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Chamber and committees

Meeting date: Thursday, February 8, 2018

Meeting of the Parliament 08 February 2018

Agenda: General Question Time, First Minister’s Question Time, East Neuk First Responders, Islands (Scotland) Bill: Stage 1, Point of Order, Islands (Scotland) Bill: Financial Resolution, Decision Time


East Neuk First Responders

I ask members of the public who are exiting the gallery to do so quietly.

The next item of business is a members’ business debate on motion S5M-10145, in the name of Willie Rennie, on East Neuk First Responders. The debate will be concluded without any question being put.

Motion debated,

That the Parliament commends the work of the charity, East Neuk First Responders, which provides care in life-threatening emergencies until an ambulance arrives; recognises the difference that early interventions can make in a medical emergency, such as CPR and defibrillation to the chances of survival from a heart attack and cardiac arrest; understands that East Neuk First Responders also provides first aid training, covers at events, runs a school lifesaver project and works in partnership with community councils to install public access defibrillators; considers that there are potential lifesavers in every community who could assist in the period it takes for the emergency services to arrive; notes the opportunities for partnerships to further utilise the expertise that exists, connecting and alerting volunteers who are qualified to provide critical care when they happen to be in the vicinity of a medical emergency, for example through the GoodSAM system, which can simultaneously dispatch the emergency services and local first aiders; recognises that, particularly in rural areas, the quick response and intervention of community first responders can save lives, and thanks the volunteers and staff at East Neuk First Responders and other initiatives that exist around the country.


I am disappointed that so many people are leaving the gallery, because they will miss the debate of the year. They still have time to turn around if they wish to hear the fantastic speech that I am about to make.

East Neuk First Responders is an independent community resuscitation charity that works to improve the survival chances of people who suffer life-threatening emergencies in the east neuk of Fife. It covers the beautiful fishing and coastal villages of Elie, St Monans, Pittenweem, Anstruther, Cellardyke and Crail, as well as the inland communities. The heart of the area is a good 20 minutes from St Andrews and 30 minutes from Leven, which are where the nearest ambulance stations are.

The charity is totally funded by public donation, and it supports its community with life-saving equipment, training, first-aid cover at events and health awareness. I want to pay tribute to the work that it does for its community. East Neuk First Responders deserves Parliament’s recognition.

East Neuk First Responders works with the Scottish Ambulance Service to respond to life-threatening emergencies and to provide care until an ambulance arrives. The responders form a vital link in the chain of survival, and they increase people’s survival chances—especially those of people who have suffered heart attacks or cardiac arrests. The charity has equipped every community in the area with a public access defibrillator—a feature of the east neuk is the flashing white light that can be seen on green boxes that are fixed to the sides of public buildings. It is also running the schools CPR—cardiopulmonary resuscitation—lifesaver project.

However, East Neuk First Responders wants to do more to save more lives. For some time, the charity has been finding it difficult to access training for volunteers to add to the network. The Scottish Ambulance Service insists that it should conduct all the training, but it has not provided sufficient local training opportunities on a frequent enough basis. It seems that volunteers are giving up because they are having to wait so long, or because it is not feasible for them to access the training that is available. My first request is for the Scottish Ambulance Service to provide more training in a range of areas across the country on a more frequent basis. Alternatively, it should change its model.

That brings me on to use of new technologies. GoodSAM, which is short for Good Smartphone Activated Medics, operates internationally. It is the world’s most advanced emergency alerting and dispatching platform. The phone app allows alerters to dial the emergency services and, at the same time, to notify nearby medically qualified responders of a medical emergency. GoodSAM connects people in need with people who have the skills to provide critical help before the emergency services arrive. It offers real-time encrypted on-scene footage—it is quite an amazing piece of technology—and people can book off and on.

Worldwide, 30,000 volunteers access the GoodSAM network; in the United Kingdom alone there are 8,000 responders. It has been used successfully in London, the East Midlands and the North West England, and has saved many lives. By the end of this year, the majority of ambulance services in England will have access to and be partnered with GoodSAM. It is endorsed by the Resuscitation Council (UK) and has been funded by Nesta, the innovation foundation.

Appropriately trained volunteers can register with the GoodSAM app by submitting their qualifications for approval. The qualifications might not have been gained through the Scottish Ambulance Service; people can be qualified by their membership of other professional bodies. That means that each community has access to a large number of first-responding volunteers at the press of a button.

We are all never further than three feet from a spider and are probably no more than 200m from a doctor, a nurse or a paramedic. The GoodSAM app connects us with that health professional if we are in trouble. A patient who suffers a cardiac arrest is 10 per cent less likely to survive with every minute that passes without CPR.

GoodSAM is a not-for-profit organisation. It was co-founded by Professor Mark Wilson, who is a neurosurgeon and air ambulance doctor. There are similar apps in the United States of America, one of which is called PulsePoint. There is one in Sweden called SMS Lifesaver. GoodSAM has been developed with the UK ambulance partners and is already being used across the UK.

A randomised control trial found that the Swedish app increased bystander CPR from 48 per cent to 62 per cent, but it did not increase the survival rate. The operators in Sweden have therefore rolled out defibrillators and connected them to the app to increase the survival rate. In Sweden now, many patients receive their first defibrillator shock within five minutes, with a survival rate of 70 per cent, which is quite a remarkable change.

GoodSAM is expanding the automated external defibrillator network in the UK and has mapped and verified what is, by far, the UK’s and world’s largest AED registry.

East Neuk First Responders is already embracing the new technology, but in a limited way only, because the Scottish Ambulance Service has not adopted it. It is considering it, but it has been doing so for some time. The technology is free to responders and would cost just £15,000 a year for the Ambulance Service. We have never, and nor will we ever, had an ambulance on every street corner, but we can have a lifesaver on every corner for next to nothing.

The benefits are clear and the potential is great. The cost is low and the number of lives saved could be high. I therefore urge the Scottish Ambulance Service to embrace the technology swiftly so that we can access that wide network of experienced health professionals in every community. With more training and the adoption of new technology, we could save more lives.


I thank Willie Rennie for securing debating time to acknowledge the hugely significant work in the east neuk. I pay tribute to all first responders across the country, some of whom I have seen at first hand probably saving the life of a former colleague.

The invaluable work that ENFR carries out in partnership with the Scottish Ambulance Service is first class, as is the speed at which responders arrive on the scene of an incident to provide lifesaving treatment before the arrival of an ambulance. That is particularly important in rural areas such as the east neuk, where it can often be difficult for an ambulance to arrive quickly.

ENFR forms a vital link in the chain of survival that is well proven to increase dramatically a casualty’s chances of survival from heart attack or cardiac arrest, in particular. That is important, because we know that there are about 3,500 out-of-hospital cardiac arrests each year in Scotland, with a sadly very low survival rate of only 8 per cent. The sooner effective CPR is started, the better the chance of survival, and for every minute’s delay the patient's chance of life drops by 10 per cent. If the first shock from a defibrillator is delivered within three to five minutes, the reported survival rates can soar to 74 per cent, as Willie Rennie said.

As the motion notes, ENFR has also done invaluable work in installing life-saving defibrillators in 24 locations across the east neuk. My colleague Miles Briggs has been a very passionate campaigner on that issue in Lothian, working in conjunction with the Jamie Skinner Foundation. The foundation was named after a talented young footballer whose life was tragically cut very short by a sudden cardiac arrest while he was playing for Tynecastle Football Club. His friends and family have asked many times whether his life could have been saved if a nearby defibrillator had been used.

Willie Rennie said much about the GoodSAM app system. I could not agree with him more on its importance. Emergency services staff and members of the public with basic life-support skills are being encouraged to sign up as volunteers, but I note Willie Rennie’s request that we need to ensure that there is better support for the volunteers—I certainly encourage my constituents to take part if they can.

I know that the organisation is strongly supported in the community, relying as it does on charitable donations and essential volunteers. Most recently, a large number of people undertook the east neuk dook to raise money for ENFR by plunging into Anstruther harbour in freezing temperatures on new year’s day. I was not there, but I could certainly have given them all my support from the beach.

At this point, I mention Scottish Mountain Rescue, which is a similar and equally commendable organisation. It also provides emergency first aid in areas that are inaccessible to the Ambulance Service in Mid Scotland and Fife and right across the country. Scotland’s Charity Air Ambulance also does important work and I am proud to say that it shares my constituency association’s office building. We see and hear a lot about what the charity does.

I commend all those who are involved with East Neuk First Responders for giving up their time and for, quite literally, providing a life service.

Members will know that Willie Rennie is in the Carnegie Harriers and will soon be taking part in the 116.5-mile run around Fife’s coastal path. We wish him well and hope that he does not trouble East Neuk First Responders on that particular occasion.


I thank Willie Rennie for bringing this members’ business debate to the chamber.

As a Fifer, I know the east neuk area well and extend my thanks to all the members of East Neuk First Responders for everything that they do.

I have spoken in many members’ business debates since I was first elected, including ones that have praised the work of local charities and community organisations, especially those from my region of Mid Scotland and Fife. We speak a lot during regular business in the chamber about the problems that face our communities and services, but members’ business debates often give us the opportunity to talk about the positive and great work that takes place on the ground.

We should all be proud of the work that East Neuk First Responders is doing and of the number of lives that it touches and changes. It is no exaggeration to say that the east neuk first responders are truly life savers.

We all know about the battle that we have had in tackling heart disease in this country. Statistics published just last week from the information services division of NHS National Services Scotland highlight that, over the past 10 years, the mortality rate from coronary heart disease in Scotland has fallen by 39.6 per cent. Although we all welcome that, heart disease is still a leading cause of death in Scotland and there is much work to be done, especially in tackling the gap between rich and poor, and among males, in this country.

However, the statistics show that we are moving in the right direction. For individuals who are admitted to hospital with their first heart attack, their chances of surviving at least 30 days have increased from 86 per cent to almost 93 per cent. Among those aged 75 and over, their chances have increased from 71 per cent to 85 per cent. That rise is not a coincidence. It is due to awareness raising about triggers for heart attacks and the early warning signs of an oncoming attack; and it is due to the hard work of our health professionals. Early intervention can make a vital difference—the use of CPR and defibrillators can make all the difference.

On last year’s European restart a heart day, the Scottish Ambulance Service released figures that showed that more Scots are being resuscitated following a cardiac arrest. Our ambulance services and paramedics do a great job in treating heart attack victims and patients who experience life-threatening emergencies. Often, the most crucial time is between the attack and the emergency services getting there. That can present a unique challenge in more rural areas and is where first responders can step in.

It can be a scary moment to be first on the scene when a person they know and love, or even a complete stranger, suffers an attack. Someone’s ability to react can be what determines whether that person survives. Everyone in the east neuk should be proud not only that East Neuk First Responders can improve the survival rates of people in their area who experience a life-threatening emergency but that the charity is resourced solely from public donations.

It is important that first responders are able to work in partnership with the Scottish Ambulance Service. Willie Rennie made good points about the benefits that would come from the Scottish Ambulance Service being prepared to invest more in training and new technology. The GoodSAM medical dispatching app provides life-saving care. That innovative solution is a vital link in the chain of survival, and we should commend all those involved in setting up the initiative and welcome the positive working relationships that are developing.

The volunteers of East Neuk First Responders are not content with just saving lives; they are committed to working with others in the local community to ensure that they, too, are equipped with the skills and—in the case of public access defibrillators—the equipment to help others. ENFR’s schools CPR life-saver project is building a whole new generation of life-savers, and perhaps a whole new generation of first responder volunteers. It is no mean feat that the project will be rolled out to every primary school in the east neuk. As has been mentioned, the project goes beyond just training children, as it actively encourages those children to pass their new skills on to family members and friends. Kirkton of Largo school pupils have trained an extra 66 people, Colinsburgh a further 79 and Anstruther an extra 105. With a success rate like that, the east neuk must be one of the leading areas in Scotland for trained life-savers per head of population. For that, and for all the work that East Neuk First Responders do, I and my constituents thank them dearly.


I congratulate Willie Rennie on securing the debate and thank him for providing an opportunity for members to highlight the fantastic contribution made by community first responders in the east neuk and throughout Scotland.

My constituency of Renfrewshire South is home to Neilston & Uplawmoor First Responders and I am delighted to welcome to the public gallery representatives Lewis McColl, Ryan Ledgerwood and Jim Wilson.

As members can imagine, I will focus a wee bit more on Neilston & Uplawmoor First Responders than I will on East Neuk First Responders. This is not the first time that Neilston & Uplawmoor First Responders have been acknowledged in the Scottish Parliament. In October 2014, my constituency neighbour, Jackson Carlaw, in his previous role as a West Scotland regional member, led a members’ business debate congratulating Neilston & Uplawmoor First Responders on dealing with their 100th emergency call since becoming operational. Within two years, that number had passed 700; I imagine that it must now be more than 1,000.

This debate complements Johann Lamont’s recent members’ business debate in which, inter alia, we discussed out-of-hospital cardiac arrests and the importance of bystander CPR. Community first responders can be important actors in the chain of survival. That was recognised by my predecessor as MSP for Renfrewshire South, Hugh Henry, who, in Mr Carlaw’s debate, rightly stated that community first responders

“can complement the work of our excellent ambulance service and ... can make a difference by saving lives.”—[Official Report, 30 October 2014; c 29.]

The value of community first responders is clear to us all and we owe a debt of gratitude to the volunteers who provide that valuable service. However, we must also recognise the great leadership that enables those community first responders to operate. In Stuart McLellan and Ross Nelson, Neilston & Uplawmoor First Responders have two outstanding leaders who have demonstrated vision and skill in taking an idea and transforming it into an organisation that is delivering front-line medical care to communities right across my Renfrewshire South constituency, including in Barrhead, Johnstone, Linwood and Lochwinnoch, not to mention communities in Eastwood and Ayrshire.

That success has been made possible thanks to not only the hard work of Stuart, Ross and the many volunteers but the generosity of organisations such as St John Scotland, which has donated thousands of pounds, and Arnold Clark Car & Van Rental, which has provided two brand-new four-by-four vehicles, which prove particularly useful during the winter months. The award-winning Uplawmoor Hotel has helped by providing accommodation for meetings, and there have been contributions from individuals such as local historian Gina Henderson, who donated £5,000 from the proceeds of her book “Recollections of Neilston”. There is a real sense of a community coming together to support a great local organisation.

As invaluable and appreciated as those contributions have been, we need to consider how we secure the financial future of all Scotland’s community first responders, and I look forward to meeting Stuart and Ross again shortly to discuss that issue. One suggestion that they previously made—indeed, they made it again recently—was to set up a national charity dedicated to community first responders, similar to the Royal National Lifeboat Institution or St Andrew’s First Aid. I am keen to explore that and I would welcome the opportunity to engage with other members on it.

I thank Willie Rennie again for bringing this subject to the chamber and reiterate my support for and gratitude to community first responders in Neilston and Uplawmoor, the east neuk and across the whole of Scotland.


I am grateful for the opportunity to take part in the debate and I congratulate Willie Rennie on bringing it to the chamber.

As politicians, we hope to do all that we can to help individuals—it is perhaps the reason why we come into this occupation. Individuals who give of their time and their talent to help others get even more of my understanding and support. It is tremendous that individuals provide such assistance. That includes the responders that we are talking about, whose professionalism ensures that help is provided before medical assistance arrives.

We have heard about the East Neuk First Responders, an independent community-based organisation that works to improve the survival rates of and outcomes for people who suffer life-threatening emergencies in the east neuk. As we have heard, the east neuk is a beautiful part of Scotland that covers little towns and villages, some of which are recognised the world over.

The East Neuk First Responders are funded by donations. They support the community by providing life-saving equipment, community training, first aid cover at events, health awareness training and carrying out myriad other roles. They carry out partnership work with the Scottish Ambulance Service, which is great to see. We have already heard about the GoodSAM mobile app. That technology is helping individuals to ensure that lives are saved. It helps to provide care in life-threatening emergencies until the ambulance service arrives.

Each volunteer is equipped with life-saving equipment, including defibrillators, which we have talked about already and which are saving lives on a regular basis. Responders deal with category A calls. The community first responder who arrives on the scene first can deliver life-saving treatment before the arrival of the back-up provided by the ambulance and other individuals who can support them.

First responders form a vital link in the chain of survival, which demonstrates that casualties’ chances of survival are greater if they are given support for a cardiac arrest or heart attack. The chain of survival is essential, but is little known outside the medical profession. There are four elements to it: early recognition and a call for help; early CPR to buy time; early defibrillation to restart the heart; and post-resuscitation care to restore quality of life for the individual.

All equipment and running costs are supported by charitable donations. The first responders are doing so well in the community because of donations from individuals and organisations.

Since 2009, when the group was formed, it has attended category A life-threatening 999 situations, provided first aid cover at local events, delivered training and essential health checks and installed more than 40 public access defibrillators across the area. The work of the East Neuk First Responders should be recognised by a wider audience and their essential life-saving for the communities that they represent, in an area that is miles from the nearest hospital, should be retained.

I commend the work of the volunteers and wish them continued success in all that they do to maintain and sustain life in the community that they serve.


I, too, thank Willie Rennie for giving us this opportunity to recognise the fantastic contribution that all staff and volunteers involved with East Neuk First Responders make to saving lives in that beautiful part of Fife. It is a beautiful part of the world, as Alexander Stewart and others have recognised—I certainly know that from family holidays—but it is a rural part of the country and it is not without its challenges. That is why it is important that Willie Rennie took the opportunity to describe the huge amount of collaborative work that is going on in the East Neuk First Responders group. In the work that they have undertaken voluntarily, they have been driven and motivated to protect and keep safe their community and I am certainly glad to have the opportunity to record my thanks for that complete dedication.

I also value the important role that is carried out by the 132 community first responder schemes across Scotland and I am delighted to have the opportunity to recognise their contribution in the Parliament.

Those who volunteer in a community first responder scheme are trained in a wide range of emergency skills, learning to use specialist equipment such as automatic external defibrillators and oxygen therapy to provide an early intervention in situations such as heart attacks or breathing problems before the ambulance crew arrives. By delivering these life-saving procedures, they are helping with patient survival and recovery.

They also support their local communities by providing training, ensuring that more and more people have these invaluable life-saving skills. However, I will absolutely reflect on Willie Rennie’s point about the potential capacity issue regarding the training of volunteers. Volunteers are a phenomenal resource and we certainly do not want to see anybody being unnecessarily put off from becoming part of the important chain of survival.

At present, there are 132 community first responder schemes, providing 894 active volunteers throughout Scotland, supported by the Scottish Ambulance Service. Although this is something that we as a society can be proud of, I believe that there is always the opportunity for expansion and the introduction of more community first responder schemes. I would therefore like to take the opportunity to encourage communities across Scotland to follow the lead of the East Neuk First Responders and other established schemes by engaging with the Scottish Ambulance Service to set up a first responder scheme in their own areas.

The underlying principle and ethos behind first responders in Scotland is to equip the community with skills that can and do save lives. Community first responder schemes are about developing greater resilience in our communities. We know that surviving a medical emergency such as a cardiac arrest depends on the chain of survival: the recognition that it is a cardiac arrest, swiftly followed by CPR and defibrillation. It is by rapid bystander intervention at incidents such as a cardiac arrest that the greatest gains in survival will be achieved. Starting CPR and calling 999 buys crucial minutes until medical help arrives.

The Scottish Ambulance Service advises—as Willie Rennie and others have described—that for every minute that passes without defibrillation, the chances of survival decrease by 14 per cent. Research also shows that applying a controlled shock within five minutes of collapse provides the best possible chance of survival.

The Scottish Government out-of-hospital cardiac arrest strategy has two key aims. By 2020, we intend to equip an additional 500,000 people in Scotland with cardiopulmonary resuscitation skills and increase survival rates from out-of-hospital cardiac arrest, saving an additional 1,000 lives.

Another part of our out-of-hospital cardiac arrest strategy involves the mapping of static defibrillators. That will allow ambulance control centres to identify and utilise publicly accessible defibrillators that are registered on the SAS computer-aided dispatch system.

That information will be built in to the ambulance control centres, so that when it receives a 999 call for a cardiac arrest, an ambulance control centre will be able to signpost the caller to the nearest defibrillator. That knowledge improves the chain of survival and helps to increase the likelihood of survival. As of 16 November last year, the Scottish Ambulance Service had registered 1,553 public access defibrillators on its command and control system. That number is expected to grow.

There are also a number of other initiatives going on throughout the country that further support our first responders and help to make communities far more resilient. As well as ensuring that we have public access defibrillators in a range of locations, supported by local training and awareness raising, Save a Life for Scotland has been working with Education Scotland to develop resources to support schools that wish to access CPR training.

However, Willie Rennie and others specifically and legitimately raised the opportunities for improving out-of-hospital cardiac arrest survival rates through innovation and new technology.

A specialist sub-group of Scotland’s cardiac arrest strategy delivery group—which includes the SAS, the British Heart Foundation, the Government and the University of Edinburgh—is looking at a strategy for the use of public access defibrillators in Scotland. The sub-group is examining the potential role of apps to assess whether and how apps, such as the GoodSAM system that is mentioned in the motion, could fit in to the service.

I recognise the comments that were made by Liz Smith, who paid tribute to the Jamie Skinner Foundation for its awareness-raising work and to Scottish Mountain Rescue for its selfless work and efforts to keep people safe on our mountains and help them to enjoy Scotland’s great outdoors safely. I agree with her tribute to Scotland’s Charity Air Ambulance at Perth airport; it is closer to the village of Balbeggie—near where I grew up—and it is a facility that I know well. It was rightly recognised in the recent Daily Record and NHS Scotland health awards for the phenomenal work that it does to keep people safe across Scotland.

I also recognise Tom Arthur’s comments about the long-term financial sustainability that is so important to keep people who volunteer involved in that important work. I am happy to listen and engage with him on those suggestions as they develop. Similarly, Claire Baker was correct and right to speak about inequalities and how we need to do more preventative work to stop poor health from happening in the first place. She recognised that work is needed to address inequalities across a range of fronts—not just health, but social security, housing, education and employability. If we do that work upstream, it will help to prevent poor health in the first place. It is right to link that preventative agenda to this debate.

I am delighted to have been part of the debate to recognise the role that all our community first responders have in helping to save lives, including the first responders in the East Neuk of Fife. Those volunteers across Scotland deserve our congratulations and our recognition. I sincerely thank Willie Rennie for today’s opportunity to do that.

13:21 Meeting suspended.  

14:30 On resuming—