Sudden Adult Death Syndrome

Gary Streeter Excerpts

Monday 25th March 2013 Westminster Hall

[Anna Soubry]

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.

[Mr Gary Streeter (in the Chair)]

In debates of this kind, the mover of the motion may have a few moments to summarise or respond at the end.