Defibrillators: Public Access

Martyn Day Excerpts

Tuesday 4th July 2023 Westminster Hall

[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.