Defibrillators: Public Access

Rosena Allin-Khan Excerpts

Tuesday 4th July 2023 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to close for the Opposition with you in the Chair, Sir Charles. I thank my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) for bringing forward this debate. She never ceases to bring the voice of her constituents right to the heart of this place, and today is yet another shining example her doing her community incredibly proud.

It is welcome that there is such unity and consensus on this issue. As we have heard, tremendous progress has been made towards making defibrillators accessible to the public, thanks to the many incredible charities and people who have been working hard to do so. The Community Heartbeat Trust, the Oliver King Foundation and SADS UK are just some of the organisations that are doing brilliant work to provide education and information about automatic external defibrillators, AEDs, and to ensure that more defibrillators are easily accessible in public spaces.

The British Heart Foundation’s Circuit project has ensured that thousands of defibrillators and their locations are registered online, but, as we have heard, that work needs to go further. People who experience the very worst in the heart of their communities need to know that they are able to find and access an AED when they so desperately need it. The Premier League defibrillator fund will provide AEDs to grassroots clubs, which is very welcome and will ensure that lifesaving treatment can be rolled out to even more stadiums.

As we have heard, in the UK one person dies every three minutes from heart or circulatory disease, and 60,000 out-of-hospital cardiac arrests occur every year. Take a minute to think about that. My hon. Friend the Member for Erith and Thamesmead quoted research published by the National Institute for Health and Care Research, which found that just over 8% of people suffering a cardiac arrest outside hospital survive—just 8% of the 60,000 out-of-hospital cardiac arrests. The same research found that the odds of survival increase to 32% if a bystander has access to a public AED, and some studies place that figure even higher. It is simple: AEDs save lives.

According to the British Heart Foundation, the low cardiac arrest survival rate in Britain can be attributed to a lack of access to defibrillators. This critical technology must be accessible to work. With my medical hat on, I will take a moment to explain how it works. CPR works to send the blood around the body to take oxygen to the tissues as a holding measure, but the AED is required to shock the heart and try to restart it again so that it can pump the oxygen around the body. Imagine somebody providing non-stop CPR for hours on end. Not only would that be far too long and the person would be brain dead at the end, but without an AED—without that shock delivered to the heart—CPR is actually pointless.

We must be clear: AEDs are simple, safe and effective. They are portable, have plain instructions and the user cannot give a shock accidentally or hurt somebody. From my professional experience in the emergency department, I know how important quick access to treatment is for patients in cardiac arrest. There can be no doubt that patients who are admitted to hospital after having received prompt treatment with chest compressions or, even more effective, a defibrillator have far improved chances of making a recovery. There is also an economic benefit, because the people whose chances of recovery are worse may spend a long time in an expensive intensive care bed, often not surviving at the end of it. That makes the argument for giving people a better outcome in the first place, which prevents those protracted stays in intensive care and saves money in the long run.

When the heart stops beating, every second counts, and a person’s chance of survival decreases by approximately 10% with every minute that defibrillation is delayed. That speaks to the importance of everyone knowing where the AEDs are. With our NHS in crisis and emergency care at breaking point, lives are being endangered. In December last year, the average ambulance wait for category 1 patients had increased to 10 minutes—the worst performance on record. Those stats make a very clear argument: the painful fact is that people are dying as a result of not being able to get the shock they need from a trained person, whether they arrived in an ambulance or came from an AED in the vicinity.

Category 1 patients are the most serious and life-threatening cases, including cardiac arrest. In a category 1 scenario, every second is the difference between life and death, and longer ambulance waits are costing lives. Sadly, after 13 years of Conservative governance, patients can no longer rely on an ambulance arriving in time. At the end of last year, one in 10 urgent cases waited over 11 hours for an ambulance. How can we in all conscience say to people who lost loved ones in such cases that their loss could not have been avoided, when we know full well that it could have been?

Last year, the Government committed to funding a defibrillator in every state-funded school in England by the end of the academic year. As the academic year is nearing its end, will the Minister outline what progress has been made on that commitment? The Government also committed last year to £1 million of funding to provide an estimated 1,000 public access defibrillators across communities in England. I note that the Department re-announced that policy just last week, so has there not been any progress on that commitment? Will he update us on how the application process is progressing and whether any PADs have been installed, and if they have, in which communities? It is crucial that they are placed in communities where the need is greatest to tackle growing health inequalities, which we have heard about extensively today.

It is really important that health inequalities are not allowed to widen any further through a lack of access to equipment that could save lives. That has to go hand in hand with training people in how to use them. I would be interested to know what work the Department is doing to encourage uptake in the communities that are most in need. While many of us will agree that public access to defibrillators will be a fantastic step towards saving lives, we must not forget that our country also deserves a well-funded, well-resourced and well-supported NHS. It is heartening that there is widespread, cross-party support for publicly accessible AEDs. I hope that the Government will build on the support from across the House and do what is needed to ensure that access is available.

[Sir Charles Walker (in the Chair)]

I remind the Minister that if he takes up the full time he must leave two minutes for the mover of the motion to wind up.

--- Later in debate ---

[Will Quince]

Absolutely. The hon. Lady pre-empts me: I am coming on to The Circuit, because that point has been made by nearly all hon. Members, but I will first conclude my remarks about the fund.

Successful applicants will be encouraged to train or facilitate CPR training in the local community. That is an important element. To expedite the distribution of funding, and in readiness for the appointment of our partner organisation—this touches on the hon. Lady’s question—on 28 June the Department published an invitation for those organisations that wish to bid for an AED to submit an expression of interest.

My hon. Friend the Minister for Social Care wrote to all hon. Members informing them of the AED expression of interest and setting out how organisations can register their interest. It is incumbent on all Members of Parliament to ensure that community groups, organisations and local authorities across our constituencies spread the message loud and clear so that we get as many expressions of interest as possible. I urge any organisation that may benefit from a defibrillator, whether it is a sports club, a local theatre or a community hall, to register and have that opportunity. It is also important that we encourage local councillors to get involved.

The hon. Member for Erith and Thamesmead asked specifically about the Department for Education. I was Schools Minister at the time the decision was made and signed off. On 17 July, the Department for Education announced that it would provide defibrillators to schools in England that do not already have access to one. That is expected to be completed by the end of the 2022-23 academic year. The scheme, of which I am very proud, is the largest distribution of defibrillators to be rolled out across England to date. It will provide more than 20,000 devices, backed by £19 million of funding.

[Dr Allin-Khan]

The end of the academic year is in two weeks’ time, on 17 July. May I ask for an update on the progress to meet the target?

[Will Quince]

I have not been the Schools Minister for many months, but I will gladly ensure that the relevant Minister—or I, having accessed that information—gets it to the hon. Lady.

I remember that a key point in the design of the scheme—this touches on a point made by many hon. Members—was that providing an AED, in and of itself, is not enough. Accompanying the roll-out, we wanted to ensure that there were awareness videos about how easy it is to use an AED. We want teachers, as part of their training and in the staffroom, and pupils in assemblies to see how easy an AED is to use. In a rolling way, we hoped to create a new generation of young people who are confident in their use. As AEDs become more prevalent across communities, that can only be a good thing.

I think it was the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) who asked about CPR and first aid training. As a Back Bencher, I campaigned to have first aid included on the curriculum. The Schools Minister at the time was not very happy about that—not because he was against having it on the curriculum, but because the curriculum was already very full—but we did manage to get it included. It is important that we upskill young people so they have the confidence to act in the unlikely but possible event that they encounter someone in cardiac arrest.

The question about vandalism of defibrillators is a fair one. I had not given it any thought, but I will certainly have a conversation with my counterparts in the Home Office and the Ministry of Justice and see if there is any scope to take further action in that area.

Turning to The Circuit, I would certainly like to recognise the incredibly important work that charities do in ensuring that the public have access to defibrillators. The British Heart Foundation, in partnership with Resuscitation Council UK, the Association of Ambulance Chief Executives and of course the national health service, set up The Circuit, which is the national defibrillator network database that provides information on where defibrillators are located.

I heard the point that the hon. Member for Tiverton and Honiton (Richard Foord) made about legislation, which I have some concerns about. At the moment, registration is entirely voluntary, so nobody is forced to register their defibrillator with The Circuit. However, registration enables the emergency services and community first responders to locate the nearest publicly accessible external defibrillator when they are treating someone suffering from an out-of-hospital sudden cardiac arrest. In those crucial moments after a cardiac arrest, we know that locating an AED quickly will help save lives.