Defibrillators: Public Access

Abena Oppong-Asare Excerpts

Tuesday 4th July 2023 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

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.

[Virginia Crosbie (Ynys Môn) (Con)]

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?

[Abena Oppong-Asare]

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.

[Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)]

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.

[Abena Oppong-Asare]

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.

[Jim Shannon (Strangford) (DUP)]

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.

[Abena Oppong-Asare]

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 and the NHS. I pay tribute to Resuscitation Council UK and St John Ambulance 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?

[Jim Shannon]

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?

--- Later in debate ---

[Abena Oppong-Asare]

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.

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[The Minister for Health and Secondary Care (Will Quince)]

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.

[Abena Oppong-Asare]

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?

[Will Quince]

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.

[Abena Oppong-Asare]

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?

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[Abena Oppong-Asare]

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.

[Will Quince]

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.

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[Abena Oppong-Asare]

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—

[Will Quince]

indicated assent.

[Abena Oppong-Asare]

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.

Resolved,

That this House has considered public access to defibrillators.