Meeting of the Parliament

Meeting date: Wednesday, May 8, 2019

Official Report 1058KB pdf

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Nation of Life-savers (Cardiopulmonary Resuscitation)

The final item of business is a members’ business debate on motion S5M-16822, in the name of Miles Briggs, on Scotland, a nation of life-savers. The debate will be concluded without any question being put.

Motion debated,

That the Parliament welcomes reports that every local authority in Scotland has now committed to training all secondary school pupils in CPR skills; believes that this will see the country sit alongside international CPR leaders, including Denmark and Norway, where cardiac arrest survival rates greatly increased after they took similar decisions to train young people; understands that the councils’ commitment is in response to poor cardiac arrest survival rates, with only one in 12 people surviving a heart attack out of hospital; believes that the use of effective CPR is critical and can potentially double the likelihood of survival, and applauds each of Scotland’s local authorities, including those in the Lothian region, on this plan to create a nation of lifesavers among the country’s young people, which it believes will help more people survive out-of-hospital cardiac arrests.

17:41  

Every day, there are, on average, 10 out-of-hospital cardiac arrests in Scotland. That represents 3,500 of our fellow Scots every year, whose hearts stop working and who need rapid resuscitation to be attempted in the community to help to save their lives.

Many of us will have been in a situation in which we were presented with such an emergency and we needed to step up to respond. I recently faced such a situation at a bus stop on London Road, when a lady called me across to help her husband who had collapsed. I am pleased to say that the Scottish Ambulance Service arrived within seconds, but, having attended a training session, I felt confident enough to attempt cardiopulmonary resuscitation.

Research shows that, when somebody is having a cardiac arrest, every minute of delay to resuscitation or defibrillation reduces their chance of survival by 10 per cent. Today, as things stand, for every 12 cardiac arrests that occur in Scotland, only one person will survive. That statistic compares unfavourably both with the rest of the United Kingdom and internationally. I therefore pay tribute to the whole team at the British Heart Foundation Scotland for initiating its campaign in response to Scotland’s poor out-of-hospital cardiac arrest survival rates, and I welcome them to the public gallery.

The nation of life-savers campaign aims to ensure that every pupil is trained in vital CPR skills before they leave secondary school and it has been praised by international experts and medical professionals. It is welcome news that, after the positive and well-received campaign by the British Heart Foundation Scotland, every local authority across Scotland has agreed to sign up to be part of the nation of life-savers campaign. The campaign will now see all secondary pupils trained in CPR before they leave school, resulting in 50,000 young people learning that life-saving skill every year.

I have seen at first hand just how passionate young Scots are to learn CPR and to equip themselves with life-saving skills. The Parliament's Public Petitions Committee recently heard evidence from two of my constituents, eight-year-old Millie Robinson and Ellie Meek, who are pupils at Parkhead primary school in West Calder. Millie and Ellie highlighted the campaign by St John Ambulance to teach first aid in schools and I take this opportunity to commend them for their enthusiastic campaigning.

I know that MSPs from across the chamber and those on the committee were hugely impressed by Millie and Ellie’s passion and saw that first aid and life-saving skills are something that all young people want to learn. It shows the passion that our young people have for the opportunity to learn those life-saving skills when they go to such extreme lengths as to bandage Brian Whittle’s smelly feet.

Members: Oh!

I digress.

An aspect of out-of-hospital cardiac arrests in Scotland that is perhaps not widely known—although I know that the minister has raised it—is inequality in the statistics on attempted resuscitation. Cardiac arrests are therefore also a social justice issue, and they contribute to Scotland’s health inequalities. Someone who lives in one of our country’s areas of high deprivation is twice as likely to experience an out-of-hospital cardiac arrest, will experience it seven years earlier, and will be 43 per cent less likely to survive it and be able to leave hospital, in comparison with the corresponding figures for people who are from more affluent areas. That has to change.

I also believe that the nation of life-savers campaign can present wider opportunities and a real challenge for all of us—regardless of age—to learn CPR, and for companies and employers to consider the potential benefits of providing CPR training opportunities. For example, back in 2014, Asda was the first large retailer to commit to having publicly accessible defibrillators and CPR-trained colleagues in all its stores, and I congratulate it on making that positive move. Since Asda has introduced defibs and rolled out staff training through its partnership with the British Heart Foundation, several lives have been saved in its stores. Only last month, a customer collapsed with a heart attack in its store in Elgin. A member of staff who was a first aider used CPR and a defib while an ambulance was called, and thankfully they managed to save that individual’s life.

The debate is also an opportunity to congratulate the British Heart Foundation Scotland on its successful campaign, which has recently been shortlisted as a finalist in the 2019 Scottish charity awards. It is thanks to the commitment from all 32 local authorities in Scotland that thousands of young people across our country will now be empowered to step in and perform potentially life-saving CPR, with the knowledge and skills to keep themselves and other people safe.

The Scottish Government has committed to training 500,000 people in CPR by 2020, through its out-of-hospital cardiac arrest strategy, and I welcome the progress that has been made in trying to realise that aim. The opportunity to create a nation of life-savers is now within our grasp. We should all be rightly proud that Scotland can—and will—become such a nation. I hope that we will soon see Scotland achieving the distinction of being the country with the highest number of citizens who are equipped with that life-saving skill.

Finally, I congratulate the Government on its work on the issue, and I thank the British Heart Foundation Scotland for all that it has done.

I see that our visitors in the public gallery are very well behaved. I have not had to tell them not to make a noise.

We move to the open debate. Speeches should be of four minutes or less, please.

17:47  

I thank Miles Briggs for securing the debate, which provides us with the opportunity to raise awareness of the importance of CPR training. One or two of the statistics that I will quote have already been mentioned by him but, as he well knows, if I say again what he has said already, he is doing well.

That is a first.

I liked that one myself.

The debate allows us to highlight how the commitment to provide CPR training in schools across Scotland will save many lives, as I am certain that it will. I thank the British Heart Foundation Scotland for establishing its nation of life-savers campaign, around which the motion is centred. Due to its determination, we can celebrate the fact that all children in Scotland who attend local authority secondary schools will receive CPR training with the use of free kits that it has offered them.

I am proud that Glasgow City Council was the first local authority to commit to training all secondary school pupils in CPR, but I am even more pleased that that commitment has now been adopted by all local authority areas the length and breadth of Scotland. Our next generation will truly become a nation of life-savers, and I thank the British Heart Foundation Scotland for its on-going accomplishment.

The campaign complements the work of St Andrew’s First Aid, which, over the past four years, has trained 45,000 people in Scotland in CPR skills. Together, organisations such as the British Heart Foundation Scotland and St Andrew's First Aid are active participants in the Scottish Government’s out-of-hospital cardiac arrest strategy. Through working proactively in line with the Scottish Government’s strategy, they have helped to improve cardiac arrest survival rates in Scotland from one in 20 to one in 12. However, we know that those rates can be further improved.

The roll-out of training will encourage a community-oriented outlook in the next generation, with people quicker to intervene and perform emergency first aid. CPR training not only prepares us technically but challenges us to act when we see someone in need, as was the case with Miles Briggs and the situation that he referred to in his speech.

According to the British Heart Foundation, many members of the public feel afraid to help, which can lead to delays in people who are suffering from cardiac arrest receiving the necessary CPR or defibrillation. Every year, 3,500 people in Scotland experience an out-of-hospital cardiac arrest and are subject to a resuscitation attempt in the community. I encourage us all to use the nation of life-savers campaign to consider how we can become not only technically but mentally prepared to perform CPR, so that we can jump into action should the need ever arise. After all, for every minute without CPR following a cardiac arrest, a person’s chance of survival decreases by 10 per cent.

I believe that that mental preparedness will come hand in hand with the roll-out of in-school CPR training. However, I also want adults to be inspired to take up any available opportunity to refresh their own first aid training. Many workplaces offer such training—indeed, it is offered in the Scottish Parliament—and I ask people not to pass up such opportunities. After all, we never know when our preparedness could save a life. Collectively, we have a duty to look out for our fellow neighbours in our communities and to help where we can, so we must equip ourselves to save lives.

17:51  

I am extremely chuffed to be speaking in this debate, as I was one of the first MSPs to back the campaign when the Glasgow Evening Times ran with it last year. I want to say a big thank you to the British Heart Foundation for organising the campaign and all those who are involved in making it happen.

CPR, which stands for cardiopulmonary resuscitation, is a life-saving medical procedure that is given to someone who is suffering a cardiac arrest, and it helps to move the blood around their body when their heart cannot do so. As we have heard, there are more than 3,000 out-of-hospital cardiac arrests in Scotland each year, but when the Evening Times learned that Glasgow had the highest number of cardiac arrests in Scotland it launched its Glasgow’s got heart campaign. After pressure was put on the council to take action, Glasgow became the first city in Scotland to roll out CPR training to all secondary schools. I was delighted to support that particular campaign. It has since evolved into the BHF’s nation of life-savers drive, and all 32 local authorities have now committed to it, which is indeed a massive achievement.

Why is the campaign so important? Because it puts into the hands of children and young people the power to save a life, be it the life of a family member, a neighbour or a stranger in the street. Currently, fewer than one in 12 people in Scotland survive a cardiac arrest, and for every minute without CPR, the chances of survival drop by 10 per cent. Those who live in the city of Glasgow are less likely to survive a cardiac arrest, because, as research shows, CPR training levels are lowest in those cities that have a high quota of deprivation. That statistic could be easily improved. In countries such as Denmark and Norway where CPR is universally taught, survival rates are much higher—indeed, as high as 25 per cent—because bystanders are far more likely to take action.

By teaching pupils and young people these skills—which will stay with them their entire lives—we are giving them the confidence to perform CPR, as well as giving everyone in Scotland a greater chance of survival. I know from personal experience that CPR training lasts a lifetime. I had the training as a teenager, but I never thought that I would have to use it; however, 30 years later, I had to. Instinct kicked in, and I knew what to do.

The British Heart Foundation has pledged to supply every secondary school in Glasgow with a £1,300 training kit, which includes a DVD and reusable inflatable mannequins. The training lasts only 30 minutes and no staff training is required to deliver it, but it is fully comprehensive and will give pupils the confidence to put their new skills into practice when needed. Individual schools have begun offering training, but full council roll-out is not expected to start until August this year and January 2020.

On where Scotland goes next to improve cardiac arrest survival rates, I was pleased to hear from the British Heart Foundation that its next campaign will focus on defibrillators. Although a person’s chances of survival increase by up to 70 per cent when a defibrillator is used properly, currently defibrillators are used in only 2 per cent of CPR cases. The BHF wants to look at the barriers to their usage and to promote where defibrillators are, what they are and how to use them properly. That will be a great campaign that I will once again be happy to support.

I thank my colleague Miles Briggs for bringing the topic to the Parliament and I thank the Evening Times and the British Heart Foundation for their tireless campaigning. Although the campaign is in its early stages, I have no doubt that it will be a life-saving one.

17:55  

I thank Miles Briggs for bringing the debate to the chamber and for highlighting the figures and statistics on out-of-hospital cardiac arrest, which I will not repeat. I also thank the British Heart Foundation for its tremendous work in lobbying Scottish local authorities to teach CPR to all secondary school pupils, which is an action that will undoubtedly save lives, as has been mentioned. I congratulate all local authorities, including Dumfries and Galloway Council and South Ayrshire Council in my South Scotland region, on signing up to that important commitment.

Last year, when my friend and colleague Stuart McMillan brought a similar debate to the chamber to highlight the Jayden Orr show some heart campaign, I spoke about the work of Dr Richard Cummins from Seattle, which is worth highlighting again. Almost 30 years ago, Dr Cummins discovered that, if a series of events take place in a set sequence, a patient who is suffering a heart attack stands a greater chance of survival. Those events are now known as the chain of survival. That chain is: early recognition and call for help; early cardiopulmonary resuscitation, or CPR; early defibrillation; and early advanced care. The chain has led to more successful survival rates among people who have cardiac events in hospital and, since the advent of community defibrillators, it has also led to better out-of-hospital survival rates.

Following that debate last year, I contacted Dumfries and Galloway Council to ask whether CPR was taught in the secondary schools in the area, and I was pleased to hear that all but one of the schools were already participating. Schools across Dumfries and Galloway and South Ayrshire have committed to taking part in the heartstart scheme since its inception by the British Heart Foundation in the early 2000s. The scheme’s main aim is to increase cardiac arrest survival rates by creating a nation of life-savers.

The call push rescue training kit, which is available to any school or community group, provides all the specialist equipment needed to teach CPR and is used to teach trainees how to recognise cardiac arrest and carry out CPR on adults and children. The kit uses a film tutorial to demonstrate CPR skills—participants watch the film and practise the skills on portable mannequins. The training also shows how public access defibrillators work and their essential role in the life-saving process so that trainees are aware of their importance and are more confident in their use, if needed.

Last year, I was pleased to attend one of the heartstart CPR education sessions at Dalbeattie high school. All the young people were fab and enjoyed the process. I used to teach CPR and resuscitation skills when I worked in the theatre department in Los Angeles, so it was great to see the young folk at the school so engaged.

I have been active in my efforts to support community defibs across the Dumfries and Galloway area and have been lobbying the Scottish Government to relax the planning rules around their installation. At present, publicly accessible defibrillators are not covered by permitted development rights, which means that the installation of a PAD may require planning permission, depending on the circumstances, location and type of building. If permitted development rights were extended to include PADs, they would be more accessible and readily available. It is important to protect the built environment, but we want to ensure that we have defibrillators in the right place. I am pleased that the Government is taking the issue into consideration in the Planning (Scotland) Bill. I have asked for it to be made simpler and easier for communities to install PAD devices.

I support the motion. I again thank Miles Briggs and the British Heart Foundation along with all the schools and young people across Scotland who will take part in the heartstart CPR scheme. I support the aim of making the next generation of Scots a nation of life-savers.

18:00  

It is a privilege to speak in this debate, which gives me the opportunity to celebrate the success of the British Heart Foundation’s fantastic campaign to bring CPR training to all of Scotland’s secondary schools and to discuss what more can be done to improve cardiac arrest survival rates. I thank Miles Briggs for lodging his very welcome motion.

As a number of members have highlighted, of the 3,500 people in Scotland who have a cardiac arrest outside of hospital each year, just one in 12 survives. That is simply not good enough. Plenty of international evidence shows that, with the right measures, we can drastically improve that survival rate. The evidence highlights the strong correlation between the introduction of CPR training in all our secondary schools and improved survival rates. When such training was introduced in Denmark, the country’s out-of-hospital cardiac arrest survival rate tripled, with one in four people now surviving.

Every minute that a person goes without CPR and defibrillation after a cardiac arrest, the chance of survival reduces by up to 10 per cent. Too often, people do not have the skills or confidence to intervene, or, as Bill Kidd highlighted, they might be afraid to intervene when someone has a cardiac arrest. In such cases, the chance of survival can often be lost.

Ensuring that more people are trained in CPR will have a transformative impact on cardiac arrest survival rates, and teaching it in schools is the most effective way to ensure that there is better society-wide awareness and that young people have the skills at the earliest possible age. The British Heart Foundation has therefore done fantastic life-saving work, in campaigning for CPR training to be taught in every secondary school in Scotland. School is all about teaching life skills, and there is no better skill than saving lives.

My only disappointment is that the BHF needed to approach every individual local authority to get them to sign up to the campaign, instead of the Scottish Government ensuring that CPR training is mandatory in every secondary school. The Government took that approach, at a national level, when it rightly signed up to the time for inclusive education campaign. Therefore, when he winds up the debate, I hope that the minister will make a commitment to underpin the support of individual local authorities by stating that the Government will ensure that CPR training becomes mandatory in our schools, which will make the training more sustainable in the long term.

Such training needs to be accompanied by broader improvements to the system of care for those who have a cardiac arrest, in order to ensure a chain of survival that offers early recognition, early defibrillation and good post-resuscitation care, not just early CPR. That means improving public awareness of the symptoms of cardiac arrest and the steps that should be taken.

Crucially, we need to ensure that defibrillators can be quickly and easily accessed. That will require an overall increase in the number of publicly available defibrillators and better awareness of where defibrillators are and how they can be accessed. They must be visible and well publicised, and we need to consider how information about their location is better shared. For example, ensuring that any public defibrillator can be searched for on Google maps would help people to identify their nearest defibrillator in an emergency.

The location of defibrillators is also important. We need to ensure that rural areas and deprived communities are not ignored, particularly given the strong link between deprivation and the risk of cardiac arrest. As Miles Briggs rightly highlighted, people in the most deprived areas are twice as likely to have a cardiac arrest—and more likely to die as a result—than those in the least deprived areas. That is a clear example of the unacceptable health inequalities that sadly continue to plague Scotland.

Despite the progress that has been made in recent years, heart and circulatory diseases remain the biggest killers in Scotland, causing almost a third of all deaths. That means that almost 50 people die from such diseases each day. The rate of coronary heart disease deaths is 80 per cent higher in the most deprived areas. Constructive, evidence-led solutions and interventions, such as the teaching of CPR in all secondary schools, will play a key role in reducing the number of such deaths.

I warmly applaud the efforts of the British Heart Foundation in securing a commitment from each local authority to provide the resources to introduce CPR training in our secondary schools. I congratulate Scotland’s local councils on embracing the initiative. It is now our job to show that same level of commitment. That means that the Government should enshrine the commitment nationally and build on the initiative by taking more action to improve the prevention of cardiac arrest and the care of those who suffer one. By doing so, just like Scotland’s young people, we will play our part in ensuring that more lives are saved in the future.

18:04  

I am delighted to contribute and to respond on behalf of the Government to this important debate. I add my congratulations to Miles Briggs on securing the debate. I also thank all our partners, who are working hard to equip many people—particularly our young people—with CPR skills.

Like other members, I was delighted last week when save a life for Scotland announced that more than 430,000 people across Scotland have learned CPR since our out-of-hospital cardiac arrest strategy was launched in 2015. We know that prompt intervention by a bystander can increase the likelihood of survival after cardiac arrest by two or three times. The greatest gains in survival will be achieved by calling 999, starting CPR and using an available defibrillator in the minutes immediately following a cardiac arrest. As members have said, CPR is a life-saving skill that practically everyone can learn. That is why we launched save a life for Scotland.

As many members know, save a life for Scotland is a partnership of public and third sector organisations such as the British Heart Foundation, St Andrew’s First Aid, the British Red Cross, the Royal Life Saving Society and Lucky2BHere. Partners are working together to encourage and equip people with CPR skills and to raise awareness and willingness to intervene at a cardiac arrest.

The save a life for Scotland partnership is a unique model that builds on a strong foundation of existing work by services, communities and individuals across Scotland. Equipping children and young people—

Will the minister also thank the firemen and women in all our fire stations, who did a great deal of initial work to help people to become confident in CPR skills when the cardiac arrest strategy was launched?

Absolutely. I thank the member for making that important point, which I was going to miss.

The British Heart Foundation’s successful campaign—as we have heard, it has secured the commitment of all 32 Scottish local authorities to teach CPR in their secondary schools—is also to be commended. That is an excellent example of the work that is being done.

At this point, it is appropriate to recognise the lead that has been shown by Glasgow and the Glasgow newspapers; that was highlighted by Annie Wells and Bill Kidd. Glasgow City Council has shown the lead to other councils across Scotland. It is fantastic that we have got buy-in across Scotland.

I hear the point that Colin Smyth made about making training in CPR in schools law, but I think that we should all commend, respect and encourage the leadership that has been shown by our local elected members across Scotland.

Will the minister take an intervention?

I want to make some progress.

Under the curriculum for excellence, health and wellbeing is one of three key curriculum areas—along with literacy and numeracy—that are the responsibility of all staff in school. One of the many benefits under curriculum for excellence is that schools have the flexibility to provide first aid training. It is up to individual schools and local authorities to decide whether and how best to deliver such training.

As Emma Harper said, many primary and secondary schools across Scotland have embedded CPR awareness and skills development. Save a life for Scotland has worked with Education Scotland to develop a resource for schools, which is delivering our aim of making CPR learning easy, accessible and free. The learning does not stop at the end of class. Children are asked to go home and teach the recovery position and CPR, using their teddy or a pillow, to whoever is at home with them. Feedback tells us that they do exactly that.

In 2015, we launched the out-of-hospital cardiac arrest strategy with the commitment to improve survival rates and outcomes for out-of-hospital cardiac arrest. The improvement of OHCA outcomes requires improvements to all six elements in the chain of survival that Emma Harper mentioned:

“Readiness; Early Recognition and Call for Help; CPR; Early Defibrillation Pre-hospital resuscitation; Post Resuscitation Care and Aftercare.”

One of the strategy’s aims is to equip an additional 500,000 people in Scotland with CPR skills by 2020. I am delighted that we are so far along the road to achieving those aims.

As a number of members have mentioned, since 2015, save a life for Scotland partners have worked with schools, community and sports groups, in workplaces, public places and at major events, to equip more than 430,000 people with CPR skills. That is a fantastic achievement, and I want to acknowledge the hard work of all the partners involved.

As much as I love consensual debate, I cannot let the minister’s speech pass without noting that the strategy comes to an end in 2020. When it comes to taking forward the plans and establishing a broader consensus and future vision, what work will the Government do with charities such as the British Heart Foundation, which has led a lot of that positive work?

All of our work in this area is being taken forward in partnership. The member is perhaps trying to get us not to be consensual, but this is an area in which we all want to continue to be consensual. The progress that has been made has been made because there has been buy-in, across not only the Parliament but society, to the idea that we want to do this and that it is important.

The strategy—I think that it was supported unanimously in 2015—has enabled more people to go home to family and friends. Data shows that, since the start of the OHCA strategy, more people than ever are being given bystander CPR—56 per cent of OHCA patients were given bystander CPR in 2017-18, which is an increase of 15 per cent. Importantly, more patients had a pulse on arrival at hospital than in previous years, with the number of those in the “return of spontaneous circulation” category up to 23.3 per cent in 2017-18. Further, one in 12 survives to leave hospital compared with one in 20 before the strategy was implemented.

The strategy is really making a difference, but I absolutely accept Miles Briggs’s point: we need to continue to think about how we can do more in order to reach the point at which as many people in Scotland can survive one of these events as is the case in other parts of Europe.

It is important to remember that we can all learn from each other, and I strongly encourage anyone who learns these life-saving skills to pass on that knowledge and teach their family, friends and colleagues. It is helpful that Miles Briggs talked about his recent experiences in the chamber today. It is through such discussion that we can overcome the fear of helping, which was mentioned by Bill Kidd and Colin Smyth.

Finally, I want to touch on public access defibrillators. Members will recall our debate in April last year on the Jayden Orr campaign, show some heart, which highlighted the importance of defibrillators. Our strategy recognises the importance of defibrillators and aims to make the most effective use of those that are available. As part of the strategy, the Scottish Ambulance Service has committed to mapping public access defibrillator locations and has launched its registration to resuscitation campaign, which will ensure that people can find out where defibrillators are when they need them. I believe that Colin Smyth raised a point about that. The campaign maps public access defibrillators on to a call-handling system so that bystanders can be directed to a nearby defibrillator if required. Through that system, we can improve their use. I urge everyone who is responsible for a public access defibrillator to register it with the Scottish Ambulance Service.

I am grateful to everyone who has spoken in the debate, and to all the communities, voluntary organisations, individuals and businesses who have fundraised to purchase defibrillators and make them publicly accessible across Scotland. Last year, we published a guide to public access defibrillators, which provides practical advice for people who want to install a defibrillator for their local community. I think that we can all acknowledge that the strategy is making excellent progress in impacting on out-of-hospital cardiac arrest outcomes in Scotland.

I close the debate by again thanking members and all those who are involved in improving outcomes from out-of-hospital cardiac arrest. I am delighted that Scotland is well on its way to creating a nation of current and future life-savers.

Meeting closed at 18:14.