Paediatric First Aid

Ann Coffey Excerpts

Monday 15th December 2014 Westminster Hall

[Mark Hunter]

I welcome the right hon. Gentleman’s intervention. The Millie’s Trust campaign has done an awful lot of work in this regard and is satisfied, I think, as most hon. Members who have considered the issue would be, that this can be done at no great cost. We hope that the Minister will make it clear that the Government are serious about their intention to address the subject. As other hon. Members have already said, with the benefit of hindsight, there is a loophole in the regulation that needs to be addressed urgently.

[Ann Coffey (Stockport) (Lab)]

I congratulate the hon. Gentleman on securing this very important debate and congratulate Millie’s Trust on its campaigning work on this issue. Was any member of staff on the premises that day trained in paediatric first aid? If there was, what happened?

[Mark Hunter]

Yes, there was. I mentioned just a few moments ago that, of the two paediatric first-aiders who were at the school at the time, one chose not to be involved, by going to look after the other children in the nursery, while the second member of staff with a qualification did carry out the back slaps, but then left the baby and went via the nursery grounds on to the main road to wait for the ambulance to arrive. So the child was actually left without the continual support of somebody qualified in paediatric first aid, which of course the guidelines clearly stipulate.

[Ann Coffey]

Would not the member of staff trained in paediatric first aid have appreciated the seriousness of the situation?

[Mark Hunter]

The only answer I can give is that one would like to think so. I think any parent would have assumed that to be the case. However, I will come on to that and to what the coroner said in this regard as well.

--- Later in debate ---

[Mr Gyimah]

I thank the hon. Gentleman for that important intervention. I know that he has a lot of experience in these matters, which brings me on to one of the points that has been raised in this debate. It has been said that the regulations have been watered down since September. That is simply not the case. We have strengthened the regulations by saying that providers must take account, as I have said, of the number of children, the staff and the layout. Although we have removed the local authority approval, we replaced that with a requirement to meet the course content for British Red Cross and St John Ambulance, so based on good practice of those with expertise.

[Ann Coffey]

The Minister seems to be saying that he is not prepared to ensure that all staff working in a nursery have training in paediatric first aid. Two staff in this nursery were trained. Does he think that the nursery had trained enough staff in paediatric first aid? If he does not think that is so, why will he not bring in regulations to ensure that the number of paediatric staff that he thinks are suitable to be trained in a nursery are trained?

[Mr Gyimah]

That is a very good intervention. I am developing my case, but as I said at the outset, it is obvious that we need two things. We need enough staff trained in paediatric first aid, but also, importantly, we need to ensure that they are confident and capable of acting in an emergency, rather than panicking and not dealing with it. We do not want it to be the case in an emergency that there are a number of people who have a first aid certificate but it is not clear who is the point person who is capable and competent to deal with that kind of situation.

[Ann Coffey]

As the Minister will be aware, the campaign that Millie’s Trust is running is aimed at ensuring that every member of staff in a nursery is trained in paediatric first aid, because it believes, rightly, that that will protect children in all situations. The Minister has not answered my question; I have heard a lot of good intentions from him, but I return to the question that I asked him. If he does not think that it was sufficient, in the nursery in this case, to have only two members of staff trained in paediatric first aid, why will he not regulate to ensure that all members of staff working in a nursery are trained in paediatric first aid?

[Mr Gyimah]

The hon. Lady makes a very passionate point. As I said, I will develop my case further. What I am saying is that the requirement of the EYFS means that nurseries must think carefully about whether they have enough trained staff. That is about more than ensuring that they have enough trained staff to cover leave or staff sickness. We know that, in some instances, the speed at which a trained first-aider can attend to a child who needs help can be crucial in ensuring a good outcome for the child. We are already seeing how the new requirement is being delivered on by many nurseries, which are taking into account staff turnover, holidays and sickness.

The hon. Member for Cheadle mentioned the House of Commons nursery, which advertises that all its staff have first aid certificates. In fact, many nurseries continue to do that as a point of differentiation between them and other nurseries, so I would say that the strengthening of the EYFS is having an effect on the market. We are putting lots of other things in place to strengthen that even further.

--- Later in debate ---

[Mr Gyimah]

I thank the hon. Gentleman for that intervention. He used Ireland as an example in his speech and, in the light of the intervention that he has made, I will refer to the Irish example. The Irish are actually moving towards the framework that we have in this country with the early years foundation stage. In response to a parliamentary question, they have said explicitly:

“The final draft will include a requirement that early years services have a person trained in first aid for children available at all times.”

The solution that we are adopting, which can best be described as one that allows nurseries to use their professional judgment in appointing the right staff to this vital role, is not as anomalous as the hon. Gentleman describes. I have said before and I will say again that not everyone who works in a nursery will be ideally suited to being a first-aider. Nurseries should ensure that their first-aiders have the confidence and the reliability to cope with an emergency, and I believe that the EYFS achieves that. At this stage, I do not feel that we need to amend those requirements further. I do, however, want to remain fully informed of the effects that those changes are having on the ground, and I know that the Department for Education plans to undertake a review of them next year.

I also know that the Thompsons were concerned that some nurseries might not know how to interpret the strengthened requirements. I am pleased that in direct response to the Millie’s Trust campaign, the Department for Education will issue in February new guidance for nurseries, setting out clearly what the expectations are and how nurseries can deliver on them effectively. I have asked the National Day Nurseries Association to help with that guidance. It will be identifying a number of nurseries delivering exemplary paediatric first aid practices, including methods used to ensure sufficiency of first aid-qualified staff, and providing case studies and videos to ensure that nurseries are absolutely clear on what the PFA requirements mean and how they should work in practice.

[Ann Coffey]

Despite what the Minister is saying, we could still have a situation in which a nursery, under his example, had decided that having two staff trained in paediatric first aid was sufficient—and a child died. That clearly shows that the way to protect children is not to rely on nurseries exercising their professional judgment, but to make it mandatory that all staff be trained in paediatric first aid. Otherwise, at some time in the future, there will be another inquest because a nursery has exercised its professional judgment. Sadly, for the child who might die in the future, that is not enough. Surely the Minister can accept that the way forward has to be making it mandatory for all staff in nurseries to have first aid training. We cannot leave this matter just to the professional judgment of individual nurseries.

[Mr Gyimah]

The hon. Lady makes another very passionate intervention. Of course we want to ensure that the requirements in the EYFS are being delivered on in every nursery. As she rightly points out, we do not want just to leave that to the nursery’s professional judgment on its own. We should remember that Ofsted regulates and inspects all early years provision. Before a nursery can open, Ofsted checks that it meets all the registration requirements, including those for first aid. It also inspects all nurseries on how they meet the EYFS requirements, including those for paediatric first aid.

If a nursery fails to meet the requirements on first aid, that will impact on Ofsted’s inspection judgment; as anyone who has looked at the nursery market will know, nurseries crave a good judgment from Ofsted because it is a point of differentiation in the market. Ofsted’s judgment is therefore really important. If the nursery does not meet the requirements on first aid, Ofsted will respond with appropriate steps. That may include giving the nursery a short time to meet the requirements. Where necessary, Ofsted can take enforcement action.

[Mr Graham Brady in the Chair]

To ensure we have consistency of practice in the sector, I would like to hear from professional bodies and training providers about how they support nurseries in providing paediatric first aid. I would be delighted to discuss the guidance further when I meet Mr and Mrs Thompson later today. The guidance will be published next year, and I very much want to have their input and involvement.