Sudden Adult Death Syndrome

John Pugh Excerpts

Monday 25th March 2013 Westminster Hall

[Steve Rotheram]

My hon. Friend and city of Liverpool colleague will know that where Liverpool leads, others often follow. The hope is that other people will recognise that what Liverpool has done is progressive. It has been done with the help of the mayor of Liverpool, the city council and, of course, the OK Foundation and it will demonstrably save lives. We do not know when that will happen, of course, because we do not know when someone will have an attack, but at some stage, that provision will save someone’s life. That will be a tremendous legacy of all the work and campaigning that the OK Foundation has done.

What is perhaps even more heartbreaking than the sudden loss of life, if such a thing is possible, is the sudden loss of life when it is avoidable. There is a quick, simple and extremely effective device that can save lives. The treatment will not cost millions of pounds in research or development, nor is it a procedure that people require a medical degree to administer. Instead, it is as simple as first aid training in schools and defibrillators in public buildings.

At this point, I declare an interest: I unashamedly want there to be a defibrillator in every public building, in much the same way as there are fire extinguishers and fire alarms in every building. As the London Ambulance Service pointed out in its briefing for today’s debate,

“56 people died in London from a fire in 2011 compared with 10,000 Londoners who suffered an out of hospital cardiac arrest—yet fire extinguishers are statutory in every building—and defibrillators are not”.

We have them here in Parliament. If they are good enough for us in Parliament, they are good enough for every other public building.

I will shortly come on to the main argument with regard to my desire for defibrillators in public buildings, but before I do that, I am keen to touch on another element of tackling SADS: screening. Three young people die each week from SADS, and in more than half of the cases the cause is a genetic problem affecting the heart. I believe that targeted expert assessment of families in which there is a high risk of inherited cardiac disease or in which there has been a sudden unexplained death will lead to a considerable decrease in the number of SADS victims annually. No one is claiming that that is a panacea; it is simply a vital step in the diagnosis of those most at risk.

I praise organisations such as Cardiac Risk in the Young, which is subsidising screening for young people, ensuring that those who believe that they need an ECG—electrocardiogram—can afford one. The OK Foundation and others are also doing that, but screening should be more widely available.

[John Pugh (Southport) (LD)]

The hon. Gentleman said earlier that Liverpool leads the way. He will be aware, as the right hon. Member for Leigh (Andy Burnham) will be aware, because we were both at the same event, that Liverpool John Moores university does an enormous amount of work on the screening of young sportsmen. A huge amount of work is being done and it is being done, again, in Liverpool.

[Steve Rotheram]

Again, I could not agree more. John Moores and other universities have done fantastic work. I looked at some of the material from the Football Association. It runs the association football medical screening programme for youth trainees, which involves the screening of 750 youth players. The International Olympic Committee has recommended that all countries screen their athletes to minimise the risk of SADS. That indicates the benefits of screening, so let us look at an early intervention strategy for at-risk groups as an initial step.

Even in the past week, it has been pleasing to see the Football Association and the British Heart Foundation form a £1.2 million fund to ensure that 900 defibrillators are made available to clubs in non-league football and the women’s super league. That is real action that will make a real difference, but although it is encouraging that sport has woken up to this condition and recognised what I would term its social and moral responsibility, there is more work for the medical profession to do and more support for the Government of this country and our partners across the developed world to give.

A simple ECG can expose whether a patient has irregular electrical or structural problems with their heart that can lead to SADS. Currently, however, standard cardiovascular risk assessment screening is not as precise as it needs to be in identifying symptoms relating to sudden cardiac arrest, which is why the British Heart Foundation is undertaking vital research into the genetics around SADS, on which it hopes to publish a report shortly. In the meantime, the Government can play a leading role in encouraging pathologists and coroners who determine that a person has died of SADS to inform immediate family members to ensure that they receive an ECG at the earliest possible opportunity. The Government should also support the medical industry’s work to improve the scientific precision of screening. Such Government measures should form part of the proposed new national strategy to improve heart safety and reduce preventable deaths from sudden cardiac arrest, as set out in the motion.

I hope that today’s debate and any subsequent debates will achieve a number of things, but it is pivotal that the imperative relationship between CPR and defibrillators is exposed: a defibrillator on its own cannot save a life; CPR on its own has an outside chance of saving a life, but the two together have a more than 50% chance of saving a life. How do we know? Ask people such as Fabrice Muamba. His collapse on a football pitch, in front of thousands of spectators at White Hart Lane and millions watching on television, was perhaps the most graphic illustration of SADS, and his recovery is the best example of what can be achieved with swift and targeted intervention.

Bystanders witness more than half the cardiac arrests that occur in public, but not enough people have the life-saving skills to help those heart attack victims. CPR is the first action in the chain of survival and is crucial in the first minutes after a cardiac arrest, because it helps keep oxygen moving around the body, including the brain, which is why the British Heart Foundation campaign tells us to phone 999 and press hard and fast to the beat of “Staying Alive”. It is a simple message, which works, and we have all seen it on television. CPR essentially buys a patient time. A defibrillator starts the heart, but cannot be used on a still heart, so unless CPR is administered, a defibrillator is effectively useless.

That point is crucial, and is at the heart of—forgive the pun—why colleagues and I, in consultation with my right hon. Friend the Member for Leigh, chose to include first aid in today’s motion. Medical experts believe that CPR combined with a defibrillator shock can triple the survival chances of somebody who has suffered a cardiac arrest outside hospital. I shall repeat that: it can triple survival chances. That is extraordinary. CPR and a defibrillator shock can buy paramedics time to arrive, prevent serious brain damage and ultimately increase the chance of a full recovery. I am not sure that there is any need for further debate. If someone’s child or loved one had a cardiac arrest, would they not want to triple their chance of survival?