Paediatric First Aid

Bob Russell Excerpts

Monday 15th December 2014 Westminster Hall

[Andrew Stephenson (Pendle) (Con)]

I congratulate my hon. Friend on securing this important debate, and congratulate Millie’s Trust on highlighting awareness of this issue. I met a member of the family at Little Blossoms nursery in Barrowford in my constituency at a fund-raiser for Millie’s Trust. I echo what my right hon. Friend the Member for North Somerset (Dr Fox) has said. When I was talking to people and raising money for Millie’s Trust, it was providing people with the free pocket face shields that can be put on a key ring. Those of us who are qualified and trained in delivering CPR always have a face shield on us in case we come across a choking incident that has developed into something where CPR needs to be given.

[Sir Bob Russell (Colchester) (LD)]

rose—

[Mark Hunter]

I give way to the chair of the all-party group on first aid.

[Sir Bob Russell]

I am grateful to my hon. Friend for securing this debate and for the manner in which he has spoken. I follow on from the previous two interventions. Sadly, I am a parent who has walked this way, albeit at a different age and in different circumstances. We need to reinforce the need for first aid right across society. In each occupation and discipline, account needs to be taken of the specialist medical needs. First aid in schools, which I have been banging on about ever since I became a Member of Parliament, needs to be brought in, but the specialist needs of occupations need to be bolted on to that.

[Mark Hunter]

My hon. Friend’s contribution was, as ever, clear and concise. It gave a clear indication of his experience personally and as the chair of the all-party group on first aid.

To move on for a moment to the current guidelines, the Department for Education published its new statutory framework for the early years foundation stage in March. It became effective in September. Paragraph 3.25 of section 3, which is on the safeguarding and welfare requirements of early years providers, states:

“At least one person who has a current paediatric first aid certificate must be on the premises and available at all times when children are present, and must accompany children on outings. Childminders, and any assistant who might be in sole charge of the children for any period of time, must hold a current paediatric first aid certificate. Paediatric first aid training must be relevant for workers caring for young children and where relevant, babies. Providers should take into account the number of children, staff and layout of premises to ensure that a paediatric first aider is able to respond to emergencies quickly.”

What the Thompsons, Millie’s Trust supporters, I and countless other Members are asking is: why stop at one person? Does that not leave a nursery open to the possibility of another such tragedy? What happens if the first-aider is off ill, called away or panics?

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[Mark Hunter]

I thank the hon. Gentleman for his intervention. I am sure that everyone involved in the Millie’s Trust campaign will be heartened by the interest shown by hon. Members from right across the House, including the hon. Gentleman.

During the inquest into Millie Thompson’s death in December 2013, the coroner, John Pollard, said:

“It is of national importance that the legislation surrounding nurseries regarding paediatric first aid is reviewed.”

He also recommended that the North West Ambulance Service review some of its policies, including what paediatric equipment each ambulance should carry. I am pleased to report that, since the inquest, it has successfully carried out that review. The coroner has said that the issue is of national importance and called for the policies around paediatric first aid treatment in nurseries to be reviewed, so I hope that the Minister will take that on board.

The North West Ambulance Service has gone further by introducing a minimum requirement list of paediatric equipment that every ambulance must now carry. The service’s urgent review and subsequent changes have ensured that any errors made in how it reacted to the 999 call regarding Millie Thompson will not be repeated. It has taken seriously what the coroner advised, and Millie’s death has had a positive outcome that will help other children in future. We acknowledge that the Department for Education deals with a wider remit than that of the North West Ambulance Service, but it is disappointing that we have seen action from the ambulance service on the coroner’s recommendations, but none as yet—although we live in hope—from the Government.

Following Millie’s tragic passing, the Thompsons decided to set up a charity to provide paediatric first aid training to anyone who wants to learn. They have successfully built what is now a national charity in just two years. It provides free training to parents and hugely discounted qualifications to anyone who needs paediatric first aid training, which is what Ofsted requests. Over the past two years, the charity has trained about 7,000 people, many of whom are nursery nurses. Millie’s Trust is a registered centre through Qualsafe, which is an Ofqual-recognised awarding body organisation.

[Sir Bob Russell]

I am grateful to my hon. Friend for allowing me to speak for a second time and for making that point. Millie’s Trust is a bona fide, regulated, registered charity. Did the coroner make any comment about the training competence of whoever trained the first aiders? I was alarmed when my hon. Friend said earlier that unregulated people may be out there providing first aid training; they may not be competent to do the job that they tell people they are able to do.

[Mark Hunter]

The coroner made a wide-ranging series of points in his response. I do not have his report to hand, but I am happy to ensure that my hon. Friend, as the chair of the all-party parliamentary group on first aid, gets to see a copy. It is fair to say that the coroner addressed the wider concerns and the relevance to any future measures that may need to be taken.

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[Sir Bob Russell (Colchester) (LD)]

I will be brief, because my hon. Friend the Member for Cheadle (Mark Hunter) has presented his case comprehensively; the interventions he took and his responses to them have dealt with virtually every aspect of the debate.

I will address the wider need for first aid. I was shocked to hear that the element of first aid required under the previous regulations for child care was withdrawn. We need an explanation of why, bearing in mind that many of us have been pushing for first aid to be made part of the national curriculum. I brought forward a Bill in the previous Parliament on that issue, and have raised it at regular intervals at Education questions; most recently, I raised it with the Secretary of State for Health when he made a statement on greater investment in the NHS a few weeks ago. A population trained in first aid would bring massive financial savings, and would save several thousand lives a year—think of those in need of attention after a heart attack or a road crash.

Today’s debate is specifically about young children and infants. We have heard a catalogue of things that went wrong. I pay tribute to Millie’s parents for the diligent way in which they have turned a personal tragedy into a hope that we can take things forward, so that no other parents—or grandparents, uncles, aunts or family friends—will experience such a tragedy in the future.

I repeat the point I made in an intervention: if we start with five-year-olds knowing about nose bleeds—both theirs and other people’s—by the time they leave school, they will be trained in life-saving techniques for the rest of their lives. On top of that, we then need to bolt on, occupation by occupation, the specific first aid requirements that each profession needs. Clearly we do not need to train someone in a car factory on how to deal with an infant who is choking, but a person working in a nursery needs to know all about dealing with whatever calamity might occur to a young person there.

One point my hon. Friend mentioned has caused me great concern. Until today I had simply assumed that people who taught first aid were qualified up to a required standard, meaning that they were registered and regulated to give first aid and first aid training. We know that St John Ambulance and the Red Cross are qualified first aid organisations, but I am aware of other organisations, companies, groups of friends or whoever, who come together to provide first aid cover at events at a much lower rate than those two charities. I do not know how qualified those people are.

That is a serious issue that the Government need to look at and investigate. Who is providing first aid at events and how qualified are those first-aiders? That is why I asked my hon. Friend whether the coroner had made any comment about who trained the two members of staff at the nursery who, on the day in question, fell short of what was required. I do not know this, but it may well be that they had not been fully trained by qualified trainers. That is a huge area that the Government need to look at, although it is probably more an issue for the Department of Health than for the Department for Education.

I congratulate my hon. Friend on securing this very moving debate. I thank hon. Members who have intervened. Specific thanks must go to Millie’s parents, who have devoted many months now to a campaign that has come quite quickly into the Houses of Parliament. We owe it to them to take the matter forward.

[Richard Graham (Gloucester) (Con)]

I pay tribute to my hon. Friend the Member for Cheadle (Mark Hunter)—not just for securing the debate, but for his calm and measured argument.

This debate marks yet another milestone in democracy. A while back, the tragic death of a nine-month-old child would not have led to a giant petition, signed by over 100,000 people, being considered by Parliament, with the chance perhaps to change the law. Although that would not have happened but for changes in parliamentary procedure, it is above all the result of the remarkable reaction and leadership shown by Millie’s parents, the Thompsons. Joanne is motivated by the purest motive that any of us parents could hope for—to make something positive out of profound tragedy, and light a candle in the darkness.

Although many of us can think of other recent examples of constituents campaigning successfully on issues dear to their hearts, today’s starting point must be to recognise both the very sad circumstances of Millie’s death and the positive reaction of Joanne and her husband afterwards in founding their charity. The heart of today’s debate is whether it should be mandatory in law for everyone working at nurseries to be given paediatric first aid training, or whether the law should stay where it was when the Childcare Act 2006 was brought in, under which it is mandatory that someone on the premises is trained, but not everyone.

My hon. Friend the Member for Colchester (Sir Bob Russell) made a case for first aid training for every individual in the United Kingdom. He has a point: it is right that we should all go on a course. It is one of the best things I have ever done—I did so fairly recently, and no doubt far too late in life. However, that does not necessarily mean that to do so should be mandatory, thereby having rules, regulations and punishments attached to it—that people should be fined or there should be some other punishment for not going on a first aid course. I am not sure that today is the moment for a discussion of whether we should legislate that everybody should go on a course.

[Sir Bob Russell]

I should point out to my hon. Friend that I was not saying that there should be first aid training for every person, but that it should be part of the school curriculum. Clearly, over three generations everybody in the country would then be a trained first aider; others could—this is the example he has set himself—go voluntarily for training. However, if parents are entrusting their children to a nursery, it should be mandatory for the staff to have specific training for the needs of the role that they may be called upon to perform.

[Richard Graham]

My hon. Friend is right to differentiate between the two. The point I was going to make was that the fact that I went on a first aid course about two years ago does not necessarily make me that competent to attend to someone in a life-or-death situation today, let alone at some point in the future. Although it is a great idea that everybody at school should learn first aid, again, that will not necessarily make them competent to act in a life-or-death situation. As other hon. Members pointed out, the stress of that situation, the possibility of panic and the absence of recent and up-to-date experience of handling dummies and so on, will be crucial.

That brings me to the key points raised by my hon. Friend the Member for Cheadle. He rightly touched on the fact that the number of children in child care is rising and on the need for care for the most vulnerable—this point will be especially relevant to the Minister, whose son cannot be much older than Millie was at the time of her death in 2012. The case that has been made today for mandatory paediatric first aid training for everybody working in child care is therefore a powerful one. The coroner concluded that, first, the ambulance service should carry paediatric equipment for such a situation and, secondly, that there should be a national review.

Joanne and her campaign for Millie’s Trust have already achieved the first objective, which other ambulance services around the country may want to consider. I shall certainly write to my own ambulance service in Gloucester. The second objective is open for the Minister’s response, and I hope he will bear in mind the already remarkable achievement of the trust in having trained several thousand teachers for free. This is a fantastic objective, and the number of teachers who have already been trained is fantastic.

I do not know the precise cost of ensuring that every person in every nursery is trained, and I hope that it would not increase the cost of the child care provided to so many of our constituents around the country. I hope that it will be absorbed by the nursery as a necessary part of providing that trust in child care that all of us who are parents would expect.

Today’s debate is an important step in recognising what an individual has done on behalf of her own child and her own family situation, but it has much wider applicability across the land to all of us who are parents and to everyone who puts their children, with trust, into a nursery school. My hon. Friend the Member for Cheadle made a strong case that is the stronger for having been measured and reasonable. I hope that the Minister—a reasonable man and a young father to boot—will be able to give us some reassurance about the national review as quickly as possible. I suspect that all of us here today hope that that review will lead to mandatory provision of paediatric first aid.

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[The Parliamentary Under-Secretary of State for Education (Mr Sam Gyimah)]

I start by offering my deepest sympathies to Mr and Mrs Thompson for the tragic death of their daughter, Millie, in October 2012. I would also like to say how much I admire the worthwhile work that the Thompsons are doing through Millie’s Trust in their daughter’s memory, providing first aid courses free of charge for people who are pregnant or have children under 12 months, and providing two-day courses for a charge to nurseries. Those are all incredible feats in a very short period of time, and I congratulate them on that. It is no accident that Joanne Thompson won the Lorraine Kelly inspirational woman of the year award.

This debate has come about following Millie’s tragic death and because of the impact of Mr and Mrs Thompson’s e-petition, which has gained more than 102,000 signatures, to have it made law that everyone working in a nursery must be trained in paediatric first aid. I congratulate the hon. Member for Cheadle (Mark Hunter) on securing today’s debate on this important matter. I also thank all the hon. Members who have spoken here today. I have listened to their contributions and I agree that Millie’s death is a wake-up call for all of us. I hope during the course of my speech to address the points that have been raised so far.

As many hon. Members have said today, we can all agree that all young children deserve the highest possible level of safety and care. As a new father myself, with an eight-month-old son who is about to start nursery, I know that I want the nursery that I choose for my son to have an exemplary safety record, so that I can be reassured that he will have the best possible care. That is because the safety and welfare of children in all settings, whether in social care, schools or early years provision, is paramount.

What do we want to achieve? We want to ensure that there are confident, capable paediatric first-aiders in all nurseries, taking responsibility and responding quickly in an emergency. What are we doing to deliver that? The statutory framework for the early years foundation stage sets the standards for learning, development and care for children from birth to age five. All nurseries must meet these standards to ensure that children learn and develop well and are kept healthy and safe.

In the light of Millie’s case, we have strengthened the early years foundation stage requirements. From this September, the early years foundation stage has made it even clearer that nurseries must always have staff available who are trained in paediatric first aid. Beyond that, we added to the paediatric first aid requirement that nurseries

“should take into account the number of children, staff and layout of premises to ensure that a paediatric first aider”

is “available at all times” and

“able to respond to emergencies quickly.”

In other words, if a nursery is operating over three floors, with children on each floor, it is not acceptable for it to say that it only has one first aider, because it is operating on three floors.

[Sir Bob Russell]

Bearing in mind what my hon. Friend the Member for Cheadle said, will the Minister state whether training in those first aid requirements are being given by people who are qualified first aid trainers and not just people who say they are qualified first aid trainers?