Paediatric First Aid

Debate between Barry Sheerman and Mark Hunter

Monday 15th December 2014 Westminster Hall

[Mark Hunter]

I thank the hon. Gentleman for his contribution and, yes, I totally agree. As the previous intervention by the hon. Member for Stoke-on-Trent South (Robert Flello) also suggested, most parents—I am a parent myself, although my children are now grown up—would assume when they are taking their children to a nursery that has all the relevant certification and regulation that the staff there will be adequately trained, and I intend to emphasise that point later.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I used to chair the Children, Schools and Families Committee and I remember pushing Ofsted on this issue; I also represent Huddersfield where the National Day Nurseries Association is based. This case has been a wake-up call to everyone that paediatric care in an emergency is totally different from first aid and needs specific training. I hope that this positive intervention from parents who are grieving—they are being positive and doing something about this issue—is an example to all of us to make these changes quickly.

[Mark Hunter]

I thank the hon. Gentleman for his intervention. Again, I could not agree more. I think that everybody, once they have focused on the issue, starts to appreciate that there is a significant difference between having a general qualification in first aid and having a qualification in paediatric first aid, which by the very nature of the fact that it involves dealing with small children—in this case, Millie was only nine months old—is rather more specialist. However, parents would naturally assume—I think we all would—that if they are placing their child in a nursery, the nursery would be covered.

The hon. Gentleman is also right to say that tribute must be paid to the Thompsons; after such a terribly tragic experience, they have made something positive through Millie’s Trust, which is creating a legacy in Millie’s memory. I will say more about that legacy later.

I will go back to the point I was making about the CCTV coverage. Millie’s parents have stated that it was obvious from that footage that when Millie was being taken out to the ambulance she was “like a rag doll” and they believe that at that point she should have been receiving CPR.

--- Later in debate ---

[Mr Sheerman]

The hon. Gentleman is absolutely right about regulation, but regulation will not do everything—it never will. What I discern in the tragic circumstances of Millie’s death is panic. I believe that people were running around and did not know what to do. I am sure that Millie’s parents, being so passionate, have already thought of this, but what we need are not Baker days, but Millie’s days, where every three months there is training for all the staff. That training will trickle down fast if the culture is changed, and then there will not be the panic that we saw.

[Mark Hunter]

The hon. Gentleman is absolutely right. He was one of the Members who referred to the rising number of children in nursery schools, which is why this debate is particularly pertinent and topical. More and more people are looking to avail themselves of the opportunity to place their children in nurseries. The Department for Education’s child care and early years providers survey in 2013, which was published in September, revealed that the number of registered places in full day care settings rose by 10% between 2011 and 2013. Due to the introduction of funded provision for disadvantaged two-years-olds, there was a whacking 72% increase between 2011 and 2013 in the number of two-year-olds attending sessional settings in the 30% most deprived areas. This debate is on a huge issue that potentially affects an awful lot of people.

As demand increases, supply rises to meet that demand. As new nursery places are provided, we have a duty to ensure that all children are safe and that all staff are well trained. None of us here will need reminding that children younger than one are extremely vulnerable and need constant care and attention. In the rush for nursery places and with the subsequent waiting lists, I firmly believe that parents are making an assumption that all nursery staff are adequately trained in how to provide the appropriate paediatric first aid, but we now know that that is sadly not always the case.

As an aside, hon. Members may be interested to know that I recently inquired about the provision of training here in Westminster, at Parliament’s nursery. The answer is that all relevant staff are trained in paediatric first aid. If it is good enough for the children of Members and House staff, it ought to be good enough for every child attending nursery anywhere in the country.

--- Later in debate ---

[Mark Hunter]

I thank the hon. Gentleman for his contribution. He is quite right. As I progress through my speech, I will be discussing the experience in Ireland and elsewhere. The Irish Government are indeed making moves towards ensuring that such regulations are in place. That is credit to the Thompsons, who, at the request of the Irish Government, have had two or three meetings with officials over there to see how that might best be done.

Millie’s parents have taken it upon themselves to use the success of the charity, combined with the recommendations of Mr Pollard, to start an awareness campaign about the current legislation. I turn to what the Thompsons and their campaign seek to achieve. The first thing to say is that they do not stand alone. Thousands of people from my Cheadle constituency, from Stockport, from Greater Manchester and from all around the UK have rallied to their side to sign their e-petition, which now has more than 102,000 signatures. For the benefit of hon. Members, I shall read out the petition:

“Following the death of Millie Thompson and the coroner’s suggestion in December 2013 that ALL nursery nurses should be trained, Millie’s parents are now campaigning to have it made law that everyone working in a nursery MUST be trained in Paediatric First Aid.

Please support and sign this petition in memory of Millie and for the future safety of your children.”

The campaign’s objectives are simple and straightforward, and I do not think that anyone here would demur from the idea that such important issues need addressing now.

Regarding the awareness campaign, it has become extremely apparent to Millie’s Trust that the majority of people, including parents and child care workers, do not know about the current legislation—just as Millie’s parents did not know about it until this tragedy struck them. Most parents presume that when they put their child in the care of a nursery, they are in the safest possible place. In fact, if disaster strikes in a situation such as Millie’s, the reality is that many staff would not know how to help a child who was choking, struggling to breathe or needing CPR. Is that really protecting our children as they should be protected? Is that really what parents should expect when they leave a child in someone’s care, often when paying high costs for the privilege?

Health and safety is up to date in every other aspect in the UK, so why has the simplest safety for children been forgotten about? Why has the legislation been allowed to fall so far behind modern times? If legislation was not there to be changed, we would still be placing children in cars without child seats and we would not be wearing seatbelts. It is time that this legislation was brought into the 21st century.

In June, the Thompsons and I met the Minister then responsible for this area, the Under-Secretary of State for Education, my hon. Friend for Crewe and Nantwich (Mr Timpson). We had a helpful meeting. The Minister listened to the Thompsons’ case and told us about the new requirements in the statutory framework that came into force in September. The Thompsons and I want the requirements to go further and we look forward to meeting the Minister who will reply today at the conclusion of the debate. I should report to hon. Members that the Minister has indicated his willingness so to do.

I am struggling to understand the reticence about moving to a requirement for all nursery staff to be trained in paediatric first aid. Under the Thompsons, Millie’s Trust has been a revelation, providing paediatric first aid training as cheaply as possible and making it available to people whatever their financial situation. The Thompsons do not want any other parent to go through the tragedy that befell them. I sincerely hope that I will not do them a disservice by saying that if they can set up a charity and begin providing the necessary training to thousands so rapidly, why can the Government not do the same, or at least make it a legal requirement?

In England, there is no mandatory requirement for anyone on a child care course to achieve a qualification in a paediatric first aid course, whether a national vocational qualification or an award from the Council for Awards in Care, Health and Education. In the National Nursery Examination Board course that child carers took during the 1990s, first aid was a requirement. When the course became an NVQ or a CACHE award, that requirement was taken out. Will the Minister address that concern as well? At the meeting with the then Minister, my hon. Friend the Member for Crewe and Nantwich, the Thompsons asked him who made the decision to remove the first aid part of the course and why—a fairly simple and straightforward question. The Minister could not give an answer off the top of his head, and Mr and Mrs Thompson were told that his Department would research the matter and contact them with the findings. It saddens me to report that some six months later they are still waiting for an answer to that simple and straightforward question.

We are not asking the Government to fund the courses for nursery establishments. The majority of nurseries are private and are run as a business, for profit. We simply want the regulations changed to make it clear that, as a business, nurseries have to build paediatric first aid training for their staff into their annual business costs.

I want to touch briefly on precedents elsewhere. For example, in Australia the legislation includes regulation 136(3):

“The approved provider of a family day care service must ensure that each family day care educator and family day care educator assistant engaged by or registered with the service—

(a) holds a current approved first aid qualification; and

(b) has undertaken current approved anaphylaxis management training; and

(c) has undertaken current approved emergency asthma management training.”

Each family day care educator and educator assistant must hold all three qualifications.

[Mr Sheerman]

Does that cover childminders?

[Mark Hunter]

The hon. Gentleman asks his question from a sedentary position, but I believe so.

[Mr Sheerman]

I am sorry. A lot of children in this country are with childminders in small groups.

[Mark Hunter]

I am sure that we can check that out afterwards. I am happy to get back to the hon. Gentleman on that.

In Minnesota, in the United States, in June 2010 at a child care centre a young girl called Hannah Kozita, aged only four, passed away after choking on a grape. Within a year, the state had seen fit to pass what is commonly referred to as Hannah’s law. One year after that tragedy, therefore, that particular state had introduced a new law including a new requirement from May 2011 for all teachers and assistant teachers in child care centres to have CPR training, including, specifically, CPR for children and infants. The law also required at least one trained staff member to be present whenever a child was on a school trip, and for training to be completed within 90 days of the law being passed. What is good enough for Minnesota, ought to be good enough for us in the UK.

The hon. Member for Mansfield (Sir Alan Meale) referred earlier to circumstances in Ireland. The Thompsons have been warmly received in the Republic of Ireland. They have made a number of visits there, at the request of the Irish Government, to talk about what ought to be done. Earlier this month, Millie’s Trust was invited to Ireland by Denis Naughten, TD, the Member for the Roscommon, South Leitrim constituency, following an earlier visit to Ireland in April. During their most recent visit, the Thompsons received vital support from Senator Jillian van Turnhout, who is also a successful children’s rights activist.

Mr and Mrs Thompson presented to TDs and Senators in Leinster house in Dublin to make them aware of the state of existing legislation. The Thompsons met with an extremely positive reaction. The TDs and Senators even received a mini-training session, which they all accepted was valuable knowledge, despite the small amount of time available. Following the presentation, a meeting was set up with Ireland’s Minister for Children, Dr James Reilly. I am pleased to report that the outcome of that meeting was also extremely positive. Dr Reilly was surprised to hear how Millie had received only “a few back slaps”. He went on to offer his own experience of watching a valuable member of his staff freezing when having to deal with working with a child in an injection scenario, even though she was extremely competent when dealing with adults. That goes back to the point made earlier by my hon. Friend the Member for Truro and Falmouth (Sarah Newton) about the understandable reaction of some to panic in such distressing circumstances.

Dr Reilly’s Department has since been in touch with Denis Naughten, TD, to ask Millie’s Trust to provide research information on legislation in other countries to see how it was worded when the law was updated. That Department has no problem with encompassing what Millie’s Trust is seeking to have done. That is extremely positive support as a consequence of the awareness that Millie’s Trust has created not only in the UK, but further afield.

In conclusion, I will revisit one or two key aspects of what I have said. The passing of Millie Thompson in a local nursery school was a tragic accident. The circumstances, choking, can happen to any infant at any mealtime in any child care provider or nursery school within the UK, or even at home. We can do nothing about such instances, but we can ensure that those responsible for responding are as well trained as possible.

The requirement for only one member of staff to be trained in paediatric first aid is simply not sufficient; it does not allow for illness, for large numbers of children or for the trained member of staff panicking when faced with a genuine emergency. My contention and that of the Thompsons and everyone behind Millie’s Trust is that the majority of parents assume that most pre-school staff will have paediatric first aid training. The best response to that mistake is to ensure that all staff are adequately trained.

The number of children in nursery schools is going up. We must ensure that they are all safe, not only the ones who go to the most diligent child care providers. More than 100,000 people have signed the Thompsons’ e-petition calling for the Government to introduce universal paediatric first aid training. Parents throughout the country want to see that change implemented. In Australia, in the state of Minnesota and, as looks increasingly likely, in the Republic of Ireland, the requirement for nursery staff to have paediatric first aid training is being implemented easily and straightforwardly. The UK must follow suit.

The last line of the Thompsons’ e-petition reads:

“Please support and sign this petition in memory of Millie and for the future safety of your children.”

That last part sums up our hope for the campaign in the future. It is not about concerns to do with new red tape, additional bureaucracy or even cost; it is about the future safety of all UK children, and it is about doing our utmost to ensure that a tragedy such as Millie’s death is never, I hope, repeated.