The next item on our agenda is the debate on Members’ legislative proposals. To move the first such proposal, Suzy Davies.

Motion NDM6222 Suzy Davies

To propose that the National Assembly for Wales:

1. Notes a proposal for a Bill on life saving skills.

2. Notes that the purpose of the Bill would be to:

a) create statutory rights for people to receive age appropriate life-saving skills education and training at various life stages

b) create statutory responsibilities to ensure:

i) that life-saving skills training is provided;

ii) provision of defibrillators in appropriate locations;

iii) provision of life-saving skills trained individuals in key positions in public services (as an upgrade to an identified first aid person); and

iv) that basic first aid materials are available to the public in public buildings not just the staff.

c) create remedies and enforcement regarding the above.

Motion moved.

Diolch, Lywydd. Could I also thank the Assembly for the chance to be the first Member to make use of this new piece of business? I’d also like to thank my former office manager, Mark Major, who brought the whole subject to my attention when I first became an Assembly Member.

A six-year campaign began with a statement of opinion in 2011, seeking support for the mandatory teaching of emergency life-saving skills in school and then a short debate in which the present education Secretary, as well as Plaid and Labour Members, spoke in its favour. Support came from every party in the fourth Assembly, and it seems that every party in this fifth Assembly also supports the principle. I want to thank all of those of you who have already tabled your support for the proposal today, the core of which is the right to be trained to save a life. In so doing, you’re supporting a principle that has been fought for over many years.

The introduction of mandatory life-saving skills onto the school curriculum is supported by the British Heart Foundation, St John Ambulance, the British Red Cross, but also the College of Paramedics, the Royal College of Physicians, Cardiac Risk in the Young, British Cardiovascular Society Education, the Association for Physical Education, the NT—in England, anyway—Sudden Arrhythmic Death Syndrome UK, the Royal College of Nursing, the Arrhythmia Alliance UK, the British Medical Association, the Welsh ambulance service, the Atrial Fibrillation Association, the Royal College of Emergency Medicine, the Royal Life Saving Society and many others. I’ve had e-mails of support and social media support for this for the last 48 hours. It’s been utterly amazing.

You are also supporting the wishes of parents and young people. The British Heart Foundation found that 86 per cent of UK parents want emergency and lifesaving skills taught in schools—it’s actually 88 per cent in Wales. Seventy-eight per cent of children themselves wanted to learn it in school, and 75 per cent of teachers, who already have a crowded curriculum, want this taught in our schools. You are also supporting the wishes of Labour MP Teresa Pearce. Ms Pearce had cross-party support for her Bill on a similar theme, but it was talked out—a process we don’t have here—by that infamous Conservative MP, Philip Davies. In this ongoing campaign, Cabinet Secretary, I wonder how comfortable you would find yourself to be on the same side of the argument as the infamous Conservative MP Philip Davies.

So, why legislation? Well, first of all, I want to congratulate all schools who have given their time voluntarily and used school time to give their children a chance to save lives. I want to congratulate those charities—I’ve mentioned some already—the public services, the military cadets, Heartstart and Reactive First Aid, who can provide training of all kinds, and charities like Cariad who help provide defibrillators. Hats off to Shoctober, Defibruary, Save a Life September, Staying Alive—you all remember Vinnie Jones on that one—defibrillators in old phone boxes, and all the awareness campaigns. This is excellent work and, without it, our poor survival rates for cardiac arrest outside the hospital environment would be even worse. Around 90 per cent of those victims will die—perhaps even more, according to one source—and even though most of these victims will have somebody with them when they suffer their event, they will still die. Without circulating blood, it takes only six minutes for a victim to have permanent brain damage. After 10 minutes, it’s basically too late. So, shouldn’t a child grow up with the right to know how to intervene—how to help save a life?

In 2013, only 20 per cent of children in England and Wales had had a minimum of one lifesaving skills lesson in the whole of their school life, and one lesson is nowhere near enough here. You can tell, because only 4 per cent of them had the confidence to intervene—4 per cent. Yet, 94 per cent of secondary schoolchildren said that they would be more confident if they had updated training relatively regularly. I wish nothing but the best for the Government’s cardiac plan, but if you can’t guarantee whole-population level uptake, competence and confidence, step one of that plan will fail because of the random occurrence of cardiac arrest. And on the basis that you say we still need a mapping exercise to know who provides CPR; that you still have to go to page two of Google to get anywhere near the ambulance service’s list of defibrillators; and that Donaldson’s curriculum change is some time away, I don’t think we have time for good will and good work to give us that whole-population level change.

Eight thousand people in Wales will have a heart attack outside a hospital setting this year, and most of them will die because of bystander ignorance or fear. So, who has that whole-population uptake, competence and confidence in first aid skills—and it’s not just CPR? Well, let’s have a look at the screens: Norway, 95 per cent; Germany, 80 per cent; Austria, 80 per cent; Iceland, 75 per cent. Even France is at 40 per cent. Now how did that happen? Because of a legislative obligation to receive mandatory lifesaving skills training at various periods in the lives of those citizens. In Denmark and Switzerland, you can’t even get your driving licence unless you’ve done this training. And which countries have the highest rate of survival for out-of-hospital cardiac arrest? Some of them are at well over 50 per cent—that’s compared to our 3 to 10 per cent. Well, I’m sure that you can guess.

This legislative proposal is not just about cardiac arrest, about CPR and defibrillators; I want our children growing up with the confidence to intervene when they encounter a person who is bleeding, unconscious, fitting, choking, who’s been electrocuted, or shows signs of drowning. A new scheme in the poorest part of northern Bangladesh has acted on this last point, and nine-year-olds there are having to learn CPR and how to save a life after a potential drowning. And these are just proposals, of course. They’re not fully developed, but they’re certainly not difficult or expensive to deliver. They don’t clash with Professor Donaldson’s suggestion that legislation should be used to define a broad set of duties. You could start consulting on these tomorrow. So, Members, I think this is an occasion where the Norway model definitely is appropriate for Wales, and I recommend these proposals to you and to the people of Wales.

May I remind Members that their contributions under this item should be three minutes? Dai Lloyd.

Diolch yn fawr, Lywydd. Can I commend Suzy Davies for her initiative, and I wholeheartedly support the intention of getting cardiopulmonary resuscitation on the school curriculum and to be more widely acknowledged and trained for the general population. Also, we need defibrillators everywhere and people confident and not afraid to use them. Because that’s what I find, as a general practitioner—I’ve been unfortunate enough to do CPR on a number of occasions over the years, occasionally successfully, most often not successfully, and, with the use of defibrillators, what you find is that lots of people in the out-of-hospital situation are afraid to use a defibrillator. Get away from being afraid: with modern defibrillators, you cannot do any damage. Somebody who’s collapsed in cardiac arrest in front of you has basically died—you can only do good, even if the success rate is only eight per cent. That’s eight per cent of people who would have just died. So, my message is: get with it, people, don’t be afraid and you can’t do any damage; you can only transform a life. Diolch yn fawr.

I’m delighted to support this initiative. I’d just like to talk about the strength of the voluntary sector in this area, because there is so much to draw upon that I think makes this proposal even more viable in terms of improving policy in this area. Can I talk about St John Cymru in particular? I’m proud to be associated with that marvellous charity, and I am indeed wearing their tie, as a very observant leader of the opposition has just spotted. Just to mention a couple of their schemes: the young lifesaver scheme is aimed at children in after-school programmes, and it’s often delivered by a teacher who has been specifically trained. An estimate that’s been made by St John is that around 130,000 accidents happen in UK schools, and they offer a one-day course for teachers, so that they can help children who have suffered an accident, as another area where vital work is being done. And it’s also high-tech—there’s a free bilingual app on first aid; don’t ask me how you use it, but I’m sure those that know will be able to advise.

St John are just one of many charities and non-governmental organisations that do valuable work in this area. I think many of us are aware of the British Heart Foundation’s CPR training programme, which is available in the workplace. We’ve had it here in the Assembly. I’ve gone on it, Presiding Officer, and I’m pleased to say the dummy survived. And I think we all should undertake that training; it’s really, really important. The figures that we saw earlier on the bar graphs speak for themselves, because if you get trained for the workplace, you also have those skills if you’re at home, if you’re on public transport, whatever. It’s essential. The need to install defibrillators in main public places, again, is really, really important. And if you’re trained and you’re out shopping, you’re in a shopping mall, whatever, you will be one of the people that could use it. And, as Dai Lloyd so poignantly said, if you don’t intervene, the outcome is pretty certain. You need to have the confidence to intervene. So, I do think, Presiding Officer, this Bill, if it could be brought forward, would be of great benefit to the people of Wales.

I’d like to thank Suzy for proposing that we legislate to ensure that everyone in Wales is provided with the basic skills to save a life. Yesterday, we discussed the heart conditions delivery plan in this Chamber, during which I highlighted the fact that, each month in Wales, 720 people will go to hospital with a heart attack and, sadly, 340 of those people will die. Without CPR and defibrillation within the first 10 minutes, the chances of surviving a cardiac arrest are virtually nil. Given that over 80 per cent of cardiac arrests take place in the home and the number of red category ambulance responses that take longer than eight minutes to arrive, it is vital that we have people on hand with the skills to save a life. It takes minutes to learn CPR, and using a defibrillator can be taught in a single morning. Despite this, how many of us can honestly say that we have the skills to save a life?

I fully support Suzy’s campaign, and would like to see every child in Wales spend just one morning a year learning how to perform CPR. We could also explore other options for improving the number of people equipped with lifesaving skills. Should CPR and emergency firs aid form part of learning to drive? Should having these skills be a requirement for having a public service vehicle licence? Can we insist that all front-of-house staff in public buildings know CPR and how to use a defibrillator? These are the considerations we must make if we are serious about ensuring that as many people as possible have the skills they need to save a life. We are very lucky in this building as many of the security staff and ushers are trained in first aid, we have a number of automated external defibrillators, and our staff have responded to emergencies both on and off the estate. People aren’t so lucky in other parts of Wales.

I urge Members to support Suzy’s call to ensure that lifesavings skills training is available to all and that AEDs are made more widely available in Wales. By taking these small steps, we can ensure that chances of surviving a cardiac arrest, whether at home or in a public place, are greatly improved. I would also urge everyone in this Chamber to learn CPR if they have not done so already. Diolch yn fawr.

In very few words I will also say that I support this proposal. We’ve already heard about the importance of first aid in emergency situations. We know how important it is that equipment such as defibrillators and first aid kits are available.

The recent survey by St John—and we’ve heard reference to this already—tells a very clear story, in that 69 per cent of schoolchildren say that they wouldn’t know how to treat a member of the family or a friend of theirs if they found themselves in a situation where that was necessary; 72 per cent of people say that they would wish to have those skills; and 83 per cent say that they would be far more confident in trying to save a life or in caring for an individual if they had been given that education.

If I could just turn to some comments made by the Welsh Government in response to the BBC, saying that pupils do learn about emergency care techniques already as part of personal and social education. Now, those comments suggest to me that there is a deal of difference between what the Government believes is happening and what’s really happening in our schools. Research demonstrates that there is dissatisfaction in terms of what is provided at present, and in addition to the fact that the pupils themselves say that they don’t have the necessary skills and that they would like to learn the skills, teachers, too, according to research and surveys, say that they lack confidence in terms of the skills that they are expected to pass on to their pupils.

But I will conclude with this question, which I would ask of any Minister listening and any official, too: if you were going for a walk one day and suffered cardiac arrest, and the only person nearby is a 15-year-old, let’s say, would you prefer for that 15-year-old to have gone through an inadequate system of learning certain skills as part of personal and social education, or would you prefer for that 15-year-old to have gone through an education system that would have taught him or her the correct skills, with that provision based in legislation? I know what my response would be, and that’s why I support this legislative proposal.

I carefully cut the grape in half and I fed one half very carefully to my precious child. She sucked out the contents and then proceeded to choke on the skin. I was utterly terrified. My CPR training—learnt when I was a rescue diver, in the days when I was younger and fitter—completely went out of my head. Thankfully my husband was present and he saved our little girl’s life. Today she is 14. I can tell you now, she does not and has not learnt any lifesaving skills at school, but she’s learnt them from her mummy and her daddy, and she will grow up to be an adult who, perhaps, won’t panic if the same thing happens to her—if her child were to choke on a grape.

I utterly support this campaign, as a mum and as a parent. I also support it with a bit of an education hat on, because I believe really firmly that we need to build resilient children. This is a debate that Lynne Neagle will be bringing to the Chamber later on today. When they’re at school, the more little skills we can give them, the more little bits added into that jigsaw puzzle, it builds confidence, builds resilience, builds determination. I think that this is something that we can easily add into the curriculum. I’ve heard before the cries of, ‘The curriculum is already really crowded’. But it’s about putting in priorities and it’s about really cleaving to Donaldson’s new six strands, and this would fit very well into those six strands. It’s a skill that, once you have learnt it—providing the panic doesn’t set in—you can use time and time again. But I would emphasise that we also need to build in constant re-teaching. It’s been a long time since I had to do CPR on anyone and I wouldn’t mind learning again. I think this is a wonderful idea and I do hope that the Government will allow Suzy Davies the opportunity to take this forward and explore it in more detail. Thank you.

I call on the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.

Thank you, Presiding Officer. I am pleased to have the opportunity to set out again what we are already doing to improve survival from out-of-hospital cardiac arrests, which includes many of the aspects in Suzy Davies’s private Member’s Bill proposal. However, whilst I do support the ambitions in the proposal in principle, I can’t support the motion as I don’t believe that imposing a statutory duty is the right approach to take at this time in delivering improvements across Wales. In particular, the impact on the school curriculum is not one that the Government can support, and I’ll hopefully explain that in some helpful detail.

I set out in my written statement in December the excellent work that took place across schools last October, when approximately 17,000 children were trained with a variety of life-saving skills. That type of approach can work well in our school system using the existing platform of personal and social education. But, looking further ahead to when we do have a new curriculum following the Donaldson process, the best evidence has shown us that using legislation in the way the motion urges us to has led to an overloaded and complicated system. We should not dismiss that argument out of hand. Donaldson was very clear about this. We want to use legislation sparingly, and I do really understand the well-meant intent, that the motion is seeking to add life-saving skills as a mandatory part of the curriculum. On this, I don’t agree with Suzy Davies’s view that this would not undermine the approach we are taking that flows from the Donaldson review. I really do think that those of us who support this significant review, and the prospect of a coherent curriculum cannot then cut across that Donaldson approach by making discrete bids for mandatory additions to the new curriculum before it’s actually been completed and implemented.

Now, work has already commenced in developing an out-of-hospital cardiac arrest plan, which will look at ways to improve CPR and access to defibrillation—common themes in the debate today. We’re already starting to make progress in Wales, particularly in relation to access to defibrillators through the register, with over 2,000 registered since I launched ‘Be a defib hero’. That campaign started in February 2015. We should also make the most of the similarities between the emergency services and their shared commitment to keep people and communities safe. Almost all fire appliances now have defibrillators, and firefighters are trained in life-saving skills. I’ve agreed with the Cabinet Secretary for Communities and Children to a set of priorities to help focus fire and rescue service support for the NHS. The priorities that we’ll be working to deliver in 2017-18 include support for an emergency medical response.

It is, though, worth noting that, in Wales, following the changes that we made to our ambulance response model, the average ambulance response time to a cardiac arrest in Wales is now between four and five minutes. That’s a significant improvement because we’ve refocused our ability to get people to those really life critical calls. Now, for the out- of-hospital cardiac arrest plan to become embedded, I think that we do need to build on that momentum that we’re already making prior to taking a decision about introducing a mandatory requirement. That plan is being developed with partners across the NHS family, emergency services and the third sector. As with other Members, too, I want to recognise and welcome the work of the campaign in the third sector, with a wide range of volunteers and the training they provide. I know that every Member has the opportunity for them and their staff to receive first aid training from a number of different organisations, and I recognise the work they are already doing. They are very much part of producing our new plan and seeing it through to reality. We do recognise that life-saving skills and emergency aid procedures are clearly extremely important, and the Welsh Government fully supports the work of those organisations in raising awareness and helping people acquire those skills.

Last week, as Members have mentioned, the Welsh Ambulance Services NHS Trust launched their latest defibrillator campaign, aimed at raising awareness of what a defibrillator is, where to find the nearest one, and what support is available to obtain one. I hope Members will take the opportunity to support that campaign and, in particular, to listen to the words of Dai Lloyd that, with modern defibrillators, they talk you through what you need to do and, if someone is in cardiac arrest—you’re absolutely right—you can only help. I hope that’s a message people do take on board and take seriously.

I do accept that it’s of the utmost importance that the population of Wales is given the opportunity—every opportunity—to survive cardiac arrest and are provided with knowledge and resources, like defibrillators, that will enable the efforts being made to save lives. We are committed to working with organisations across Wales to achieve this, but, at this point, I’m not persuaded that this requires legislation. Now, if this were a Stage 1 debate, then the Government would oppose the motion. However, the Government will abstain today and backbenchers in my party have a free vote. But, in abstaining, the Government wishes to signal its support for continuing to improve life-saving skills and our view that legislation is a potential future option where it is clear that it is either the best way forward or the only way to make further progress. But we will continue to make progress with our out-of-hospital cardiac arrest plan. We want to see what comes from that and then we’ll continue to work with stakeholders, including Members in this place, regardless of what party they’re in, to try and save lives and review what our next steps should be as we move forward in trying to improve lives and, of course, to save lives.

I call on Suzy Davies to reply to the debate.

First of all, can I please say thank you to everyone who’s supporting this today, and thank you also to the Cabinet Secretary, because I’m not against what he’s planning to do? What I’m saying is it’s going to take way too long. It takes two hours to train a child to save a life; it takes 10 minutes to kill a cardiac arrest victim. So, I’m disappointed that you haven’t been able to show support for this today. Dai Lloyd is quite right: nobody in Wales should be dying of ignorance or fear, and that’s what lack of population-level life-saving skills could mean for Wales. However, I’m determined to do my little bit before you all leave, and so, if you’re happy, we’re just going to do a little bit of life-saving training now. Thank you.

A DVD was shown. The transcription in quotation marks below is a transcription of the oral contributions on the DVD. The presentation can be accessed by following this link:

DVD presentation.

‘Baby CPR is crucial to know. There are a few simple steps, so here we go.’

‘Get to a phone.’

‘Don’t take a chance.’

‘First you must call an ambulance.’

‘But while you wait for the ambulance to arrive, here are some tips to help your baby survive.’

‘Place your baby on a nice flat surface and tilt their head back. Don’t be nervous—nervous, oh.’

‘Give five puffs over the mouth and nose. Not sure what we mean? Well, here’s how it goes.’

‘One puffs, two puffs, three puffs and four. Five is enough, don’t puff any more.’

‘Place two fingers upon the chest and pump 30 times, no more, no less.’

‘Puff, puff and 30 more pumps. Repeat this until the ambulance comes. Puff, puff and 30 more pumps. Repeat this until the ambulance comes.’

‘Gosh, that was fun.’

‘And full of information.’

‘Our work here is done.’

‘Oh, I need a vacation.’

The proposal is to note the motion. Does any Member object? [Objection.] I will defer voting under this item until voting time.

Voting deferred until voting time.