Defibrillators: Public Access

Luke Pollard Excerpts

Tuesday 4th July 2023 Westminster Hall

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

It is good to see you in the Chair again, Sir Charles. I congratulate my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) on the way she introduced the debate and the passion she put into it. If we could all be as passionate, we would save more lives, which is wonderful, and I thank her.

Defibrillators save lives and that is why we need to have more of them. Everyone who has spoken in the debate so far has had a story of how a defibrillator has saved someone in their community, and that is because defibrillators save lives. If we know where defibrillators are, how to use them and what to do in medical emergencies, we will save more lives and be more confident in allowing communities to be a part of the healthcare response, especially at a time when our NHS is in crisis. According to the British Heart Foundation, around 3,500 out-of-hospital cardiac arrests happen each year in the south-west of England. In Plymouth alone, 28,000 people struggle with high blood pressure, and 25,000 people in my city live with heart-related conditions. That means we need to ensure that support is available in every one of our communities, should it be required.

Without doubt, the availability of defibrillators would improve cardiac arrest survival rates, and I know this at first hand. In March I held a #MeetLuke public meeting in Compton ward, at which local residents had an opportunity to ask questions to me and local councillors. Our three local councillors—Labour, Conservative and independent—had just been asked an exciting question about cuts to local buses, but the independent councillor struggled to answer. They said they needed some air, and they quickly wanted some water. When they stood up, they fell to the ground having a heart attack. If it had not been for the quick reactions of people in that room, that person would have died. One of the councillors started doing CPR on their fellow councillor, while the other one ran to get the defib, which had been installed in a church opposite to where we were. They called 999 to get the access code to the locked cabinet, and that triggered an emergency response from the ambulance service because a defib had been activated, and a police car was sent as well as an ambulance.

If it had not been for the quick measures and thinking of Labour Councillor Dylan Tippetts and Conservative Councillor Charlotte Carlyle, the independent Councillor Nick Kelly would have died right there. We had help from doctors and first aiders in the room, but if it had not been for the defib, he probably would not have survived. As much as we pride ourselves on having political banter, everyone should be able to go home to their family at the end of the day. When I saw a defibrillator being used right in front of me and how it saved a life, it left not only a harrowing memory, but a responsibility to ensure that there is a defibrillator in every one of our communities.

Councillor Carlyle is working with the local Pearn Charitable Trust to fund more defibrillators in that community, which is admirable. In addition to Compton ward, every other ward in the patch I represent needs defibrillators, and that is especially true of our poorer communities. Richer communities have more access to defibrillators than poorer communities. That is often because of the high upfront cost of a defibrillator, so I welcome the initiative the Minister has outlined to provide funding for communities to bid for a defibrillator. However, I share the concern of my hon. Friend the Member for Erith and Thamesmead about where defibrillators are located. We need to ensure that they go where the need is, not just to where people are good at filling in bids. We are aware from other areas of funding that if someone is a good bid-writer, they are more likely to succeed in the bid. That does not necessarily mean that they have a more worthy cause. I would be grateful if the Minister could set out how his Department is ensuring that the funding goes to where the need is, and not just to where the most successful bids are.

Regarding availability of AEDs and the overall package, it is absolutely important to consider where the risk is. The £1 million funding announced by the Minister is welcome, but it will soon be spent and the great need for AEDs will remain. Where are the deficits? Which areas have a lower concentration and density? They will also be the areas on the map where people are at higher risk of heart disease, and that is why we need to ensure that they have AEDs.

I second the call for defibrillator guardians to register their device with The Circuit. When people dial 999, they will then be able to access a nearby defibrillator and the emergency code to unlock it. It is important that people know about that. I recently visited the O2 store in Drake Circus in Plymouth, which had just installed a defibrillator and trained all staff in how to use it. That is an incredibly welcome move. I would like big corporates to take the initiative and ensure that they are looking after not just their own staff but customers and others nearby.

I challenged local supermarkets in Plymouth on whether they had defibrillators, but not all of them did. The shopping demographic includes people of all ages. For some, leaving the house to push a trolley or carry a basket around a supermarket can be quite intense. We know that cardiac arrests happen when people go shopping. As a basic piece of social responsibility, every single supermarket should have a defibrillator and a sign on the front of the store informing people that it can be used in the event of a problem. What additional conversations is the Minister having with large chains and corporates to ensure that defibrillators are not only registered on The Circuit but visibly signposted?

I echo the call about parliamentary AEDs. There is one outside the office of my hon. Friend the Member for Tooting (Dr Allin-Khan), who will speak in a moment, and my office is situated between hers and that of my hon. Friend the Member for Erith and Thamesmead. That means that I know where the nearest AED to my office is located, but I am not in my office at the moment and I do not know the location of the nearest AED. There is a challenge to onboard people. I like the idea that we should be a beacon of best practice. All staff should be onboarded when they arrive on the parliamentary estate and informed about not only where AEDs are located but how to use them. We are often confused by advice on how to use the staff training allowance provided to us by the Independent Parliamentary Standards Authority, but I think it could be put to good use with first aid training. Following the incident at my public meeting, all my staff will shortly go on a first aid course so that they can feel confident about how to respond in the event of a medical emergency. But that should be a standard for everyone in this place. We should lead by example.

Finally, there needs to be more focus in education and training. If we are faced with someone having a cardiac arrest or a suspected one, knowing what to do in those first few seconds could be the difference between that person surviving or not. As a country, we should aspire to equip each and every one of our citizens with a minimum level of first aid knowledge. Wherever someone is, they should have an understanding about how to provide basic first aid and what to do in the event of an emergency. That training should be repeated throughout their life as a refresher to top up their knowledge, so that wherever someone is, and regardless of whether they have a defibrillator near them, they know what to do in the event of an emergency.

What conversations has the Minister had with the Department for Education to make sure that our young people leave school equipped with first aid? They need to feel confident about operating an AED, especially given that there are places where young people are encouraged not to touch that thing on the wall because it is dangerous. I have heard that said a few times about defibrillators, but we want our young people to know what they should do in the event of an emergency. We should not scare them, but equip them with the knowledge about what should happen.

The defibrillator that saved Nick Kelly’s life in Plymouth was installed only a month before the public meeting. Had the meeting taken place two months previously, as I had originally intended, he would not be alive today. We owe an enormous thanks not only to the organisations, charitable groups and individuals who fundraise and host defibrillators, but to the organisations that pay for the recharging and upkeep, because it is often more prominent to buy a defibrillator in the first place, incurring a high capital cost. It is often less prominent in fundraising to pay to keep it tip-top and in good condition, so that it can be used.

I want to say a special thanks to the congregation and clergy at Emmanuel Church for taking the risk to buy a defibrillator, the benefits of which they have seen almost immediately. I hope that every single church, supermarket, public building and major location in Plymouth takes note of that, buys a defibrillator and puts the maintenance of it in its annual budget. If they do that, we will save more lives and it will help the health service to be able to respond to medical emergencies quicker when they do happen.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) for securing today’s important debate on public access to defibrillators, and I congratulate her on the thorough way in which she opened it. It is always a pleasure to take part in debates that are so consensual, and I suspect we are all on the same page, which is nice for a change.

Cardiac arrests strike without warning, and usually outside the confines of a hospital, leaving people in immediate need of medical attention. We have heard from a number of speakers that fewer than one in 10 people survive, which is truly frightening. According to medical professionals, every passing minute without defibrillation reduces a cardiac arrest victim’s chances of survival by a staggering 10%. In such critical moments, defibrillators emerge as vital instruments that are capable of restoring the rhythm of a failing heart, so accessibility and knowledge of where they are located are vital. Incredibly, there is no official centralised database that records the number of defibrillators and their locations.

Thankfully, as we have heard, some organisations have launched their own maps, such as the British Heart Foundation’s Circuit, to improve access to defibrillators. The Circuit is a comprehensive national network of defibrillators, which aims to improve survival rates by mapping the locations of defibrillators across the UK, enabling prompt access during emergencies. There are currently 60,000 defibrillators registered on The Circuit, but it is estimated that tens of thousands remain unknown to the emergency services. Raising awareness about The Circuit and encouraging registration of these devices will enhance their effectiveness in critical situations.

[Luke Pollard]

Having the data on one database is really important. Does the hon. Gentleman agree that the data has to be accessible and pulled through to other devices? I just googled “defibrillators near me” on Google Maps, and there really are not any, so we need to make sure not only that the data is stored, but that it is publicly available for people, especially on their handheld devices.

[Martyn Day]

That is a very good point. None of us, myself included, goes anywhere without a mobile device nowadays, so that is the obvious tool of choice.

Timely defibrillation is a cornerstone of improving survival, and Scotland’s out-of-hospital cardiac arrest strategy aims to increase to 20% the rate of incidents where a PAD is applied to the patient before the arrival of the Scottish ambulance service. I encourage groups and organisations with a defibrillator to ensure that it is registered.

Early defibrillation can massively increase someone’s chances of surviving out-of-hospital cardiac arrest, but many defibrillators are never used because the emergency services simply do not know about them. “Scotland’s Out-of-Hospital Cardiac Arrest Report 2019-22” highlights:

“The number of Public Access Defibrillators (PAD) in communities across Scotland that are registered on the national defibrillator network (The Circuit) has more than doubled since 2019”.

That is good, but we need to do better. Currently around 5,000 are registered. Registration on The Circuit makes a PAD device visible to the Scottish Ambulance Service and alerts emergency call handlers that there is a pad near an out-of-hospital cardiac arrest. That makes registration a vital component in that chain of survival.

I am reminded of the Gandhi quote: “You cannot help everyone, but everyone can help someone.” Each of us as an individual can play a crucial role in bridging the gap between cardiac emergencies and lifesaving interventions. The British Heart Foundation’s map of The Circuit offers a valuable resource that allows individuals to check the availability of nearby defibrillators. By using the tool, anyone can quickly identify the nearest defibrillator, which improves response times and potentially saves lives.

Of course, 80% of cardiac arrests occur at home, so it is vital that Governments continue to consider ways to increase engagement at community level. For example, the Scottish Government want bystanders who witness an out-of-hospital cardiac arrest to feel able to take action. To achieve that, Scotland’s out-of-hospital cardiac arrest strategy aims to familiarise a total of 1 million people in Scotland with CPR skills; it works through increased engagement with community organisations such as sports hubs, local businesses and other community groups to raise awareness of and offer opportunities to learn CPR. I had CPR training in the past, but I think I could do with a refresher, as I suspect could many of us who have had the training. It is not done often enough; if an emergency occurred, I am not sure that I would feel as confident as I would have done a month or a couple of months after the training.

As I repeatedly point out in health debates, we cannot escape the fact that health inequality and poverty go hand in hand, and that is the case with out-of-hospital cardiac arrests. Those in the most deprived areas are twice as likely to have an out-of-hospital cardiac arrest and 60% less likely to survive than those in less deprived areas. Deprivation also has a significant effect on the likelihood of receiving bystander CPR. Then there are geographic and demographic issues: around 11% of the population of Scotland live in rural areas; they are 32% less likely to survive or to leave hospital after an out-of-hospital cardiac arrest than those living in urban areas. Over the last seven years, we have started to understand more clearly the association between measures of socioeconomic position and decreased survival rates after such incidents.

Ethnicity can also be a factor in how likely a person is to experience an out-of-hospital cardiac arrest. For example, people from south Asian backgrounds are at up to 50% higher risk of developing coronary heart disease than white Europeans, and coronary heart disease can lead to heart attack or cardiac arrest. In addition, international studies show that women are less likely to have CPR performed on them—a pattern that we also see in the Scottish data. The misconception that breasts make CPR more challenging, fear of doing harm, fear of inappropriate touching and fear of being accused of sexual assault have been given by the public as reasons for that gender discrepancy. It is important that we work to combat those fears and embed the knowledge that CPR is a gender-neutral lifesaving technique. Those health inequalities confirm beyond doubt the importance of prioritising pads in areas of the highest risk first, as a number of other speakers have mentioned.

Availability and accessibility of defibrillators are critical factors in reducing the devastating impact of cardiac arrests. One way of making defibrillators more accessible would be to make them more affordable. Currently, charities and local authorities can claim a VAT exemption when purchasing a defibrillator, but that should be extended to anyone buying the equipment. Quite simply, the UK should follow Ireland’s example and remove the tax. However, raising awareness of initiatives such as The Circuit, encouraging greater community involvement and tackling poverty all remain essential. By embracing those measures and working together, we can create a society in which every individual has a fighting chance against cardiac emergencies, and ultimately save more lives.