Billy Timmins (Wicklow, Fine Gael)
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I thank the Chair for giving me an opportunity to raise this important issue. Cardiac Self-Help Wicklow is a voluntary group that was established in the autumn of 2003 with a view to making defibrillators available in the wider community. Several thousand people die in Ireland from sudden cardiac arrest each year. The many causes of sudden cardiac arrest include genetic propensity, illness, heart attack, environmental conditions and physical contact. A hard blow to the chest can knock a person, even a fit young athlete, into cardiac arrest. Dehydration or heat exertion can also bring on sudden cardiac arrest. A person of any age can be a victim of sudden cardiac arrest.

As a result of the ambulance service's work with voluntary groups in County Wicklow, the first responders scheme is in operation in 14 parts of the county. Under the scheme, trained local volunteers assist the ambulance service when a person in the locality suffers or is threatened with cardiac arrest. A further eight communities are in the process of getting involved in the scheme. Cardiac Self-Help Wicklow intends to extend the first responders scheme to all parts of the county, with the co-operation of local communities. Under the targeted defibrillation programme, local groups can privately purchase a defibrillator and make it available in their immediate areas. Shopping centres, airports, schools and sporting clubs have defibrillators on site and have trained people to use them. Local community groups have been called into service more than 40 times since the scheme became operational in County Wicklow in the spring of this year. The scheme, which is extremely successful, provides assistance and assurance, particularly in isolated areas. The success of the first responders scheme in County Wicklow is due in no small part to the progressive involvement of the ambulance service in the HSE region that succeeded the former ERHA area. Other HSE areas are reluctant to get involved, however.

I am aware that a Government task force, chaired by Dr. Brian Maurer, will report soon on the issue of sudden cardiac death. I am confident that he will strongly recommend the national roll-out of a first responders scheme like that in operation in County Wicklow. While the resources needed to establish and maintain such a scheme are minimal for the return, human resources need to be specifically allocated to the project. The Garda, fire service and other statutory bodies can also play a role. Planning guidelines need to be amended to provide for the inclusion of defibrillators in commercial developments. The Department of Education and Science has a role to play in including cardiopulmonary resuscitation in the school curriculum. Legislation is necessary to deal with the concerns of volunteers who have a fear of litigation and to assist with the concept of targeted defibrillation. Fine Gael has placed such legislation, the Good Samaritan Bill 2005, on the Dáil Order Paper. The Minister for Health and Children has repeatedly called for ideas from this side of the House. I have been pushing this idea, the implementation of which would greatly improve the health service at a nominal cost, for over two years.

I know there is resistance to the first responders scheme among general practitioners and others involved in the medical profession, who have concerns about handing a piece of medical equipment to people in the community who might not be well trained in its use. The scheme, which has been very successful in County Wicklow to date, has worked beyond our wildest dreams because local people have given a tremendous level of commitment to it. My colleague, Deputy Lowry, raised on the Adjournment some time ago the issue of targeted defibrillations. I am aware that the editor of the Irish Medical Times has written a very condescending and ill-informed article on the issue. I invite him and anyone else involved in the medical profession who has doubts about the matter to travel to County Wicklow to see how the scheme is operated there by volunteers who have been trained by the ambulance service.

The scheme is validated every 90 days by the ambulance service. If a person in the parts of County Wicklow in which the scheme is in operation dials 999, or whatever the relevant number is, not only will an ambulance come from Naas, Wicklow or Baltinglass, but the local scheme volunteer will also be contacted by mobile telephone so that he or she can get to the scene of the difficulty. It is a very successful scheme. When Dr. Maurer's report has been published, I hope the Minister for Health and Children will initiate a proactive and progressive campaign to bring the scheme into operation throughout the country.

Seán Power (Kildare South, Fianna Fail)
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I thank Deputy Timmins for raising this matter and giving me an opportunity to outline to the House some details of the work being done to improve how cardiac emergencies are dealt with. As the Deputy said, Deputy Lowry raised a similar matter in the House some months ago. I would like to update the House on the developments since then. The Health Act 2004 provided for the establishment of the Health Service Executive on 1 January last. Under the Act, the HSE is responsible for managing and delivering, or arranging to be delivered on its behalf, health and personal social services. As part of the reform of the health service, a national ambulance office has been established, under the auspices of the national hospitals office within the HSE, with responsibility for the provision of pre-hospital emergency care, including the development of the first responder service where required. The 2001 report of the strategic review of the ambulance service has largely formed the basis for the development of pre-hospital emergency medical services in recent years. The report recommended that all ambulance services should consider establishing first responder programmes to support the ambulance service. In line with that recommendation, the eastern region of the HSE trained more than 1,000 people last year in cardiopulmonary resuscitation in the community. The Department of Health and Children has been advised that a number of community first responder schemes are in operation throughout the country. The HSE has advised that the further roll-out of such schemes will take place subject to the pre-hospital care needs of particular regions.

Deputy Timmins is aware that a national task force on sudden cardiac death was established in September 2004 to address the problem of sudden cardiac death. The task force, which is chaired by Dr. Brian Maurer, has almost completed its work. It will make recommendations on the prevention of sudden cardiac death and the detection of those at high risk. The task force will advise on equipment and training programmes, to improve the outcomes in the cases of those suffering from sudden cardiac collapse, and on the establishment of appropriate surveillance systems. In particular, the task force will advise on maximising access to basic life support and automatic external defibrillators, appropriate levels of training in basic life support and the use of automatic external defibrillators and the maintenance of that training. It will also consider who should be deemed to be priority individuals and priority groups for such training.

The task force will make decisions on the geographic areas and functional locations of greatest need, the best practice models of first responder schemes and public access defibrillation and the integration of such training services. I understand that the task force has been involved in widespread consultation with individuals and organisations and that a report will be published shortly. I thank Deputy Timmins for his contribution. It was heartening to hear his report on the success of the first responder scheme in County Wicklow. The task force's recommendations will inform future policy in this area. Funding will be provided through the HSE to support the implementation of the recommendations.