Meeting date: Thursday, November 22, 2018
Public Petitions Committee 22 November 2018
Agenda: New Petitions, Continued Petitions
Public Access Defibrillators (PE1707)
I welcome everyone to the 17th meeting in 2018 of the Public Petitions Committee. The first item on our agenda is the consideration of new petitions.
The first petition is PE1707, by Kathleen Orr, on public access defibrillators. The committee will take evidence from the petitioner, who is accompanied by Stuart McMillan MSP. Members might be aware that Mr McMillan has worked closely with the petitioner and had a members’ business debate in April on the specific events motivating the petition. Mr McMillan is here to support Mrs Orr, rather than as a member who has an interest in the petition’s general subject matter. We might ask certain questions that Stuart McMillan will be better placed to answer than the petitioner—we are entirely relaxed about that.
I thank you both for appearing before the committee. You have an opportunity to make a brief opening statement of up to five minutes, after which we will move to questions.
I lodged the petition in memory of my son. It all started off as a normal day on 4 August 2017, just 10 days back from being on a family holiday. Jayden went skating in the morning, as usual, and to his normal skate club in the evening. While he was doing his normal skate routine, he collapsed on the ice and never got back up again. That was when my world fell apart.
Jayden was lifted from the ice by my husband and taken to the first aid room. I do not remember too much after that, but I know that there were a lot of members of staff and not one of them knew what the others were doing. To my knowledge, there was a defibrillator, but none of the staff used it because they were not fully trained and were scared of doing so.
I started the campaign in January. I want to—and I will—achieve my goal of ensuring that all schools and public places have access to defibrillators, which are mapped. I started with schools, because they have a lot of activities, including after-school clubs. When I was doing my research on defibrillators, I noticed that a lot of young people pass away suddenly from cardiac arrest while they are taking part in sporting activity.
I am now Jayden’s voice, and I will be the voice of other families who have lost their loved ones who could have been saved if there had been a defibrillator that was registered and able to be used by the public.
I thank the Greenock Telegraph for standing by me throughout my campaign. Stuart McMillan has been by my side from day 1. He has taken things at my pace, never pushing me in any way. That has made me feel a lot more comfortable.
Thank you very much. I appreciate how difficult this is for you, so we will go at your pace. We want to be as helpful as possible on the issues that the petition raises, but we are very conscious that the personal dimension must be very tough for you. We will ask you a number of questions in order to tease out some of the issues that we will want to address with other people. You have told us powerfully about the motivation behind the petition, and we can all relate to that.
You mention that you have met officials from the public health minister’s team. What was the outcome of that meeting?
There was no further correspondence from the minister’s office. I did not feel that the meeting was of any great benefit. The office was also meant to get back to me with information on local contacts, but that never happened.
That is something that we can raise and pursue. During your meeting, did you discuss the possibility of there being an official public awareness-raising campaign? If so, what response did you get?
I asked whether the Government would consider piloting a scheme in Inverclyde, given that that is where we are from and the nature of what we are trying to do. I was told that such schemes were happening in other places around the country and that the details on what was happening would be passed on, but I have not received that information either.
Good morning, and thank you very much for coming in. I am aware of your tragedy—I spoke in the debate in the chamber that was secured by Mr McMillan, who eloquently highlighted the issue.
In your petition, you ask for public access defibrillators to be fitted to buildings based on floor space. Why do you highlight a particular floor space?
Along with Stuart McMillan’s office, we looked at empty properties on websites such as Rightmove and Zoopla. We looked at commercial properties that were up for rent and at their floor space by square metre. We then tried to work out what size the building would have to be to mean a significant footfall each day or a significant number of people working in the building. However, I am happy to discuss the figure if the committee feels that it should be higher or lower.
I am keen to establish whether it is the size of the building or footfall that is most relevant to delivering the aims of the petition. In the members’ business debate in April, we heard that the Government had funded the University of Edinburgh resuscitation research group to carry out modelling to inform consideration of where defibrillators are best located in order to save lives. Are you aware of that work? Have you seen any of the outcomes? At the end of the day, we want the very best outcome.
I am not aware of any work being carried out by the University of Edinburgh. However, I believe that we need to strike a balance between footfall and floor space. If the location of a defibrillator was based purely on footfall, we could end up with one in every shop on a high street, which would be too much. However, floor space would balance that out—that is why I came up with a figure of 7,500m². Again, I would be happy to have any guidance from the University of Edinburgh.
We had quite a lot of discussion on that aspect and there was a feeling that, if the floor space figure was set too low, that could have a financial impact on smaller businesses, particularly given the tough economic conditions across the country. We felt that, if the measure applied to buildings with a larger floor space, that would probably encompass larger businesses with more footfall, so there would not be an economic impact on small businesses. As Kathleen Orr stated, the figure of 7,500m² is not set in stone. We reached that figure so that we had something to put in the petition.
I am raising the issue because I am trying to put it in context. For example, the main town in many constituencies has no shop that is 7,500m², but we would want a defibrillator in those locations.
The suggestion is that, once the principle of accessibility to defibrillators is established, we would look at how best that could be done.
Yes. The figure came about through discussion, and it is intended to be a point for further discussion—it is not set in stone.
I commend Kathleen Orr for bringing the petition to Parliament. I have asked the Scottish Government questions about it recently, because of some constituency work that I have been doing. Those questions are available on the Parliament’s website. I am due to receive the answers in five days, and they might help your campaign. The petition is important, because performing cardiopulmonary resuscitation and using a defib can double the chance of survival.
I want your opinion on one of the questions that I have asked the Government. I do not know whether you have seen “Out-of-Hospital Cardiac Arrest: A Strategy for Scotland”, but it aims
“to ensure that Public Access Defibrillators (PADs) are mapped, maintained and accessible to the public.”
I asked the Government what its plans are to introduce a standardised identification system for all public access defibrillators to enable the Scottish Ambulance Service to more easily locate them in an emergency situation. What are your thoughts on that and how would it work with your campaign?09:45
When I started my campaign, only a handful of PADs were registered in Inverclyde. Now, a lot more people realise that they are needed and they understand the real importance of having them registered. I have gone to lots of places and told people that there is no point in them having a defibrillator if it is not registered because nobody knows that there is one in the building. I have made it clear that that is highly important—they have to be registered. At the beginning, there was not a lot of information at all about that.
The Government’s strategy is well meaning but more needs to be done by 2020, which is the target date set in it.
I think that David Torrance will ask you some questions later about the British Heart Foundation but it is relevant to mention it now because it is really important that everybody works together, including the Scottish Government, the Scottish Ambulance Service and the BHF. At some points during your research, have you felt that everybody is doing different things?
Yes. We are all doing different things even though we are all trying to achieve the same thing.
I suppose that it might help if everyone worked together.
Yes. It would help if everyone worked on the same page.
As a consequence of the Jayden’s Rainbow campaign, we set about trying to talk to all the local partners who would be involved in this sphere. It was clear that each organisation seemed to be doing its own thing, without an Inverclyde focus or strategy.
It has taken a bit of time to tie down a date, but on Monday I am hosting a round-table discussion. Kathleen Orr, St Andrew’s First Aid, and Heartstart Inverclyde will be there. We asked Inverclyde Council to come—it could not supply anyone for Monday but we will keep it fully abreast of the discussion and any outcomes from it.
The purpose of the discussion is to try to ensure that we have that focus in the Inverclyde area. Since the Jayden’s Rainbow campaign started earlier this year, £20,000 been raised, defibrillator machines have been purchased and Kathleen Orr has started to distribute them to local schools. It is clear that the different organisations want to work together but the issue is finding a way to do that. Monday’s discussion is the first step in trying to forge an Inverclyde-wide strategy.
I would like to move on to some of the details that you put in the background information of the petition, Kathleen. You say:
“PADs have an excellent safety record and low upkeep costs ... I have been going into schools and showing kids how to do basic CPR and also how to use a PAD in an emergency. While conducting this work, I have realised that placing PADs in schools is great and showing the kids how to use them is vital.”
You say that you have moved on from there to try to roll out that programme further.
Our briefing appears to support your position that PADs give a significant life-saving advantage. For example, if one is used within three to five minutes of a collapse, it can produce survival rates as high as 75 per cent. I am keen to hear your views on that. Also, can you give me a rough idea of what the “low upkeep costs” might be?
Replacing pads after they have been used can cost between £70 and £90, depending on whether the replacement pads are for a child or an adult. Batteries cost about £100—that depends on the make and model of the machine. For the PADs that I give out, a replacement battery costs £100 and has a lifespan of two to three years.
As for the initial installation, housing a box comes in at £400 or upwards, but that is a one-off cost—there are no costs after it. The only other cost is from electricity and heat for the machine.
You have partly answered the question that I will ask. How aware do you think people are of the Scottish Ambulance Service’s public access defibrillators service?
People in Inverclyde are definitely more aware now than they were a few years ago, but that is partly because of my campaign and the stories that have been in our local paper. Stuart McMillan promotes the Scottish Ambulance Service’s yearly campaign to get PADs registered, but that is the only vehicle other than my campaign that I am aware of for registering PADs.
I agree absolutely with Kathleen Orr that local awareness has increased about the importance of defibrillators. I was a wee bit concerned initially about the change that will take place with Microsoft and the database, as I did not have all the information, but the situation has been clarified for me. I felt that confusion might arise if two databases ran in tandem, but that will not be the case—all the United Kingdom ambulance services will feed into the Microsoft-supported database. That will have a positive effect for people who live in the Borders, because the closest defibrillator to someone in Scotland might be in England and, for someone who lives down south, it might be in Scotland.
The important element of any database is the information that goes into it. If people purchase a defibrillator or if one is donated to a school, community hall or other facility, it must be registered. It is important to purchase defibrillators but, if a defibrillator is not registered, the Ambulance Service cannot direct someone to get it and use it to try to save a life. Registering is so important. The information that goes into the database will help to save lives.
Four years ago, a defibrillator was put in a shop in my area. When I asked about it in the shop, none of the staff knew where it was, because the staff had changed so much. How do we keep staff members in leisure centres or whatever aware of what is on the premises?
My PADs are being placed in schools but, within the year, I would like to get PADs placed outside school buildings, so that they are accessible and the public can see them. When staff change in a school, they should be clearly notified of the school’s defibrillator and of where it is placed.
On the day when I hand over the defibrillator, I hang about in the building until I know that the school has gone online to register the machine. I am pushy on that subject so that the defibrillator is registered while I am there. I say that I will go home and check my side of things, although I do not do that—I make sure that the defibrillator is definitely registered while I am there.
The challenge is that not everyone has a Kathleen Orr to make sure that we are doing the right thing. The powerful message that you are sending—and rightly so—is about how we ensure that this sort of thing is systematic across communities.
I have been involved in work to give people confidence in cardiopulmonary resuscitation through first aid training and so on. If I were to ask the people in this room, “Where is the nearest defib and if something happened, would you know what to do with it?”, I suspect that most people would not know and would not have the confidence to use it. I was lucky to be involved in work on CPR with St Andrew’s First Aid; after all, the defib might be there, but we might just walk away from it if we do not have the confidence to use it or if we do not do the initial things that might help. That is a huge issue. Have you had any involvement with not just the British Heart Foundation but other first aid organisations to take into schools and communities the message that first aid is a skill that not just the designated first aid person in a building but all of us should have?
I have spoken to Heartstart, which is going around the schools in Inverclyde at the moment, and my son, my daughter and I also go into schools as a family with training defibrillators and let the kids have a shot at them as part of a scenario that we set up. The way I see it is this: the kids are the ones who are out playing in the streets, so we need to ensure that they know what a defibrillator is and that, when they see it housed in a box, they know exactly what to do with it and are not scared of it. As I have said, I take my training defibrillators and wee dummies into the schools and let every kid have a shot. The questions that they ask me are amazing, and it seems that, given how much has been published on this issue and how much everyone is talking about it, everyone wants to have training. When Heartstart sets up its wee place in community centres, a lot of people attend; it has only been since this campaign started that everyone wants to know where the defibrillators are, how they use a defibrillator and whether they will kill someone with it. They are scared to use a defibrillator, but when they have a shot of it, they realise that they will not kill anyone, because it will not administer treatment if it does not have to.
Being able to save a life is an amazing skill. I have just been told that Fulton MacGregor MSP is going to ask a question at this afternoon’s Scottish Parliamentary Corporate Body question time about support for first aid in the Parliament, and that, too, is important for general awareness raising. Should anything specific be done about awareness raising or training? You are doing wonderful things in your area, but how do we ensure that that sort of thing happens across the piece and does not simply rely on someone such as you being so focused on the issue? What do the Government and local authorities need to do to support that kind of work?
I know that first aid training happens in secondary schools, but it is unfair that there are no such courses for primary school kids. The younger that people learn, the better, because when they grow up, they will know a whole lot more. Kids in high school take the training seriously—although it has to be fun—but younger kids need to know how to use this equipment, too, because if someone collapses in the street, it is probably going to be a nine-year-old who will have to get the box and save that person. I do not want any kids to be scared of using it—it is not scary. As I have said to kids, “Don’t worry—you are not going to hurt the person when you use it.” Schools are taking this on, but there is no push to give this training to primary school kids. I do not think that it should be just high school children who get it.
I suppose that it is age-and-stage stuff; in other words, it is all about what a child is capable of understanding. The advice that we were given when we did our first aid training was that the equipment tells you how it should be used as soon as you start using it, and it is not possible to do it wrong. That is a very simple and helpful message to give people.
Did you have a final question, Rachael?10:00
We have covered many parts of this issue, from encouraging people to have defibs in place to training, maintenance and so on, and Kathleen Orr’s campaign will highlight that so much.
I want to add one little point. Stuart McMillan said that the national defibrillator network will launch in spring 2019, when everyone will be able to register their defib with the local ambulance service. I know that that seems like quite a long way away, but Kathleen’s campaign will really highlight that, and I hope that everybody will replicate what she is doing. We will take on board her point about training for primary school-aged children.
I want to come in on the convener’s previous question, which was about the next steps. At the round-table discussion that we will have on Monday, I am hopeful that, with Inverclyde being quite a compact area, the various partners who will be around the table can forge ahead with a coherent local strategy. When something comes of that, it can be rolled out to other parts of the country.
The Jayden’s Rainbow campaign has helped hugely in making more people aware of access to and the importance of defibrillators. Over the past few months, Heartstart Inverclyde has increased the number of training sessions that it has undertaken in Inverclyde—I went on one in the summer. St Andrew’s First Aid has also increased its local activity. Therefore there are three willing organisations that want to do the best for Inverclyde and, if we can put together something coherent and deliverable, that could be rolled out and utilised in other parts of the country.
It would be useful for us to get an update from you after the round table. If anything comes out of it that would inform our thinking, I would appreciate that.
The question with the petition is how we can take the experience of and lessons from Kathleen Orr’s tragedy, as well as Inverclyde’s experience in trying to address it, and help communities around Scotland.
Kathleen’s points have been powerfully made. Sometimes, these things are so obvious but they are not being done, so it might be a question of driving them through. I take it that the committee is aware of the sensible comments, points and requests that have been made in the petition. Do members have suggestions about who we should contact?
On the point that you made about people knowing how to administer a defibrillator and not being frightened to use it, it strikes me that everybody in the Parliament has access to a set of training sessions. If we have access to that, why do we not lead the way and give everybody in Parliament access to training on defibrillators and where the nearest defibrillator is? I do not know where the nearest one is. If we can roll out the training that we currently get, why on earth would we not do something similar on defibrillators? That would add a great deal of weight and publicity to the campaign that Mrs Orr is undertaking, and Parliament would lead the way.
I have been banging on about this for a while. In any workplace that I have ever been in, there has been an identified first aider, but if something happens and they are not there, what happens? Therefore, giving everybody that life skill really matters. We could pursue that further.
I suggest that we write to the Scottish Government to get an update on Kathleen Orr’s meeting with the Minister for Public Health, Sport and Wellbeing and to get its response to the petition. We have mentioned the British Heart Foundation. I suggest that we also contact St Andrew’s First Aid for its views on how we take what is being done in Kathleen Orr’s location out into other communities.
You are suggesting that we write to those organisations but, because this is such an important issue, perhaps we should have a round-table evidence session with the Scottish Ambulance Service and the British Heart Foundation. The Resuscitation Council (UK), which is working on registration, is also important. I do not know how practical it is to get people from those organisations round the table. Another one is St John Scotland, which is different from St John Ambulance and which is based here in Edinburgh. It has volunteers throughout Scotland and is training people to use defibrillators. What is the practicality of bringing people in for evidence?
There is a live petition from St Andrew’s First Aid on giving all primary school children training in first aid. Once we have looked at that, we could consider having a further session to pull all the issues together. However, in the first instance, it would be worth while to get a response from the Scottish Government and the organisations that we have all identified, including the ones that Rachael Hamilton identified, on the asks in the petition. That would inform our decision on whether to have a round-table session. We can also get the information from Stuart McMillan’s event on Monday. We will not leave it at that; we will reflect on what comes back. To be honest, the conversation with the Government seems to have run into the sand a little—it has not come back with the information that Kathleen Orr expected. We can raise that with the Government as well.
We recognise that we will definitely come back to the issue and to other petitions on related issues but, specifically on this petition, we will ask about the demands as a starter for 10. Is that acceptable?
Members indicated agreement.
Kathleen, is there anything that you want to say before we move on?
I would like to add that the machines that I am buying cost £1,000 and upwards. Maybe further down the line, when there is a new build or a new school is put up, an extra £1,000 should be spent on putting one in. In my area, a lot of schools have been refurbished, which costs up to millions of pounds but, in the whole time that that has been done, not once has any thought been given to even putting an outlet on the outside of a building in case anyone wanted to put in a defibrillator, and there has never been any thought about spending an extra £1,000 to have a machine inside. That is nothing to a massive company, but it is life-saving equipment. Everybody has to have a fire extinguisher, because that is the law and because fire extinguishers save lives, but defibrillators save lives, too.
That is a very important point, and it is rational, sensible and logical. We have to ask why that has not already been done. We can pursue the issue in legislative terms but, actually, we should also simply ask the Scottish Government and perhaps the Convention of Scottish Local Authorities about their policies when they are building. We have had conversations about fire safety and having sprinkler systems hardwired into new buildings. Is it not logical to ensure that there is at least the possibility of attaching a defibrillator to any new building? Those are hugely interesting issues and are practical points in taking forward your proposal.
Thank you very much for your attendance. I appreciate just how difficult this is for you and your family, and we thank you very much for all that you have been doing to pursue these important issues.10:09 Meeting suspended.
10:13 On resuming—
Additional Support Needs Schools (PE1709)
The next petition for consideration is PE1709, by Claire Mooney, on the installation of closed-circuit television cameras and the provision of full-time social work support in all additional support needs schools. Members have a copy of the petition and the briefing that has been prepared by the Scottish Parliament information centre and the clerks.
The petitioner raises concerns about restraint practices in additional support needs schools and is of the view that the way to address those concerns is to install CCTV cameras and establish a full-time social work presence in all additional support needs schools in Scotland. Our briefing note explains that approaches to the delivery of specialist additional support needs education differ between local authorities and it draws our attention to PE1548, on national guidance on restraint and seclusion in schools, which covers similar issues with regard to restraint practices in schools.
Do members have any comments or suggestions for action?
As you say, we looked at a petition that was specifically about restraint. I am of a mind to reflect back on the outcome of that. It seems to me that PE1709 is about child protection. That is laudable, obviously, but it seems to me that the flip side of that is that it becomes very big brothery rather than being about education of the staff.10:15
Beth Morrison’s petition PE1548, which has been going on for a while, is about inappropriate restraint and seclusion of young people, and putting them in spaces that are not comfortable. PE1709 raises an interesting point about how we are made aware of those practices. A young person with a learning disability is regarded as not being a reliable witness.
These are interesting questions. I am not sure whether we would come to the conclusion that we should put in CCTV, but we can understand what drives the suggestion. If there is inappropriate behaviour towards a young person and they are not regarded as being able to describe what has happened, what evidence is there? That is why there is also a suggestion that social work support be made available in every additional support needs school. I suppose another question is what protections are in place for young people in such circumstances who are in mainstream education.
I would be interested to see the responses of the Scottish Government and local authorities to the challenge that the petitioner legitimately makes. How do we keep our young people safe? What evidence can be used? I imagine that, in many cases, colleagues in the school would be aware of inappropriate behaviour, and I am sure that they have an obligation and a responsibility to report anything they see that is inappropriate.
I suppose the committee needs to think about what the issues are and then separately ask whether the solutions that are proposed in the petition are the correct ones.
I would be interested to find out whether CCTV is being used in similar settings in other countries. What examples do we have? What evidence is there to suggest that the approach works well? At the moment, I am unaware of that. It may be a great idea, but I am unaware of how it could actually be of benefit, so I would like to see some evidence of where it is being used. However, I might be wrong about that; it might never have been considered elsewhere in the world.
We could ask SPICe to look into that and see whether there are international comparisons.
Given the concerns that have been expressed to the committee in the past, particularly in PE1548, by Beth Morrison, on restraint in ASN schools, I can see where the petitioner is coming from. There is merit in Rachael Hamilton’s suggestion that we look further afield and see whether there are examples of CCTV being installed in other countries specifically for this purpose.
It is interesting to note from the papers that those who are employed in such settings do not support the proposal. There is some suggestion of a concern about it.
How should inappropriate behaviour be managed? Should that be done through CCTV? I suppose that the question we are really asking is, “If not that, then what?” I suggest that we write to the Scottish Government, COSLA and the Scottish Social Services Council and that we ask SPICe what the international situation is. Do members have any other suggestions?
The other issue is data protection and the right to privacy. The proposal might be a non-starter because of that. Should we therefore look at whether it breaches any human rights regarding privacy?
Do you mean the human rights of the young person or the human rights of the employee? They might not necessarily be in alignment.
We need to look at both because we might get to a point at which we have seen good examples, SPICe does its research and then suddenly we come across a barrier that says that this is completely impossible because of the protections.
I am interested in asking organisations that represent people who have learning disabilities, and advocacy organisations. If somebody is not able to say for themselves, “This is what happened to me”, how would the advocacy system understand what happened and give people their rights? The petition frames the issue in terms of the human rights of the young person, so how are those rights enforced in a situation in which the person is not seen to be a credible or reliable witness? That is an interesting area that has also been opened up.
I agree. The first question is whether there is a gap. If there is, how do we close that gap? Is CCTV the way forward? I would be interested to see what social services’ take on that is.
It might also be good to speak to the representative organisations of people who are employed in the sector. Their view will, of course, be coloured by the fact that they are representing the employees, but it would tease out the issue of human rights and the responsibilities and accountabilities of people who operate in social work. The petitioner clearly regards having social work services in the institution as a way of protecting rights. What would the teaching unions or other support unions think about that? It might be worth flagging that up.
Do we agree to the suggested action?
Members indicated agreement.
We thank the petitioner for lodging the petition. It raises important and challenging questions that are in tune with the earlier petition and we want to explore whether the proposal in the petition is the solution and, if not that, what is?
It is reasonable to say that young people should feel safe and protected in their education environment, even if they are not in a position to bear witness to the challenges that they have experienced. We have quite a bit to do with this petition. Again, I thank the petitioner for bringing the issue to our attention.