First Aid Techniques: National Curriculum

Julie Hilling Excerpts

Tuesday 10th March 2015 Westminster Hall

[Sir David Amess (in the Chair)]

There is wide interest in the debate. From the Chair’s point of view, it would be helpful if colleagues quietly let the Clerk know who wishes to make a speech and who intends merely to intervene. Aside from the main speakers, it looks as though there will be about five minutes each for the rest.

[Julie Hilling (Bolton West) (Lab)]

It is a real pleasure to serve under your chairmanship, Sir David. I am grateful for the opportunity to have one last go in this Parliament to persuade the Government and my Front Benchers that there is a chance simply, easily, cheaply and immediately to save lives and to transform society.

Teaching emergency life support skills in schools and the community is

“a no brainer, it’s just common sense”.

Those words are not mine, but those of Dr Andy Lockey at the Resuscitation Council. There are 150,000 people a year who die in situations in which, if only someone had known what to do, their lives might have been saved. There are 30,000 people who have out-of-hospital cardiac arrests, but fewer than one in 10 survives. If only someone knew how to do cardiopulmonary resuscitation, or CPR, and if a defibrillator was available, survival rates could increase to 50%.

Emergency life support skills are a set of actions needed to keep somebody alive until professional help arrives. They include performing CPR, putting an unconscious person into the recovery position, dealing with choking and serious bleeding, and helping someone who might be having a heart attack. Such skills are particularly crucial at the time of a cardiac arrest, when every second counts. For every minute that passes in cardiac arrest, the chance of survival falls by 10%. If CPR is started immediately, the time that the person remains in a shockable, and hence reversible, condition will be prolonged. It also means that there will be more of the person’s brain function left—more of them left—if they are resuscitated. At the moment, it is down to luck.

Three years ago, Fabrice Muamba had a cardiac arrest when he was playing for Bolton Wanderers against Tottenham. Fabrice was lucky because he had his cardiac arrest where there were people who were trained in what to do. He was lucky because the club medics and the paramedics gave him immediate CPR on the pitch, so his brain was saved. He was lucky because medics did not give up on him and worked on him for 78 minutes until his heart restarted. Because he was with people who knew what to do, we still have the charming, intelligent Fabrice in this world with us.

My sister’s friend, Malcolm McCormick, was also lucky. Just a month after Fabrice’s cardiac arrest, Malcolm went to school to pick up his grandchildren and he keeled over, effectively dead, not breathing, heart not beating. Malcolm was lucky because one of the people waiting to collect children was a retained firefighter who started to give CPR. He was very lucky because once a month another firefighter volunteers in the school tuck shop, and it was his Friday to be working, so he came and took control of the situation.

Malcolm was also lucky because a defibrillator was available, and he was rushed to a specialist hospital. Three days later he left hospital with very sore ribs, but alive and with his brain intact. Four months later, he was a Games maker at the Paralympics.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

A mother and daughter were at the launch of the campaign in Parliament square. The daughter had saved her mother’s life by recognising that she was not breathing, and she was able to do CPR until the ambulance came. Seeing mother at the launch, chirpy and with it, was a heart-warming thing.

[Julie Hilling]

The hon. and learned Gentleman clearly caught sight of my speech before he raised his point. I was about to go on to say that Mandy Hobbs was really lucky, too. Her 14-year-old daughter, Samantha, woke up to hear her father on the phone saying that he thought her mum was dead. Samantha had learnt CPR at her swimming life-saving club, and she says that she went on to autopilot and started chest compressions. When she got too tired to carry on, she taught her father what to do. Mandy survived and now Samantha has become the pin-up girl of the British Heart Foundation. Mandy, dad Nick and Samantha are regular visitors to Parliament, trying to persuade the Government to make first aid compulsory in schools.

[Guy Opperman (Hexham) (Con)]

I congratulate the hon. Lady on securing this important debate and I take the point that she is making as a fundamental premise, but does she agree that there is a role for local community campaigns, such as Heart of Gold and the Stephen Carey fund in Northumberland, which are trying to institute and organise more public access defibrillators around the county of Northumberland so that rural dwellers have that access, which saves lives?

[Julie Hilling]

I absolutely agree with the hon. Gentleman. For me, it starts in schools. If only we could have—I will go on to talk about this more—a generation of life savers coming out of school. We have millions of people in the community who will not have had the benefit of being trained in schools. I applaud his organisations and the organisations in my constituency and across the country that do amazing work to raise money for defibrillators and for training individuals in how to do CPR.

Survival should not be down to luck. There are far too many other examples of people who suffer cardiac arrest and are not saved because the people around them do not know what to do: children such as Ciaran Geddes, who died aged 7; 12-year-old Oliver King; 16-year-old Daniel Young; or 17-year-old Guy Evans. Their mums are campaigning for defibrillators and emergency life-saving skills to be taught in schools.

[Nia Griffith (Llanelli) (Lab)]

Before I became an MP in 2005, I taught in a school where every single pupil in year 8 did a 12-week first aid course as part of their personal and social education. Does my hon. Friend agree that that is the type of programme that should be implemented so that every single child coming out of school would have those skills?

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[Julie Hilling]

I thank my hon. Friend for that intervention. Absolutely, every school leaver a life saver is what we should be aiming for.

This Government—it may be my Government in two months’ time—have a chance to make a real difference. We want the national curriculum to reflect the essential knowledge and understanding that pupils should be expected to have to enable them to take their place as an educated member of society. Knowing how to save a life would be absolutely in keeping with that aspiration. Knowing how to save the life of a family member or a member of the public would enable children to have an impact on the health of society. Ensuring that life-saving skills were taught in schools would provide the chance to instil in all children how valuable life is and how important it is to be a good citizen.

[Mark Hunter (Cheadle) (LD)]

I congratulate the hon. Lady on securing the debate. She is making a passionate case for something she clearly believes in deeply. Does she accept that this is part of a wider awareness that is needed among the community at large to raise the profile of first aid issues, not only in schools and in the workplace, but across the spectrum, because there are still not enough people who know what to do in an emergency of the kind that she has talked about? If I may, I will acknowledge the support she gave to my campaign for Millie’s Trust, which wants trained paediatric first aid nurses in nursery schools to be a statutory requirement.

[Julie Hilling]

The hon. Gentleman is absolutely right and I congratulate him on Millie’s campaign, because it is absolutely crucial that people do not die when they could be saved. Currently, 7% of the population know how to save a life. Surely we could do much better.

We could join other countries such as France, Denmark and Norway, where emergency life support skills are already part of the curriculum, as they are in various states in Australia and in 36 states in America. In Seattle, children have to learn first aid skills before they can graduate from school, and it is also part of the driving licence requirement. More than half of the population in Seattle is now trained in emergency life support, so people are rarely more than 12 feet away from somebody who could save their life.

However, it is not enough to learn CPR. Michelle, a staff member at Rivington and Blackrod high school in my constituency, knew what to do when her dad had a cardiac arrest. She and others did CPR for a long time before the ambulance arrived far too late to make any difference. Had there been an automatic external defibrillator, they might have been able to shock his heart back into rhythm, but there was not. That is why I applaud the work of the Bolton implantable cardiac defibrillator support group, who work so hard to raise funds and have just donated their 67th defibrillator.

The chain of survival is just that—a chain of action that needs to be undertaken for a person to survive a cardiac arrest. It needs someone to call for help, someone to do CPR, a defibrillator and someone confident enough to use it, and an ambulance to take the person to hospital for treatment. That is why children need to learn how to do CPR and how to use a defibrillator.

The British Heart Foundation is giving Resusci Annies—the resuscitation dolls—to high schools and has produced a CD that teaches those skills in just half an hour, but we should be more ambitious. It is essential that we also teach children to deal with choking and bleeding and to put somebody in the recovery position. Nine out of ten 11 to 16-year-olds have been confronted with a medical emergency, often when no adults are around. Even when there are adults, it is often the child or young person who takes control and, for instance, delivers back blows to stop someone choking or deals with a serious bleed.

According to research by St John Ambulance and the British Red Cross, only 7% of the UK population have the skills and the confidence to carry out basic first aid in an emergency, but 91% of pupils want to learn first aid at school; 98% of parents want first aid on the curriculum; and 96% of teachers think it is important for students to learn first aid. Ninety-five per cent of teachers agree that first aid teaching develops the general confidence and optimism of young people, yet only 21% of our schools equip young people with first aid skills.

[Mr Philip Hollobone (Kettering) (Con)]

I am enjoying the hon. Lady’s speech immensely; she is making a very powerful case. An argument against having CPR training in schools is that it would take up too much time, but surely what she is saying is that it would not require that much teaching time to get across to young people the skills that they need.

[Julie Hilling]

I absolutely agree with the hon. Gentleman. I will go on to say more about that in a moment, but let me reiterate the point now: if someone goes for half an hour’s training a year over their time in secondary school, we are talking about two and half hours. If they stay on, it is three and a half hours. If they go for an hour’s training, we are talking about five, six or seven hours. In terms of a school day, it is quicker than going on a cross-country run. We are talking about schools being able to take this skill into the national curriculum and to train people in it.

St John Ambulance and the British Red Cross believe that CPR and public access defibrillator training are important, but that other skills, such as the ability to deal with choking, bleeding and burns, and the ability to place somebody in the recovery position, must also be taught in schools. They believe that that could be done for just one hour a year, some of which could be delivered during an assembly. They, too, have provided free resources online for schools to use.

We still have Heartstart schools, where that range of skills is taught for two hours a year. It would take a tiny amount of the time that children are in school utterly to transform our society and have a nation of life savers. First aid provision also helps to meet Ofsted’s requirement on school safety and on the promotion of pupils’ spiritual, moral, social and cultural development.

We need to end the scenario in which, when somebody collapses or has a road traffic accident, we all stand around in a circle waiting for someone to act because we are too frightened to intervene. We need to end the fear of companies and organisations that are worried about the consequences of having a defibrillator. No one has ever been successfully sued for attempting to save someone’s life, and as one of my local firefighters said, “If someone’s heart has stopped, they are dead. You cannot make them any deader.”

Schools, companies, businesses and community groups should be far more worried about how they would feel if someone died when, if only they had invested in an AED and someone had known what to do, they could have saved them. Indeed, I believe that we should make AEDs compulsory, like fire extinguishers.

I cannot imagine anything worse than watching a loved one die and finding out that if only I had known what to do, they could have survived, so I have put my money where my mouth is. I have trained as a Heartstart tutor, so that I can teach people to do CPR and deal with choking and bleeding. My staff are Heartstart-trained and all the secondary schools in Bolton West have committed to or have become Heartstart schools.

I have worked closely with Sara Harris and the North West ambulance service to encourage the teaching of emergency life support skills and the roll-out of defibrillators. Sara works closely with the British Heart Foundation on its programmes. I have worked with Greater Manchester fire and rescue service, many of whose firefighters go into schools to teach life-saving skills. I have worked with Bolton Wanderers community trust, which is doing a great job in teaching life support skills and promoting defibrillators. I am working with Bolton implantable cardiac defibrillator support group, who are doing such an amazing job in raising money for defibrillators.

Recently, I have started to work with Lagan’s Foundation, which is a foundation that supports parents of children with heart disease and is also doing CPR training. I have campaigned with The Bolton News for every school leaver to be a life saver, and I have met with Ministers and shadow Ministers, and spoken on the subject many times in this place, including introducing a ten-minute rule Bill.

However, that is not enough, because every time there is a change of head teacher or the staff member responsible for emergency life support skills leaves, we have to start again. The only way to ensure that all children learn how to save a life is to put life-saving skills into the national curriculum. The only way to ensure that a defibrillator is available in our schools and other public buildings is to legislate for them to be a requirement. Since I started campaigning for that four years ago, I have heard some tragic and inspirational stories. I appeal to the Minister and to the shadow Minister to commit to introducing emergency life-saving skills to the national curriculum and, as a bare minimum, to ensuring that pupils know how to do CPR and how to use a defibrillator.

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[Chris Ruane (Vale of Clwyd) (Lab)]

I thank my hon. Friend the Member for Bolton West (Julie Hilling), who secured the debate, and the hon. Member for South Derbyshire (Heather Wheeler). The numbers that have been outlined during the debate speak for themselves. More than 30,000 cardiac arrests occur out of hospital each year, and less than one in 10 people survive. That statistic should worry us all as MPs with constituents, and as members of families and communities where such deaths regularly occur year in, year out. Those statistics mean that, if I were to have a cardiac arrest outside hospital now, my chances of being able to go home and see my family tonight would be minimal.

That does not have to be the case. In places around the world such as Seattle, parts of Holland and parts of Norway, survival rates can reach 25%, which means that a quarter of people who have out-of-hospital cardiac arrests make it home to see their loved ones. If we matched the survival rates achieved in parts of Norway, we would save 5,000 lives a year. That is 5,000 families still together; 5,000 mothers, fathers and children together would see the benefits of such changes.

I am proud to be the chair of the all-party group on heart disease, and I have worked with the British Heart Foundation and colleagues in Parliament to push the case that life-saving skills are essential for young people and society, and that they should not be optional. I take this opportunity to pay tribute to the British Heart Foundation, which provides the secretariat to our all-party group: chief executive Simon Gillespie, policy director Mike Hobday, Maura Gillespie, Rachel Almeida, John Howard and Susannah Kerr. The BHF has done great work on genetics, on the impact of sugars, salts and fats on heart disease, on plain packaging, on exercise and on defibrillators. The CPR campaign is one of its most important campaigns because it is, quite literally, life saving.

I will provide two examples from right here in Parliament. Bob Sheldon, an ex-MP who is now Lord Sheldon, died outside Parliament about 15 years ago. Duncan Goodhew, the swimmer, was walking past and saw it happen, and he brought Bob back to life. Paul Keetch, a former Liberal Democrat MP, was flying from England to New York, and he died over Northern Ireland. He was lucky—I have to make sure I get this the right way around—to be flying on a Virgin Atlantic plane, which had a defibrillator. The defibrillator was used and he was saved. If he had been in a British Airways aeroplane, he would not have been brought back and would not have survived. I apologise if I have got that the wrong way around.

The incident involving young Samantha Hobbs has already been relayed. I met Samantha and her mother in Portcullis House when Samantha gave us a lesson about how she saved her mum. It was absolutely lovely to see mother and daughter still bonded with each other because of Samantha’s skills. The BHF campaign is a great way to get the message across to the public: it tells us to pump the heart to the rhythm of “Stayin’ Alive”:

“Ah, ha, ha, ha, stayin’ alive”.

[Julie Hilling]

Will my hon. Friend give way?

[Chris Ruane]

I will, as long as my hon. Friend does not ask me to sing a duet with her.

[Julie Hilling]

Those of us who are more musically challenged can do it to “Nellie the Elephant”.

[Chris Ruane]

For those who are not impressed by the examples I have given of people being saved—the mother and daughter, Bob Sheldon and Paul Keetch—in cold-hearted actuarial terms, the insurance industry reckons that every person who dies prematurely costs the country £1 million in lost taxes, lost education and lost life. If we prevent 5,000 people from dying prematurely from heart disease every year, the country will save £5 billion. Over the next 10 years, the saving would be £50 billion. It makes economic sense, but most of all, it makes health sense to introduce lessons about CPR.

Charities such as the British Heart Foundation are doing their part. To date, 930 secondary schools across the country, plus two community groups in my constituency, have signed up to help build a nation of life savers. As has been mentioned, the BHF is providing kits free of charge to schools and clubs. The charity is doing its bit, and it is time for the Government to meet it halfway and help to deliver CPR and public access defibrillator awareness across the four nations. The BHF’s innovative “Call Push Rescue” training scheme teaches CPR and PAD awareness in less than 30 minutes. It takes just 30 minutes to save a life.

Will CPR awareness sessions affect our children’s maths and English? Will they reduce our children’s skills? Will they adversely affect our children’s standard assessment tests, their GCSEs or their A-levels? Such training can be slotted into the curriculum in many different ways, as has been said. For example, it could be taught in biology lessons or—my favourite option—in PE lessons. The good thing about CPR is that it can be taught anywhere in the school curriculum, and it must be possible to find 30 minutes somewhere in that curriculum.

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[Mr Gibb]

If not, I am sure that he or she has been snapped up elsewhere.

We heard powerful speeches from the hon. Members for Erith and Thamesmead (Teresa Pearce) and for Vale of Clwyd (Chris Ruane); I am sure the latter will receive a letter from either Willie Walsh or Richard Branson, depending on which airline did not have a defibrillator. There was also a powerful speech from the hon. Member for Strangford (Jim Shannon).

I recognise that the intention of the hon. Member for Bolton West is to ensure that more people have the knowledge and skills that could prove so valuable in assisting a child, teacher or someone visiting a school who suffers a cardiac arrest. However, whether teaching such knowledge and skills should be an addition to the national curriculum is another question.

The new national curriculum, which came into force in September 2014, represents a clear step forward for schools. It will ensure that all children have the opportunity to acquire the essential knowledge in key academic and non-academic subjects. However, I am afraid that it has now become somewhat routine for Education Ministers to come to such debates to make the case against the inclusion of a particular new requirement in the national curriculum. Proposals such as this are often supported by a persuasive argument, but their sheer number means that we need to start from a position of caution when addressing them.

The national curriculum creates a minimum expectation for the content of curriculums in maintained schools. Quite deliberately, it does not represent everything that a school should teach. Also, schools do not have a monopoly on the provision of education to children; parents and voluntary groups outside school also play an important role.

Many schools choose to include CPR and defibrillator awareness as part of their PSHE teaching. In the introduction to the new national curriculum, we have highlighted the expectation that PSHE should be taught, and improving the quality of PSHE teaching is a priority of this Government. However, we do not want to prescribe exactly which issues schools should have to cover in PSHE or other related parts of what we would call the school curriculum, as opposed to the national curriculum.

Prescribing a long list of specific content to be covered could be unproductive, leading to a tick-box approach that did not properly address the most important issues. Nor would it ensure that schools addressed those matters that were most relevant to their pupils. Indeed, we should trust schools to provide the right education for their pupils, within the overall framework of the national curriculum.

[Julie Hilling]

I had some optimism at the start of the Minister’s speech, but I have come back to a state of depression after listening to what he has had to say. He is talking about a list of issues that come to him, but how many of them could save 150,000 lives a year and how many would combine a range of issues including citizenship and boosting confidence? I ask him to consider the fact that this subject potentially has a special, indeed unique, position in our national curriculum.

[Mr Gibb]

I am not arguing against the inclusion of CPR in a school’s teaching curriculum; I am arguing about whether teaching these things should be statutory. There is more than one way to achieve an objective.

Also, if we look at the list of issues that people argue should be included for consideration in the national curriculum, we see that many of them would save a significant number of lives each year: relationships; drugs and alcohol; emotional and mental health, and well-being; emergency life support skills; homelessness; forced marriage; violence; transgender issues; tobacco; animal welfare; bullying; gambling; gender equality; cancer; symptoms of brain tumours in young people; fire and road safety; body image; the UN declaration on the rights of the child; environment; the dangers of carbon monoxide; cooking; media literacy; knife crime; parenting; chess; and foetal alcohol spectrum disorder.

Those are all specific cases where Governments, including the previous Government, have been lobbied over the years for things to be included in the national curriculum. It would be easy for any Minister—Conservative, Labour or Liberal Democrat—to say yes to those issues, only to find that there was little time in the national curriculum for the core academic subjects that we want children to learn. However, that does not mean that we do not think those other things should be taught in schools.

CPR is included in the non-statutory PSHE programme of study produced by the PSHE Association, which should please my hon. Friend the Member for Romsey and Southampton North. That suggested programme of study, which was produced by some of the leading experts in PSHE teaching, includes teaching young people how to recognise and follow health and safety procedures and ways to reduce risk and minimise harm in risky situations, and how to use emergency and basic first aid. Many schools also make use of organisations such as the Red Cross and St John Ambulance to provide information to young people about first aid and dealing with emergencies.

The British Heart Foundation has been mentioned by a number of hon. Members. It has offered to provide free CPR training kits to every secondary school in the country, allowing young people to gain first-hand experience of that important life-saving skill. The training kit covers how and when to perform CPR on an adult or child; how and when to put someone in the recovery position, which was referred to in the debate; and how and when to use a public access defibrillator. It contains an educational DVD demonstrating how to carry out CPR while trainees join in by using mannequins, so that no instructor is needed. The kit includes 35 mannequins, enabling every pupil in a class to learn CPR together.

We will work with the British Heart Foundation to promote that kit to schools. Indeed, the DFE is notifying all schools of the foundation’s “Call, Push, Rescue” kit in the next all-school termly e-mail, and we will continue to work with the foundation to promote its resources, as well as those provided by St John Ambulance and the British Red Cross, to all schools.

Many schools are already making good use of the resources and opportunities that are available to teach CPR, and to raise awareness of public access defibrillators. At Fulford school in York, for example, CPR training is managed by the deputy head teacher as part of his responsibility for pastoral care and character. One day each year is set aside to train all year 7 students; CPR training is part of their personal development lessons. At the last training session, around 30 teachers stayed behind to help and to learn the skills themselves. Feedback from the parent council has been favourable, as has been the response from students.

Other schools approach the training in a different way. For example, at Devonport high school for boys, CPR training sessions using the “Call, Push, Rescue” kit have been run in PSHE classes on Friday mornings. Since the school received the kit, year 10 students from three of the school’s six houses have undertaken the training.

I again thank the hon. Member for Bolton West and other hon. Members for their thoughtful and constructive contributions to the debate. I reassure them that I agree with them about the value and importance of first aid skills, and I also support access to defibrillators in schools. Although we do not believe that adding teaching on those issues to the national curriculum would advance the cause most effectively, we will always remain open to further discussions about the best way to promote those issues to schools and to ensure that schools have the resources they need to keep their staff and pupils safe.