Infant First Aid Training for Parents

Julie Cooper Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Julie Cooper (Burnley) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) on securing this important debate. The subject has had a lot of attention in the news recently, but not much attention in this place. Having listened to the speeches and talked to colleagues across the House, I do not think there will be much disagreement here today. The fact that there are not many Members here says more about the subject than it does about any other business in this House, important as it is: any Member seeing the title of this debate might say, “It’s a no-brainer. What is there to talk about? Of course it is something we support.” It is important to put these things on the record.

Members have talked about their personal experiences as parents and grandparents—I am sure we all want to congratulate the hon. Member for Moray (Douglas Ross) on the new addition to his family. People have spoken movingly about their own children and grandchildren. As a parent and a grandparent—I am going to be a grandparent again next week—I am reminded of how important the subject is, and we ought to give proper consideration to it. This debate gives us that opportunity, so I am grateful to the hon. Lady for securing it.

[John Howell]

As the hon. Lady rightly says, a lot of people have spoken from personal experience, but we as MPs have a role far beyond that—we are champions in our own constituencies. Does she not think that we should take the lessons learned and go out and make these points very forcefully in our constituencies?

[Julie Cooper]

I am grateful to the hon. Gentleman for that important intervention. I shall certainly speak with a loud voice about the subject in my constituency, and I encourage all Members to do the same.

The other point made by the hon. Member for Moray was that access is not easy. In preparation for this debate I checked up on access to training courses for my constituents and found that, even though I represent an urban community, it involves a 60-mile drive or a long train journey on a slow, rickety train line. That presents a massive barrier to my constituents accessing such training. I totally take the point that the hon. Gentleman makes, and I agree with him entirely.

The safety of our children is and always should be paramount, and it is therefore important that, in the event of an obvious health emergency, parents have at least a basic knowledge of first aid so that they can take action before professional help arrives—actions that might save the child’s life. The hon. Member for Truro and Falmouth made a strong point about how it is important that parents are trained to recognise the symptoms of what can be serious diseases, such as sepsis and meningitis. It would be useful if parents were equipped to recognise the symptoms before they decide whether to call 999 or take their child to hospital, because knowing how to spot the symptoms really does save lives.

First aid, as the term suggests, is the first medical attention that a person receives after an accident or during a medical emergency. Despite what many people have been led to believe, first aid does not have to be delivered by medical professionals—we have established that. A person’s chances of surviving a medical emergency are increased dramatically if a member of the community can respond with first aid immediately. What happens in the crucial minutes after someone dials 999 or the NHS’s 111 and before professional help arrives can be the difference between life and death. The British Red Cross reported that close to a quarter of infant deaths could have been prevented had there been a qualified first aider on hand, and who better to be trained than the parent?

[Dr Caroline Johnson]

A few weeks ago I was walking to a parliamentary event across the square, and I came across a man who was unconscious and not very well. When I called 999 for an ambulance, I noticed that the ambulance operators who answer the phone provide detailed and step-by-step advice to callers about what to do. That is a beneficial thing to note.

[Julie Cooper]

That is an important point. I have been on the receiving end of that with a family member, waiting for an ambulance and listening to instructions. Nevertheless, I appreciate that having the confidence to follow those instructions, particularly with a young child, might go a little beyond that.

This is about re-teaching people about what they think they know. There is a lot of so-called knowledge out there among people who think they know first aid, but that is often based on what they have seen in the media, which sometimes puts style before substance. In fact, procedures shown for dramatic effect often bear little resemblance to safe first aid. Furthermore, carrying out procedures without proper training might do more harm than good. First aid for babies is also vastly different from first aid for adults and other young children. Such important matters should be regarded as key parenting skills.

All parents, irrespective of their ability to pay, should have access to high-quality first aid training as a priority. Access to first aid training is about more than skills; it is also about building confidence and resilience. The British Red Cross surveyed a group of people it had trained in first aid, and asked whether they felt the training had contributed to their personal wellbeing. Three quarters of the respondents said it had made them more capable and more reliable in an emergency, and half said it had made them more determined and better at finding their way out of difficult situations.

Ahead of this debate, the British Red Cross shared with me the case of Leanne, a young mum from Swindon. When her baby, Maia, was six months old, Leanne took a baby first aid course with the British Red Cross. When Maia was 18 months old, she had a febrile seizure. Using knowledge from her first aid course, Leanne was able to save Maia’s life by instantly recognising the signs, taking steps to cool her down by removing her blanket, and placing her on the floor so that she did not injure herself during the seizure. After the seizure was over, Leanne further reduced Maia’s temperature by stripping her down to her vest, and she placed her in the infant recovery position. Leanne’s quick thinking saved Maia’s life before the paramedics arrived, and Maia is back to her playful, happy self. Leanne was able to do that only because she recognised the signs of a febrile seizure from her baby and child first aid course.

A seizure can be a terrifying and violent event for a parent to witness, especially when they do not understand what is happening. Febrile seizures are not unusual in babies and children between the ages of six months and three years. However, the Red Cross reports that, when questioned, 66% of parents had not been taught to recognise a febrile seizure, and 65% did not even know what one was. The baby and first aid course gave Leanne the knowledge and skills to act, but most importantly it also gave her the confidence. She said:

“I’m grateful that I had attended a baby and child first aid course which meant I knew what to look out for and how to deal with a febrile seizure.”

Because of her first aid knowledge, she felt calm and able to act for her daughter.

We have heard many examples of such events, and we are grateful to the hon. Member for Sleaford and North Hykeham (Dr Johnson) for sharing her expertise. People in the wider public often talk about MPs living in a bubble or ivory tower, but the hon. Lady’s expert and practical knowledge demonstrates yet again that Members of Parliament are in touch and know what is happening out there. As the hon. Member for Henley (John Howell) said, it is right and proper to use our position to spread that knowledge and champion causes such as this.

In 2014, Mumsnet sponsored 20 mums to take part in British Red Cross baby and infant first aid training. All the mums rated the training highly, and one said:

“I really enjoyed the course as every single thing discussed could easily relate to me and my children. All the videos of real-life scenarios really brought it home how easily these things could happen, but now I feel confident and that I could make a real difference to the outcome, and would feel so much more knowledgeable on what to do in an emergency situation.”

As we have heard, there are many different providers of first aid training for parents of infants. I specifically mentioned the British Red Cross, and other hon. Members have mentioned St John Ambulance, which offers first aid courses designed specifically for babies and children. There are also local providers, such as the one championed by the hon. Member for Truro and Falmouth. In addition, the NHS provides an online app to support parents with first aid for their infants. One parent said:

“Although you could read everything on the app and watch the videos for free, I think doing it in a class environment really makes you take it all in. It will also make you feel more confident if you were ever to need to help someone or your own child.”

As the Secretary of State for Health and Social Care often reminds us, technology in the NHS is helpful, but it is not a substitute for services delivered by real people. In terms of first aid provision for parents, such apps can be useful to reinforce training given in a class setting, but they should not be seen as a substitute.

[Dr Caroline Johnson]

The hon. Lady is generous in giving way. Does she agree that both technology and face-to-face contact have their benefits and can be combined? A “sim” dolly is an electronic version of a resuscitation dolly, and when supervised resuscitation is provided to a baby, it provides electronic feedback on whether compressions are deep or fast enough, as that can be measured electronically by the dummy itself.

[Julie Cooper]

I am grateful to the hon. Lady for her expertise in that technology, and such things can be used in combination with a class setting and training to support existing knowledge. I agree that, on specific occasions, such technology has an important role.

In terms of treatment, we lack consistency of provision and access. We have already spoken about distances to, and charges for, courses being a barrier for some parents. Shockingly, research by the Red Cross showed that 95% of parents did not know what to do when shown three examples of life-threatening medical emergencies. Surely it is time to ensure that training is available for every parent in every region. I take the point that we ought not to be prescriptive, but in leaving things to local providers, we must ensure that no one falls through the gaps and no parent is missed.

The Royal College of Paediatrics and Child Health has warned that UK infant mortality levels are among the highest in the developed world. There are many reasons for that, but cuts to local child services, community health projects, and community midwives and health visitors have undoubtedly not helped. It is clearly desirable to ensure that this important provision is adequately funded, but a significant proportion of deaths could be prevented by ensuring that all parents are equipped with important first aid skills.

Of course, a parent first aider is no replacement for a health visitor or paramedic, but they can be the first line of defence when it comes to helping their children live longer and healthier lives. Informed parents can prevent unnecessary trips to the GP and inappropriate hospital admissions, and it is a shame that despite the support that community and parent first aiders provide to the NHS and families, they are barely mentioned in the NHS long-term plan. That is important because if the Secretary of State is serious about making the NHS the best health service in the world, and about having an NHS that promotes health and wellbeing through a focus on prevention, the Government must make first aid in the community a priority. Equipping parents to look after their infants is a good and important step.

Will the Minister take action to ensure that universal first aid training forms part of the antenatal care available to parents? This is about providing families and communities with the skills to step forward in an emergency so that tragedies can be avoided. Learning such skills can be the difference between a life saved and a life lost.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I join all colleagues in thanking my hon. Friend the Member for Truro and Falmouth (Sarah Newton) for bringing this important subject forward for debate. She has brought to it her characteristic good sense and made her case extremely well. I join colleagues in paying tribute to her work as a Minister. I must say that I had to work with her regularly when she was Minister for Disabled People and I miss her terribly, but if today is anything to go by, I am sure she will keep me busy from her position on the Back Benches, and I thank her for that.

I thank all hon. Members who have participated today, particularly my hon. Friend the Member for Moray (Douglas Ross), who brought his perspective as a new parent. If he will forgive my saying so, as he was articulating some of the things he learned, it brought home to me how new parents can be a bit like rabbits caught in headlights, thinking, “Oh my goodness, I’ve got this fragile thing, what am I to do?” Again, that brings home the need for parents to feel confident in looking after their newborns.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) gave a forensic exposition of the risks children face, and reminded us that we are equipping people with good, common-sense practical skills for things that can happen to anybody. She made her arguments extremely well. It is always a pleasure to listen to the hon. Member for Glasgow East (David Linden); again, he brought the subject to life beautifully with his own experience and spoke excellent common sense.

I am surprised to hear that the hon. Member for Burnley (Julie Cooper) is a grandmother, but that probably explains why she speaks from such a well-informed perspective. I am glad that she shared Leanne’s story, because it was a perfect example of how going through a course made that parent feel confident about how to deal with a child in distress, and helped her to understand exactly what the condition in front of her was.

Faced with such evidence, we can only do more to spread the news to parents that it is a good idea to equip themselves with first aid skills. From an NHS perspective, as the hon. Lady mentioned, if parents know more about their children’s conditions, there will be fewer visits to A&E and fewer visits to GPs, and that will make the NHS more effective. In a sense, what is not to like?

There are many providers of such products in the market. We have heard about St John Ambulance, the Red Cross and other local providers, and I would not want to favour one or other of them, beyond highlighting that those courses are available, as well as material on the NHS app. I hear what the hon. Lady says—that that is no substitute—but I tend to see these things as complementary. Today’s new parents are of the smartphone generation and want to access material via apps, and we must ensure that we have a good spread of information available to parents.

The death of any child is a tragedy, and the more we can do to support people to be the best possible parents, the better, because it is vital to the longer-term outcomes for the health and life chances of their children. I know my hon. Friend the Member for Truro and Falmouth brought her experience from her campaign to raise awareness of sepsis, which she referred to in her speech. Sepsis is a silent killer, and probably one of the most preventable causes of death, if we can identify it quickly enough. It is important that we continue to raise awareness so that people, and particularly parents, can spot the signs of sepsis and make decisions and interventions that will help sufferers.

Reference has been made to where we have these interventions and who can give new parents advice on first aid. I see midwives and health visitors as being on the frontline of doing that. My hon. Friend the Member for Moray explained that antenatal period when we are building a relationship and lapping up the information. The trust parents have in midwives and health visitors is a special relationship and presents a powerful opportunity for us to make an intervention to improve health outcomes for all. I see them as the cornerstone of ensuring that parents have the knowledge and skills they need before, during and after their baby’s birth, and that they have access to all the information they need.

There is information on the NHS website with tips for new parents, including information on the signs of a serious illness in a baby or toddler, but it is important that health visitors talk through common conditions with parents. It is a question of confidence; it is about making parents feel confident that they know what is happening to their child and that they can do their best to help them.

That was brought home by the account my hon. Friend the Member for Truro and Falmouth gave of Rowena’s story and the fact that Rowena felt able to take someone’s child and help them because she had had that grounding. Such things can obviously go the other way, and none of us wants to be in the position of thinking, “What if?” or, “If only”. There is clearly every reason to encourage as widespread training in first aid as is possible.

My hon. Friend has a simple ask: she wishes the Government to fund a pilot project to generate evidence for a further roll-out of the project she has witnessed locally in Cornwall. The National Institute for Health Research welcomes funding applications for research into any aspect of human health, and any application will of course be judged in the normal way. Awards are made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality, so I encourage her and the team she is working with to apply for such a grant so that we can, as she says, demonstrate that the training has an impact on outcomes and provides better value for money for the NHS. It seems to me to speak for itself, but I encourage her to go through that process.

[Julie Cooper]

Can the Minister assure us that, if funding is achieved for such a pilot and the training is shown to be beneficial, the Government will commit to universal provision?

[Jackie Doyle-Price]

That will come down to the evidence base. The hon. Lady raised some questions about prevention in her speech. Following the long-term plan, we are working up our wider proposals for prevention, and we see interventions in the early years and childhood as extremely important, so we will look at what measures we need to take in that context. At this stage, I am not able to commit to universal provision of a particular product, but we need to look at how we can best equip parents with the tools to look after their children as well as they possibly can.

Every parent wants their child to stay safe. Frankly, my hon. Friend the Member for Sleaford and North Hykeham scared me to death with the risks she highlighted, because they illustrate just how easily any one of us could fall victim to an accident, and for a child that is especially the case. We know that unintentional injuries are one of the main causes of premature death and illness for children in England. To put a figure on that, every year in England 55 children under the age of five die from injuries in and around the home, which is 7% of all deaths of children aged one to four. That is pretty stark. We can factor on to that the 370,000 visits to A&E departments and 40,000 emergency hospital admissions in England each year because of accidents at home among under-fives.

Preventing accidents is part of Public Health England’s priority of giving children and young people the best start in life, and is an area to focus on. I was struck by the reference to choking, because that is a situation where knowing what we are doing can be the difference between life and death; by the time an ambulance has been called, it will be too late. There is much more that we need to do to educate people on how to deal with a child who is choking, because it is something that can happen to any child. We have all seen children excited and gobbling their food down, and with that obviously comes the attendant risk.

As I mentioned, health visitors are accessible to all parents and provide a trusted source of knowledge, advice and information. I want to make sure that we take full advantage of health visitors in that space. Through our work on early years, we are looking at what more we can do to support them, to make the most of that intervention. I am confident that if we make better use of that workforce, we can take a lot of action in this area, not least because parents find engaging with their health visitor less intimidating than they perhaps find medical professionals or anyone else; it is a relationship built up in the home. Health visitors are also the part of the scheme that deals not only with mum but with dad and the rest of the family as well, which is so important. Health visitors lead and support the delivery of preventive programmes for infants and children from nought to five years old through the healthy child programme, including by giving regular advice on accident prevention and links to wider community resources.

[Julie Cooper]

Does that mean that the Minister is committed to restoring the number of health visitors?

[Jackie Doyle-Price]

The hon. Lady will be aware that there has been a fall in the number of health visitors, following a peak in 2015. I am extremely committed to making sure that we have an ample supply of health visitors, because they are on the frontline of early intervention; they are an army. She will know that the NHS long-term plan, recognising that local authorities have borne the brunt of fiscal discipline in this area, explicitly says that we will strengthen the relationship between the NHS and local authorities in this space, because that is clearly good for health outcomes. I hope that that reassures the hon. Lady.

I could go on for much longer, Mr Hollobone, but I do not want to stretch your indulgence unduly. I thank my hon. Friend the Member for Truro and Falmouth for all her work on this matter and on raising awareness of sepsis. We will continue to co-operate in this area. I can tell her that Public Health England very much has this area on its radar, in terms of giving advice to parents on how best to look after their children. We will continue to work with the Royal College of Paediatrics and Child Health to establish a single, England-wide paediatric early warning system to improve the recognition and response of healthcare services to deteriorating children or young people across England in primary and community care, including in the ambulance service and hospitals. Information and advice to help parents recognise and respond to signs and symptoms of ill health are freely available.

We must continue to champion and promote this cause. I thank midwives and health visitors for their tremendous work—they play such an important role in this—as well as providers of first aid courses. I look forward to engaging with my hon. Friend further on this matter.