Feargal Quinn (Independent) | Oireachtas source

I move: "That the Bill be now read a Second Time."

I welcome the Minister for Health. I hope this Bill will be welcomed too. I could do with half an hour, rather than ten minutes. I will have to speed it up and see what I can do. I am pleased to have an opportunity to open the Second Stage debate on this Bill, which deals with an issue that affects many people. There is increased awareness of the need for defibrillators to be available. Advances in technology have meant that the prospects of survival can be greatly improved, but we need to take the steps proposed in this Bill. Life is precious. As a society, we do all we can to avoid needless deaths. Regrettably, suicide has become more prevalent in recent years. Much has been done in the area of suicide awareness and prevention. We have made great progress in reducing road deaths; more must be done. Advances in science and medicine have led to the development of vaccines. The search for cures for life-threatening illnesses goes on. These efforts are yielding results.

Deaths from heart disease and cardiac arrest can be prevented. Collectively, we must do all we can to minimise avoidable loss of life. Cardiac arrest is the sudden and abrupt loss of heart function. Sudden death occurs within minutes of the onset of symptoms. The most common underlying reason people die suddenly from cardiac arrest is coronary heart disease. Much more is known now about the causes of heart disease and the risk factors associated with it than was known before. The figures are very interesting. There are between 5,000 and 6,000 cardiac arrests in Ireland each year. Approximately 70% of these events happen in the home in the presence of family and friends. In the 12 months up to October 2012, 123 people were saved as a direct result of the use of defibrillators. We cannot ignore these figures.

I would like to speak about the role of defibrillators. Cardiopulmonary resuscitation, CPR, and defibrillation can mean the difference between life and death. This is why it is vital to provide for the increased availability of defibrillators and to train as many people as possible in CPR and defibrillation. An automatic external defibrillator is a computerised device that analyses the heart system of a person in cardiac arrest. It can recognise a shockable rhythm. The computerised system can advise the operator whether the rhythm should be shocked. Advances in technology and reduced production costs mean defibrillators are now more affordable. As a result, they should be far more widely available.

Defibrillation is a crucial link in what the experts call the "chain of survival". The first link in the chain is recognition, which relates to the ability of those who are coming to the assistance of a patient to recognise that he or she is having a heart attack. The second link is the delivery of CPR at an early stage, which is really crucial if the chances of survival are to be increased. The third link is rapid defibrillation. Until recent years, defibrillation was not possible until the emergency services arrived on the scene. The wider availability of defibrillation now means it is possible for the defibrillator to be applied to the patient by people in his or her immediate vicinity before the emergency services arrive. The fourth link in the chain is early advanced care, which is provided by nurses and doctors. The fifth and final link in the chain of survival is post-cardiac-arrest care administered in a hospital setting.

When speaking about the chain of survival, it strikes me that the assistance of lay people is crucial to a person's prospects of survival. The first three links in the chain can be administered by ordinary people moments after the emergency occurs. First reaction and assistance are crucial in this context. According to the experts, every minute that passes without the administration of CPR or defibrillation causes a person's chances of survival to decrease by between 7% and 10%. I find it interesting that the survival rate for out-of-hospital cardiac arrests in Ireland was 1% in 2006, but this figure had increased to 6.5% by 2012. The goal is to achieve a survival rate of 40%. This can only be achieved through an increased level of training in CPR and defibrillation, as well as an increase in the availability of defibrillators.

The Irish Heart Foundation, which trained over 500,000 people in CPR over the last ten years, is doing sterling work in this area. In 2009, the foundation developed and self-funded a great initiative - the CPR for schools programme - under which all transition year students in this country received CPR training. This was a real success. I would like to think the Department of Health could work with the Department of Education and Skills to make CPR training a normal part of the transition year curriculum. This would mean that all students leaving secondary school would be trained in CPR and perhaps also in the use of defibrillators. Even in the absence of legislation, defibrillators are becoming more widely available, but there is still a long way to go. It is clear that we will not reach the 40% survival rate target in the absence of a real resolve and determination to put in place the measures that are needed. That is why I believe the proposals contained in the legislation I am proposing are so important.

Section 4 of the Bill before the House will require the owners of certain types of premises, referred to in the Bill as "designated places", to install defibrillators. Under the Bill, this requirement will apply to 18 categories of venue. Those in a further five categories will be required to install defibrillators when more than 100 people per day are in attendance. I decided to distinguish between different categories of premises because I am conscious of the cost of compliance with this requirement. I do not want to impose particular additional costs on venues where the footfall does not warrant it. While we cannot put a price on the cost of saving a life, I realise that cost is a sensitive matter, particularly at a time of recession. It costs approximately €1,500 to buy a defibrillator. The yearly cost of maintaining a defibrillator is approximately €100. The provision of training is a really key part of the story because research has shown that training increases the likelihood of a person's surviving in an emergency situation.

As I understand it, there are very many organisations engaged in the provision of CPR and defibrillation training. The cost of training a person in the use of a defibrillator ranges from approximately €60 to €100. This takes place in other jurisdictions. In Portugal recently I was queuing to go to the airport when I noticed a defibrillator on a poster and a few metres away was another defibrillator.

I learned later that the figures for their use by the Dublin Airport Authority, DAA, are fascinating. While approximately 6.5% of people recover if a defibrillator is used, the figure for the DAA is 40% because there are plenty of defibrillators and enough people are trained to use them. A 40% survival rate is huge. It is possible to do this.

In preparation for discussing the Bill I examined the approach to public access to defibrillators initiatives around the world. In 2011, Portugal introduced a requirement for supermarkets, airports, train stations, buses and so on to be equipped with defibrillators. The United States has been very progressive in this area, many states have introduced laws providing for public access to defibrillators and Canada has also been to the fore in this respect. The proposals contained in this Bill are loosely based on a Bill which was enacted in Manitoba, Canada, in 2011. Ireland led the way in introducing a workplace smoking ban and hopefully it can lead the way in accessibility of defibrillators.

This is the third Bill that I have initiated in the past six months or so. I have another one ready for publication and I hope that my Construction Contracts Bill will be passed next week or certainly next month. The Seanad is doing important work in implementing and supplementing the Government's legislative agenda. I look forward to my colleagues' contributions and once again I thank the Minister for his attendance here today and hope that he will find the debate in this House to be well-informed and constructive. This is a non-contentious Bill. It is not perfect and I am very open to accepting amendments to it. I even have a few of my own. The proposal contained in this Bill addresses an issue that I can safely say is a concern for Members on all sides of this House. I believe I have taken a reasonable approach to the Bill and hope that the Minister will support its passage through the House and into the Dáil. I believe it is worthy of support, that it will save lives and there are many points that can be made about it. I look forward to a very healthy debate on this.