is believed that more people suffer from PSP than from MND, despite the fact that the latter disease is much more commonly known in general society.
PSP and CBD are similar diseases, and PSP is often used as shorthand for both conditions. In progressive supranuclear palsy, progressive means that it gets steadily worse over time; supranuclear means that it damages parts of the brain above the pea-sized nuclei that control eye movement; and palsy means that it causes weakness. Members may never have come across PSP before, but, sadly, it takes many lives.
PSP is caused by the progressive death of nerve cells in the brain, leading to difficulty with balance, movement, vision, speech and swallowing. Over time, PSP can rob people of the ability to walk, talk, feed themselves and communicate effectively. The average life expectancy is seven years from the point of diagnosis. Those who are diagnosed with PSP suffer severe and unpredictable impairments that have an enormous impact on the individual and their family. PSP is a dreadful disease.
I am pleased that since 2010, having written several times to the Department of Health, there is now better recording of PSP on death certificates, giving a clearer indication of the number of sufferers. Our attention, however, must now turn to diagnosis. Statistics show that some 4,000 people are living with PSP in the UK, but because diagnosis is still so uncertain, neurologists believe the figure could be as high as 10,000. Astonishingly, as my hon. Friend mentioned, there may be more PSP sufferers than sufferers of MND in the UK today.
I congratulate my hon. Friend on securing this debate. She has mentioned the relatively small number of people living with PSP, but is not part of the problem that many health care and social care professionals do not fully understand the condition?
(11 years, 10 months ago)
Commons ChamberNo, no. Order. I must say to the Minister that when a retraction is required, that is what is required and that is all that is required. We move on.
3. What representations he has received from clinicians in Yorkshire and the Humber on the decision to close the children’s heart surgery unit at Leeds children’s hospital.
I know that some are disappointed at the decision by the Joint Committee of Primary Care Trusts and want to see children’s congenital heart surgery continue at their local hospitals. However, the Safe and Sustainable review was an NHS review, independent of Government. Under the circumstances, and given that legal proceedings and a review by the independent reconfiguration panel are under way, my hon. Friend will understand that it is not appropriate for me to comment further.
One hundred and seventy clinicians from across Yorkshire and northern Lincolnshire have written to express their dismay at the decision, stating that for time-critical transfers it
“exposes a number of children to the risk of death,”
largely because it will require transfers to Newcastle, where services are not co-located. Does that not prove that the decision does not enjoy clinical support in Yorkshire and north Lincolnshire and that it is simply not true that this has been a clinically led review?
I have seen the letter to which my hon. Friend refers and I understand that these are extremely complex issues. Let me reassure him that when I take my final decision, it will be on a clinically led basis. I will do that when I have received the IRP’s report, which I am due to receive by 28 March.
(12 years ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to take part in a debate under your chairmanship again, Mr Hollobone. I, too, congratulate my hon. Friend the Member for Pudsey (Stuart Andrew). This is something of an action replay, not only for you, Mr Hollobone—you were in the Chair last week for the debate on Glenfield hospital in Leicester—but for the Minister. I apologise to her that some of the points that I am going to press her on now are identical to those that I raised last week. One is the point about distance.
It is noticeable that three out of the four representatives from northern Lincolnshire are here to take part in the debate. We are the remotest part of the area served by the hospital. That does not just present problems for people visiting. As we have heard in previous debates and meetings, getting babies to a unit has actually made the difference between life and death, and that cannot be ignored. In the Cleethorpes area, there are a large number of parents and grandparents whose children have received treatment here. We held a public meeting in July and the strength of opinion was evident.
In last week’s debate on the Leicester unit I was slightly disappointed by the Minister’s response. I appreciate that she is walking a tightrope, but she is noted for being an independent voice. She showed signs of being sucked into the departmental bureaucratic nonsense that we often hear, but I am sure she will rectify that in half an hour’s time. Commenting in her reply on something that I said, she made the perfectly valid point that in cases of the kind that we are considering we want
“fewer, but much bigger units.”—[Official Report, 22 October 2012; Vol. 551, c. 186WH.]
That is the opinion of some experts, but equally, of course, other experts disagree. If we are to be ruled by expert opinion, there are two possibilities. One is that we pack up and go home, because we are superfluous. The other is that because experts always disagree, someone democratically accountable is needed to arbitrate between them. My hon. Friend the Member for Brigg and Goole (Andrew Percy) wishes to intervene, as usual.
I want to intervene to defend the Minister. My hon. Friend is entirely right about the geographical problems in our area; but even if we accept the argument that we need bigger units, is not the core issue the fact that the population—the patient base—is in our region, not in the north-east? If we must go along this line—let us assume that we must—we should move the doctors to where the patients are, not the other way around.
As usual, my hon. Friend and neighbour is correct. Because of the remoteness and so on, the assumption that all patients in northern Lincolnshire will transfer to Newcastle will simply not be borne out. They will choose alternatives and I suggest that most will gravitate south. Therefore the Newcastle target of 403 will not be achieved.
There are expert opinions on both sides of the argument. The significant point is that the parents and grandparents of the children who receive the treatment are not convinced about the alternatives, because they have seen surgeons and other experts in Leeds performing miracles on their children with modern medical technology. That is their doubt: they do not have confidence in the alternatives when they have seen the Leeds centre of excellence in action.
My hon. Friend the Member for Pudsey stole a line from me because I too was going to quote the point that my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) made in last week’s debate. I will take another line from his speech:
“The Secretary of State has the levers of power in this question and he must pull them—he must exercise them”.—[Official Report, 22 October 2012; Vol. 551, c. 188WH.]
That is what we expect. We do not want the question shuffled off to a panel of experts, with automatic acceptance of what they say. Different experts come up with different decisions.
Time is pressing. In Leeds we have a centre of excellence. It deserves our support, and already has the support of those we represent. I am sure that the Minister and the Secretary of State would not want to be responsible for destroying it.