Sudden Cardiac Death: Young People
Debate between Greg Smith and Jim Shannon(1 day, 13 hours ago)
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Greg Smith (Mid Buckinghamshire) (Con)
I have initiated this Adjournment debate on behalf of my late constituent and his family. It concerns a tragic case that raises serious questions about emergency response, clinical training, information sharing, and whether the systems meant to save young lives are fit for purpose.
On 31 January 2024, Adam Ankers, aged just 17, collapsed while playing football for the Wycombe Wanderers Foundation’s under-19 development team. He was a much-loved son, brother, friend and team-mate. He dreamed of a career in professional football, and on the captain’s armband that he was wearing that day he had written the words “strength, inspiration, leader, desire.” Despite the presence of first-aid-trained coaches, despite a defibrillator being brought straight to the pitch, and despite multiple calls to 999, no one recognised that Adam was in sudden cardiac arrest. No cardiopulmonary resuscitation was started.
The coroner found that Adam’s brain had been was starved of oxygen for about eight minutes because no one had attempted CPR, and heard evidence that for every minute without CPR, the chances of survival decrease by 10%. South Central Ambulance Service’s serious incident review reached the same conclusion independently, acknowledging an eight-minute period in which CPR should have started and did not. The ambulance arrived within 11 minutes of the first 999 call, at 2.31 pm, but by then the critical window in which to act, having been led by telephone, had already been missed.
Jim Shannon (Strangford) (DUP)
The hon. Member has raised a heart-rending and very difficult case, and I congratulate him on that.
The British Heart Foundation estimates that in Northern Ireland one person under the age of 35 dies every month from an undiagnosed heart condition. In view of that, does the hon. Member agree that more must be done to ensure that the public are equipped to perform effective CPR and to use a defibrillator, and are confident about carrying out bystander CPR?
Greg Smith
I do agree with the hon. Gentleman, and I will explore many of those issues later in my speech.
When paramedics arrived, they found Adam cold, blue, not breathing, and without a pulse. They immediately started CPR, and took him to Harefield hospital, with the support of Thames Valley Air Ambulance. Despite the best efforts of clinicians, Adam was declared brain-stem dead on 4 February—in law, that was the moment of his death—and his heart stopped for the final time on 5 February, when life support was withdrawn. His parents, Alastair Ankers and Naomi Wakefield, both work in healthcare. Through devastating experience, they came to the conclusion that Adam’s death could have been prevented.
Adam’s parents fought for more than two years for a proper, in-depth inquest, rather than the four-hour online hearing first offered. They were represented by a single barrister, paid for by remortgaging their house, against an array of solicitors and counsel for the NHS bodies and the Football Association. That is not a fair fight. The underlying condition was arrhythmogenic right ventricular cardiomyopathy—ARVC, a genetic heart disease, the first sign of which can be sudden cardiac arrest. This was a failure to identify a life-threatening emergency in real time, and it is why recognition, escalation and response matter so much.
The inquest raised serious concerns about the handling of 999 calls and the ability of call handlers to recognise abnormal breathing and cardiac arrest. Ambulance services in England use one of two systems: MPDS—the medical priority dispatch system—and NHS Pathways. NHS Pathways is used by just over half of 999 services and by all 111 services in England, and it was the system used on the call that day. The inquest heard expert evidence from paramedic David Davis—not the one of this parish—who told the court,
“I am unable to say that NHS Pathways as is currently configured can always properly support members of the public to identify agonal or ineffective breathing. I am also uncertain as to whether NHS Pathways can adequately identify potential out-of-hospital cardiac arrest where there is seizure-like activity at the outset.”
That is about as serious a warning as an expert witness can give. If the system cannot reliably recognise the signs of cardiac arrest, people are being put in danger, and if the public are left uncertain about whether to follow the advice they are given or to act on instinct, that is a public safety problem.
The coroner issued a five-point prevention of future deaths report on 16 April this year. It was addressed to 13 bodies, including NHS England, the Department of Health and Social Care, the Football Association, South Central Ambulance Service, the UK National Screening Committee and Cardiac Risk in the Young. Responses were due by 11 June. There is a pattern in those responses: every organisation expressed sympathy and described some work under way, but almost none attached a date to anything. NHS England says that a genetic service specification is “currently being revised”, but with no timetable. Staff at Resuscitation Council UK say that responsibility sits with NHS England and the Department of Health and Social Care, not them. The Association of Ambulance Chief Executives says that it is
“not constituted to mandate or instruct ambulance services”.
Everybody has pointed to somebody else, and there have been warnings for years about call handlers and cardiac arrest, sepsis and other conditions, with no clear public evidence of improvement. Why?
I therefore ask the Minister to instruct the Care Quality Commission to urgently and regularly assess ambulance services on call-handler skill in detecting and managing abnormal breathing and suspected cardiac arrest. A CQC inspection of South Central Ambulance Service before Adam’s death had already found call handlers struggling to recognise abnormal breathing, with serious incidents leading to patient harm as a result—this is not new information to the trust. South Central Ambulance Service’s own response to the coroner’s report suggests that the public should understand that call handlers follow a fixed script, and that callers may need to act independently of the advice given. If it is genuinely the Government’s position that people in the worst moment of their life should second-guess the emergency services, the public deserve to hear that plainly, not discover it buried in a filing after a child has died.
Training alone will not be enough. NHS Pathways plays a central role in how millions of emergency and urgent care calls are handled every year, yet there is strikingly little publicly available data on its safety and effectiveness. That is not good enough. Will the Minister commit to a fully independent review of the effectiveness and the culture of NHS Pathways—not simply a restatement that the National Clinical Assurance Group already provides oversight? That body assures the clinical safety of dispositions; it does not examine culture. Its terms of reference are set by NHS England and it reports to NHS England, which is the body that runs NHS Pathways.
I want to press further on one other point, because it speaks to whether the Government can even get the basic facts right in responding to a dead child’s inquest. NHS England’s own prevention of future death response states that Adam was triaged through “Protocol 12, Convulsions/Fitting”—an MPDS reference. However, the coroner’s findings state that NHS Pathways, a different system owned and run by NHS England itself, was used as the script for that call. Why did NHS England’s response point to the wrong system entirely, rather than confront the failings of the system it actually runs? Did national leadership check its own response against the coroner’s findings before sending it? Will it now formally correct the record and explain how that error ever happened?
Moving on, there is the question of how genetic risk is communicated within families. Distant relatives in Scotland had known since 2018 that a genetic variant, PKP2, which is associated with ARVC, ran in the family, but that was not passed to Adam’s immediate family in full until after his death, and only then because Adam’s parents themselves had to go back to that distant relative and ask directly whether there was a letter he had not shared. There was. Once the risk was confirmed, the genetic service’s answer for cascading that information further to the wider family was a brown paper envelope containing 10 photocopied letters, which the family were left to hand round themselves—a grieving family doing the NHS’s job of tracing and warning their own relatives, with no support offered.
Adam’s grandmother had, in fact, raised the family history with her cardiologist at Papworth hospital, who accepted that it was recorded in three places in her notes but said he had not seen it. A 2022 referral from the GP was read by this doctor but never followed up due to an administrative error. Separately, NHS Greater Glasgow and Clyde, which held the original genetic records, refused to disclose them to the English coroner’s inquest as it fell outside its jurisdiction. The coroner considered applying to the Scottish High Court to compel co-operation, but decided against as it was not a proportionate use of public funds. No family should be told that it is not proportionate to pursue the truth about their son’s death across a devolved border. I ask the Minister to raise this issue with counterparts in the devolved health systems, so that no hospital anywhere in this United Kingdom refuses to co-operate with an inquest into a child’s death ever again.
Energy Development Proposals: Mid Buckinghamshire
Debate between Greg Smith and Jim Shannon(1 year, 6 months ago)
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Greg Smith (Mid Buckinghamshire) (Con)
I rise to register my outrage at the unacceptable situation that all my constituents in Mid Buckinghamshire are facing: a tidal wave of energy infrastructure driven by hype, speculation and a closed-minded approach to energy security. As we have seen with countless other large-scale infrastructure projects, be they road, rail or housing, it is rural areas that are thrown under the bus with no thought for the huge impact that both the construction and the operation of those projects has on communities. I therefore strongly encourage the Government to take note of what I believe is a ticking time bomb that risks permanently devastating not just my constituency but countless others across the United Kingdom.
I am sadly no stranger to the problem of big infrastructure. From the moment I was first elected, I have taken every opportunity to put on record the terrible destruction that High Speed 2 has brought on my constituency, from the shameless turfing out of farmers, who have often been left without compensation for years on end, to the sorry state of the roads used by heavy goods vehicles and the sheer size of the compounds that litter the Buckinghamshire countryside—literally industrial waste—for there is no justification for spending £200 billion of taxpayers’ money on a railway that has effectively already become obsolete.
The same is true of ground-based energy infrastructure, which is the least efficient form of energy production. Put simply, the enormous loss of agricultural land required to double the share of national energy consumption generated by solar, which will amount to less than 10% even with the proposed increase, is not worth it.
Greg Smith
It would not be an Adjournment debate without the hon. Gentleman. I am interested to see how he will get Mid Buckinghamshire into his intervention. I am all ears.
Madam Deputy Speaker (Ms Nusrat Ghani)
I remind you, Mr Shannon, that this debate is about energy development proposals in Mid Buckinghamshire. We are ready for your intervention.
Jim Shannon
The hon. Gentleman mentioned the importance of land. The priority for agricultural land is to provide the food to feed this nation, not for solar energy projects that clog and take away the land. My constituency is similar to his, and my interest is to ensure that that good land is kept for the production of food, as it should be.
Greg Smith
The hon. Gentleman is always on point on these matters. I will come to the important matter of food security later, but he is right. The inefficiency of some energy projects coming forward in Mid Buckinghamshire, as well as in communities in Strangford, I dare say, is a huge challenge not just to food security but to the rural way of life that those in our communities enjoy.
It takes 2,000 acres of solar panels to generate enough electricity to power 50,000 homes on current usage—before everyone has two Teslas on the drive—yet a small modular reactor requires just two football pitches to produce enough power for a million homes on current usage. It cannot be right that the Government are pursuing this technology. I put it to the Minister and to right hon. and hon. Members across the House that nuclear is the answer, but fingers seem to be in ears whenever it is raised. I assume that that is obvious to the Government, as is the vital importance of food security, which is directly compromised by taking land out of food production and giving it over to solar.
The Government seem content with ploughing on. Last week’s revelation in The Daily Telegraph of intentions to convert a tenth of our farmland to use for net zero gives a blank cheque to those intent on destroying rather than preserving our countryside. The countryside is for farming. It is not a building site for solar panels, power plants, battery storage sites or wind turbines. It is for growing food. It is for the local communities and businesses that rely on it.
Attempts to take land away from food production in my constituency are simply unjustifiable. An unjustifiable 3,000 acres of land are already lost or at risk of being subsumed by solar panels. Those 3,000 acres are taken out of food production, no longer farmed by families who have farmed them for generations but are now turfed out, with little to no compensation, and the land unlikely ever to return to food production. Let us bear in mind that that is just for the projects that have been proposed or consented to.
Rosefield is a monster project of immense scale. For this monstrosity alone, over 2,000 acres of land—much of it arable grade 3a and 3b—have been sold off to EDF Renewables for the construction of vast swathes of solar panels right in the heart of the Claydons. That land produces a 10-tonne-a-hectare wheat harvest. Many farmers would bite your right hand off to get that, but it is cast aside by the consultants and proposers of the site as low-grade land. It simply is not. As the name suggests, the area is rich in clay soil, which is incredibly valuable to farmers as it retains rich levels of both nutrients and water. It allows us in Buckinghamshire to produce immense quantities of wheat, barley, beans, oilseed rape and much more.
We are facing a clear trade-off between food security and what is considered today to be energy security. Members will know that I have consistently questioned the suitability and sustainability of solar as a renewable source of electricity. There is nothing renewable about land left to rot underneath solar panels, or the huge amount of emissions from the construction of these vast sites.
We in Buckinghamshire face an equal if not greater threat from battery energy storage sites. These shipping container-sized units use hundreds of lithium ion batteries to store surplus energy, which is later sold back to the grid to meet demand when required. Not only are the battery storage sites noisy and unsightly, but they displace water run-off because of their concrete bases, create light pollution, are a target for vandalism and are a huge fire risk, as I will discuss shortly.
On top of that, such sites are not a sustainable form of energy production. In fact, they do nothing more than hold surplus energy, no matter how or where that energy has been generated. In fact, with less than 5% of today’s energy consumption coming from solar, the chances are that the energy stored by these sites has not come from the site next door. It is utterly shameful of BESS promoters to label their projects as “sustainable” and “part of the solution”. It is, I am afraid to say, simply a matter of profiteering off the taxpayer while doing little to nothing—that is, for those who do not enjoy a chemically fuelled bonfire. It has been proven time and again, with tragic results, how dangerous battery energy storage sites can be. In September 2020, for example, a fire at a BESS site in Liverpool took 59 hours to extinguish. While the promoters may spout about new technology guarding us against fire today, it does not and cannot justify placing such sites in rural areas. That is because—surprise, surprise—it takes far longer for fire crews to respond in rural areas, especially ones that are prone to flooding, such as the Claydons, in my constituency, where three BESS applications have been lodged in just one year.
It is not surprising that pouring concrete on to farmland exacerbates flooding, or that hundreds of shipping containers ruin the view for miles around.
Income Tax (Charge)
Debate between Greg Smith and Jim Shannon(1 year, 9 months ago)
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Greg Smith (Mid Buckinghamshire) (Con)
I congratulate the hon. Member for North Somerset (Sadik Al-Hassan) on a powerfully delivered maiden speech and wish him well in this House. I thank him for his kind words about his predecessor, Dr Liam Fox, who was a true champion of this House.
The Budget of broken promises came as a hammer blow to communities up and down the land, but before I get into the detail of that, and in the interest of balance and fairness, I would like to thank the Chancellor for one of the measures in it. Following FairFuelUK’s campaign, The Sun’s “Keep It Down” campaign, and indeed, the campaign led by my hon. Friend the Member for Meriden and Solihull East (Saqib Bhatti), the freeze on fuel duty, which the last Conservative Government implemented for so many years, will continue. It is very apparent to me that petrol and diesel are overtaxed as it is, and working people up and down the land absolutely depend on being able to afford a tank of fuel to get the kids to school, go to work and go about their daily lives. As a request ahead of next year’s Budget, I ask the Chancellor to consider fixing a double taxation in the system: the point at which VAT is applied to petrol and diesel. At the moment, it is applied after fuel duty, rather than before; we therefore pay VAT not just on the petrol and diesel itself, but on the fuel duty that has been put on top of it.
There is so much to dislike in this Budget of broken promises, beginning with the increase in employers’ national insurance contributions, which is a direct tax on jobs. It is a tax on small and large businesses alike, and it is a tax on our general practitioners—I am sure I am not alone in this House in already having correspondence on this issue with many of the GPs in my constituency. There is the perversity of putting bus fares up to £3, scrapping the Conservatives’ £2 bus fare cap. Working people up and down the land rely on buses; it is only in Labour’s world that putting the bus fare up means getting more people to work. The £40 billion tax hike is going to lead to higher inflation, lower wages and increased Government debt.
For my constituency of Mid Buckinghamshire, though, the very worst part of this Budget was the full-frontal attack on our farmers and agricultural communities. The changes to agricultural property relief will cause family farms up and down the land to have to sell such a huge proportion of their farm in order to meet that tax bill that those farms themselves may well become unviable.
Jim Shannon
I commend the hon. Gentleman on that comment. Every farmer in Northern Ireland will be impacted by this change. The Ulster Farmers’ Union—I declare an interest as a member—has said that the change is universally discredited and universally opposed. The threshold for agricultural relief for farms should have been higher—perhaps £4 million or £5 million, not £1 million, which brings everybody into the equation.
Greg Smith
As ever, the hon. Gentleman has hit the nail exactly on the head. In its briefing, which I am sure all Members have received, the National Farmers Union points out that the Treasury’s own figures on who will get caught up in the APR changes are fundamentally wrong, because they include a lot of very small-scale areas—perhaps a private residence with one or two fields or a very small number of livestock. That is not what any of us would define as a working farm. In reality, when all those family farms are brought into the numbers, the vast majority of our food producers who contribute to food supply chains will get caught up in those changes.
When the Chancellor was on the BBC on Sunday morning, she said that the individual claim for agricultural property relief is now £1 million, but if a farm is owned by two people, that allowance could be transferred to the other person. Some confusion needs to be ironed out here, because unlike the nil-rate band and residential nil-rate band, the policy paper entitled “Summary of reforms to agricultural property relief and business property relief” published on 30 October this year states that
“any unused allowance will not be transferable between spouses and civil partners.”
Perhaps in summing up the Minister can clear up that confusion caused by the Chancellor on the Kuenssberg show.
The APR changes are not the only changes that will hammer our farming families and agricultural communities. I am sure there is a joke somewhere along the lines of “When is a pick-up truck not a pick-up truck?”, but it is no laughing matter for farmers. For them, it is just a basic bit of equipment that they need to operate, but this Government are hammering them on the cost of that equipment if it happens to have rear seats. As I raised earlier today in this House during the urgent question, the Government’s carbon tax will put up the price of fertiliser by between £50 and £75 a tonne. Either that is going to have a direct impact on the cost of food, or the Government are asking farmers—already operating on incredibly tight margins, often with no profit at all—just to swallow that extra cost. I urge them to reconsider.
Other measures in the Budget that are clearly wrong and the Government must U-turn on include VAT on private school fees. The vast majority of parents I talk to in my constituency who choose to send their children to independent schools scrimp and save and make sacrifices in order to give their children that opportunity. An additional 20% in fees makes that unaffordable for those parents, and when I talk to representatives of independent schools in my constituency some are saying that they can see a path to having to close their doors. I know that a lot of Labour Members would probably quite like that outcome, but the reality is that it will be denying children opportunity and denying parents choice, and it will have the knock-on impact of class sizes in my kids’ school—and, I am sure, every other hon. Member’s kids’ school in the state sector—going up. That will cause overcrowding and put pressure on our state schools. This is all before I come on to the other problems in this Budget, not least the cruel attack on our pensioners through the withdrawal of the winter fuel payment.
Lastly, just to prove how bizarre and simply unserious the Government are about value for money, they have chosen someone as their new value-for-money tsar who is inextricably linked to one of the most inefficient and wasteful projects ever to come out of the British state: HS2. How on earth can someone so linked to that project be considered an arbiter of value for money?