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Seanad Éireann debate -
Wednesday, 19 Jun 2013

Vol. 224 No. 2

Public Health (Availability of Defibrillators) Bill 2013: Second Stage [Private Members]

I welcome the Minister, Deputy Reilly, to the House. Senator Quinn has ten minutes.

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 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.

I second this Bill. I concur completely with Senator Quinn's closing sentiment that this is a non-contentious Bill. It is a no-brainer. In years to come people will understand that the need to have defibrillators in places where large numbers of the public congregate or where particular risk activities occur is as acceptable as having a fire exit or a rule against smoking. I have been a doctor for more years than I care to admit and have seen many patients who have been successfully resuscitated through defibrillation and allied measures. It is certainly one of the most gratifying things in medicine to see somebody who clinically has already possibly breathed his or her last because their heart has stopped, recovering.

I am not sure whether Senator Quinn or anybody else was aware that the portable defibrillator was invented by an Irishman, Dr. Frank Pantridge, in Belfast, that all the early work on it was done there and the first ambulances in the world to be equipped with mobile defibrillators were in Northern Ireland. It is particularly appropriate that we consider introducing this critically important lifesaving measure.

I am going to depart from the script for a second while I have the Minister captive here. I have mentioned this issue on a couple of occasions and the Leader of the Seanad asked that I bring it to the Minister's attention when he was here today for the reading of the Health (Amendment) Bill but he was called away. There is a real problem brewing with private insurance companies not paying for cancer drugs and making patients go back to the public system for drugs which have been approved by the national cancer control programme, NCCP. The drug in question is Ipilimumab. I know it has been close to the Minister's heart and he has a very laudable record in using his own good judgment and offices to make this drug available to patients with melanoma who need it. It is intensely frustrating to me that several large private insurance companies are not covering this drug and are insisting that patients who have been paying premia to them, allegedly for the service of having choice in their care, are being told that they cannot choose to have this drug. They are being sent back to the public system where it is costing the taxpayer a considerable sum of money. One of these companies, Aviva, makes it available to its clients in the UK but not to its clients in Ireland. This is wrong.

The two companies that have been most cast-iron in their refusal are Aviva and Laya. The people who are thinking of signing up to, or buying insurance from, these companies should think again and consider the alternatives. The VHI does reimburse for the drug which reflects the fact, which will be relevant in the new social health reform revolution which will occur here, that it is a not-for-profit company but exists to provide a social service. It attempts to do so with a business model which I know can be difficult for it but that is what it is trying to do. It made the right decision in this case and the companies that are in the business for profit are wrong.

I am sorry to eat into the time for this Bill but the Minister is a very busy man and getting access to him can sometimes be difficult. I am very supportive of yet another very practical Bill from Senator Quinn which should have uniform support across the House, and the Government and which, more than most Bills that come before the House, would actually save lives.

I apologise at the outset because I will have to leave for an important meeting at approximately 5.25 p.m. There is nothing at all contentious in the health sector, as Senators know. We welcome our friends from the Irish Heart Foundation in the Visitors' Gallery.

I am grateful to the Senator for providing me with the opportunity to speak on this matter in Seanad Éireann. It is estimated that approximately 5,000 people die every year as a result of sudden cardiac death. Most of these deaths occur from late middle age onwards as a result of coronary heart disease. It is important therefore to place the Public Health (Availability of Defibrillators) Bill 2013 in a broader context of prevention as well managing cardiovascular disease.

Let us start by acknowledging the improvements in cardiac care brought about through various means, including the national cardiovascular health policy. This policy, named Changing Cardiovascular Health, 2010-2019, provides an integrated and quality assured approach to the prevention, detection and treatment of cardiovascular disease, including stroke. Since 2010 significant improvements have been made with regard to access for acute treatments for coronary heart disease as well as the development of stroke units across the country. The policy report also included a section on sudden cardiac death, a key element of which involves first response survival from cardiac arrest through the development, co-ordination and integration of the emergency medical services with co-responder networks.

On publication of this policy the HSE published the sudden cardiac death steering group report later in 2010. A key element in this was improving first response for a cardiac event. This included guidelines for communities and groups wishing to set up a first responder group, and the integration of the HSE pre-hospital emergency care with community risk responder programmes. It also involved the development of standards for first responders, mainly for general practitioners and voluntary organisations. The HSE has established three programmes to implement the different elements of the cardiovascular policy covering acute coronary syndrome, heart failure and stroke. For the purposes of developing a range of initiatives to improve service delivery in these areas, the Department continues to liaise with the HSE on the implementation of the strategy. Key elements of stroke care include new and existing stroke units provided with additional therapy, nursing and consultant posts. The clinical programme for stroke continues to work to develop and disseminate care pathways and protocols for treatment, a national 24-7 access to safe stroke thrombolysis through service development, telemedicine and training is already available in many hospitals with access protocols agreed for others. Ambulance protocols are being developed for rapid access to hospitals.

Thrombolysis is now available in all acute hospitals admitting stroke patients and 9.5% of patients are being thrombolysed. This rate compares well the best European figures and exceeds our target of 7.5%. In 18 months we have gone from the bottom of the league in Europe to the top. We are now saving a life a day through the stroke programme.

Key elements of the acute coronary syndrome care include improving and standardising the care of acute coronary syndrome patients by having put in place an optimum reprofusion service for patients, otherwise known as stenting; having ambulances equipped and paramedics trained to recognise a major heart attack and transporting these patients to the best place, that is a primary PCI centre hospital for appropriate care; having designated primary PCI or percutaneous intervention centre hospitals based on having available catheter labs plus a requisite number of cardiologists who are trained in PCI; additional cardiologists experienced in PCI are being recruited during 2013; and other non-PCI centre hospitals being clear on how best to treat all ACS patients and arranging their timely transfer.

Key elements of the heart failure care include structured services for the management of advanced heart failure which have been established in 11 hospitals. The heart failure programme in conjunction with the diabetes clinical care programme has recently commenced a screening project for left ventricular dysfunction among diabetic patients in order to prevent further complications. A new diagnostic clinic in Gorey, Wexford, St. Vincent's University Hospital Group, provides direct access for general practitioners to echocardiography in the community with remote specialist advice on echocardiographic results and specialist review of patients in the community when required. This is very welcome as it underscores our principle of bringing the services to the patient rather than the patient to the service where we can. Another element is training for pharmacists to screen for cardiovascular disease and to link in with the heart failure programme.

In 2006, the then Minister for Health and Children launched Reducing the Risk: A Strategic Approach, The Report of the Task Force on Sudden Cardiac Death. The report made a range of recommendations covering four areas of change, including the detection and assessment of those at high risk of sudden cardiac death, systematic assessment of those engaged in sports and exercise, reducing response time, and surveillance and audit. The report made specific reference to automated external defibrillators or AEDs. It noted that the number of AEDs is increasing across the country and that there were no restrictions on who could purchase an AED or where they should be placed. There is evidence that some locations are more appropriate than others and the scientific literature has identified facility types at which the incidence of cardiac arrest is highest. These include health facilities, important transport hubs, universities and colleges and other venues for major public events. The report identified a number of issues in relation to storage and maintenance of AEDs, national signage for defibrillators, traceability of devices, adverse event reporting and that these responder programmes are compatible with the local ambulance service model.

The National Cardiovascular Health Policy 2010-2019 endorsed the recommendations of the Report of the Task Force on Sudden Cardiac Death. In this regard, the Pre-Hospital Emergency Care Council has developed educational standards. These include the cardiac first response standard, the first statutory standard for basic life support, and the standard for AED use in Ireland. In addition, clinical practice guidelines have been developed to support the delivery of interventions by emergency medical technicians, paramedics and advanced paramedics. On publication of the national cardiovascular policy, the HSE established a sudden cardiac death steering group which reported later in 2010. A key element of this report was improving the first response to a cardiac event. A number of actions have been implemented, including guidelines for communities and groups wishing to establish a first responder group and the integration of HSE pre-hospital emergency care with community risk responder programmes. It also involved training and development of standards for first responders, mainly for general practitioners and other voluntary organisations. Work on the AED register is ongoing and is an important feature in improving defibrillation and resuscitation in Ireland and, as a Senator pointed out, in improving survival rates.

The Bill proposed by Senator Quinn sets out the requirement to provide defibrillators in a range of settings and for events which have a regular attendance of in excess of 100 persons per day. Defibrillators would have to be registered and maintained and staff would have to be trained in their use. The Bill proposes that the Health and Safety Authority ensure compliance with the Act and that the relevant Safety, Health and Welfare At Work Act 2005 is amended accordingly. On this point, I wish to point out that the Health and Safety Authority is statutorily mandated to focus on workplace and chemical safety only. In addition, the places on the list of designated places are public venues and not places that the Health and Safety Authority would identify for any level of inspection save in a workplace context.

I wish to clearly state that I endorse the general principle of making defibrillators available in public places, however, we must always be mindful of prevention as a first principle and, in turn, we must continue to progress the configuration and integration of the emergency medical services for co-responder networks, as I outlined earlier.

I want to speak about prevention. We all know that prevention is better than cure. Historically we have been quick to pay lip service to it and slow to pay for it. The actions that we take against the tobacco industry, making tobacco products less available and making children less vulnerable to the advertising of them are hugely important. I equally believe that the other areas we need to address are those of obesity and the abuse of alcohol and that addressing those will hugely reduce cardiovascular events. I accept that the principle of having more defibrillators available will also be valuable in fighting the loss of life resulting from cardiac events.

As most cardiac arrests take place outside the hospital, a public health programme based on trained lay first responders providing early cardiopulmonary resuscitation or CPR and defibrillation may save lives. However, the majority of cardiac arrests occur in the home and less than half of these have a heart rhythm abnormality that cannot be corrected by a defibrillator.

Evidence suggests that the clinical benefits and cost effectiveness of a public defibrillation programme are strongly related to the likelihood that a cardiac arrest will occur at a location where a defibrillator is sited. There are therefore a number of questions that need to be considered when designing such a programme for Ireland, including the quantification of clinical benefits, the identification of the appropriate sites for the defibrillators and to address other organisational issues, including costs.

I have sought and received Government approval that the Health Information and Quality Authority undertake a health technology assessment of a public access defibrillator programme in Ireland. The advice from the assessment will inform my subsequent decisions on the design and implementation of a national programme. I also have approval to draft a general scheme of a public health (availability of defibrillators) Bill, subject to the technology assessment which should also include a regulatory impact assessment, to which the Senator has alluded indirectly in terms of the cost of businesses and so on, and also subject to identifying where defibrillators are currently sited. There is no need to double up on their provision in that if they are already sited in the local Garda station and the GAA, would one be also needed in the post office as well in a small village? It would be hard to justify the cost of that. We need to get the best advice on where they should be sited and where they are currently sited to maximise the return in terms of lives saved.

There is therefore a considerable requirement in defining the range of settings and events as well as monitoring and evaluating the provisions of a community defibrillator programme. The health technology assessment will address key issues in determining how we advance this programme.

I thank Senator Quinn for introducing the Bill and request that the Seanad support my approach in conducting a health technology and risk assessment, HTA, and subject to that my Department will draft a general scheme of a public health (availability of defibrillators) Bill. I will not oppose the Bill. I hope that I will have the Senator's support to carry out the health technology assessment.

I thank the Minister for returning to the House again today. I appreciate all the time that he gives us. I commend Senator Quinn in particular and Senator Crown on bringing forward this Bill. It is a no-brainer. Senator Quinn has made the points on the positive impact that this can have. The statistics seem to show it is all about how quickly a person can have access to a defibrillator. The key period is five minutes and if access to a defibrillator is secured within five minutes survivability is of the order of 50% for young people but if ten minutes elapse before access is secured almost none would survive, but with CPR around 10% to 20% would survive.

It is a no-brainer. Defibrillators should be made available as widely as possible and, thankfully, they are. The bar that I frequent has one and it is clearly visible behind the bar counter. My local football club is fundraising in order to install one in its clubhouse. Senator Quinn has done us a service by making a pitch for the installation of defibrillators at designated locations and I agree with all of them. The process need not be delayed. It is good that the Minister does not oppose the Bill. It is also good that HIQA is examining the potential to extend the Senator's list. We should push on and use the Senator's Bill as a template for making defibrillators and training widely available. Frankly, I disagree with the Minister's statement that if a post office has a defibrillator the local GAA club does not need one. The measure is about saving lives to the extent that funds are available. Funding could be secured by encouraging the private sector to get involved. The Government could provide a tax write-off to an individual or company that sponsors the installation of a defibrillator and training. Local communities will not be found wanting when it comes to fundraising. They would further supplement capital costs incurred by the Department, the HSE or whatever body is assigned to rolling out the scheme.

The Construction Contracts Bill was abandoned for a long period, but now there has been some progress. Today's Bill provides a template and leaves us with no excuse to delay the programme. Perhaps HIQA could be asked to bring its deliberations to a speedy conclusion. If that happened we could kick on and roll out a national programme and worry about the cost at that time. The overall picture would be a gain because the saving of lives greatly outweighs the creation of a capital outlay for the State programme.

Senator Quinn mentioned a survival rate for out-of-hospital cardiac arrests that was formerly 1% and is now around 6%. The target of a 50% survival rate for young people is achievable and is something that we should strive for.

The Minister used much of his speech to praise one of his clinical programmes entitled Changing Cardiovascular Health. He celebrated the fact that we have risen from the bottom of the league to the very top in 18 months. That is in the eye of the beholder and depends on which side of the House one sits on. The clinical programmes have been widely celebrated. The national cancer control programme and the new approach to cardiac care have been a great success for 80% of people. I am sure that objective commentators find statistics showing that these clinical programmes provide 80% coverage when operating at optimum levels acceptable and something to be celebrated. The north west region does not have the appropriate infrastructure to roll out the ambitions contained in Changing Cardiovascular Health. I have said that many times here. The region does not have a cardio categorisation laboratory and there is no plan to create one. Instead, when Professor John R. Higgins rolled out the new hospital programmes in a private briefing to Oireachtas Members he said to me that the road between Sligo and Galway would improve and cross-Border co-operation would be expanded. Let us put politics aside. The people of the north west region deserve a little bit more strategic planning by their Government. It does not matter that whether people support the Labour Party, Fine Gael or Sinn Féin. It is extremely insulting for someone to simply say we are going to improve the road from Sligo to Galway and we are going to talk a little bit more with the North-South Ministerial Council. The Minister of the day has the comfort of hiding behind statistics. The clinical programmes have been extremely successful but only if one lives in the right part of the country. It is a different picture if one lives north of a line between Dublin and Galway and west of Mullingar.

We all wish the peace process continued success. However, I like to think that the Minister of State, Deputy Michael Ring, is looking after my sporting needs in the context of legislation rather than his counterpart across the Border. I do not expect the Queen of England to look after our health. There is much to celebrate about the clinical programmes but at some stage the Government will need to take appropriate cognisance of the fact that the region has inadequate cardiac care and no radiotherapy for cancer treatment. I apologise for going off on an aside but the Minister did the same when he made his address.

I commend the Bill to the House and commend Senator Quinn on his introduction of it. I regret that Private Members' Bills presented by non-Independent Senators are not always openly encouraged.

Or done as well-----

That is in the eye of the beholder.

-----even by those on the Government benches.

Sadly, Private Members' Bills such as the Access to Cancer Treatment Bill introduced by Senator Crown and me, the Family Home Bill and other Bills were interpreted as political ammunition even though they were not. I take solace in the fact that some of good suggestions made by Independent Senators have been embraced. I hope that today's Bill will move forward apace, unlike the Construction Contracts Bill, and I congratulate Senator Quinn again.

I welcome the Minister of State and I thank the Minister for Health for being here earlier. I also thank the proposer and seconder of the Bill. I thank Senator Quinn and his advisers for a carefully drafted Bill. I have drafted legislation so I know it takes time to draft and prepare legislation.

I will start by referring to the Minister of State's area of Castlebar. In the past few weeks an inquest on a 39-year old man who died outside a nightclub was reported. The jury recommended that all Garda stations should have defibrillators and gardaí should be appropriately trained. Twenty-five years ago there were very few fire extinguishers on properties but legislation made it mandatory to install a certain number of fire extinguishers per square foot in a building. The regulation led to greater fire prevention and ensured that outbreaks were dealt with immediately, with less reliance on a response by the fire service. That proves that when action is taken everyone benefits. The same applies to this proposal. I am familiar with the issue of cardiac arrest. A member of my family survived a heart attack due to the fast reaction of his GP and the emergency services. Therefore, I support the Bill.

Last December a report on equipping GP surgeries with defibrillators was published. Professor Gerard Bury, professor of general practice at University College Dublin, led the study. He stated in his report that only one in 20 people would survive a sudden cardiac arrest if it happened out of hospital. That statistic further emphasises the importance of today's Bill. Professor Bury further stated that the availability and proper use of defibrillators by GPs increased survival rates three- or fourfold. He pointed out that it costs around €4,000 for a defibrillator and training to be provided to a GP. If all GP surgeries were fitted with a defibrillator and training was provided there would be a great improvement in how GPs respond to and deal with such emergencies.

All GP surgeries in the country should have defibrillators and proper training should be supplied. The Department of Health should examine this immediately. The infrastructure is in place in GP surgeries. We are talking about having primary care units around the country and perhaps we should examine the basics of having something as simple as this. Perhaps we should be working with the existing structures and ensuring both the equipment and training are provided. That would be of assistance in dealing with the issue. Many of us make the presumption that GP surgeries might have defibrillators, but I was surprised to find that such a large number of GPs would not necessarily know how to use one. This is very relevant in rural areas, in particular, where the nearest hospital might be 20 or 25 miles away. We should urgently examine this issue, especially in rural areas where there is a distance to be travelled by the emergency services and in transporting the patient to the nearest suitable unit.

The Bill is welcome. It has my full support in dealing with and progressing this issue. In my earlier discussions with Senator Feargal Quinn he accepted that there probably would be a need for some amendments to it. We should not put this Bill on the shelf and wait another four or five years before any action is taken in this matter. I welcome the Bill and the Senator has my full support.

I welcome the Minister of State. I will not take six minutes because, like Senator John Crown, I am delighted with the Bill on which I congratulate Senator Feargal Quinn. As Senator Marc MacSharry said, this is a no-brainer. The Minister for Health, Deputy James Reilly, talked about prevention, which we all want to see. We want to see nil use of tobacco, responsible use of alcohol, correct diet and exercise, which is a wonderful, educational, long-term goal for Ireland. I also believe "prevention" is a word we need to use in conjunction with the Bill. We will get it through and it will prevent deaths and save the health service money because somebody who survives a heart attack but is incapacitated in hospital long term is costly to the State. What is more important for us in the Seanad and the country than the health of citizens? To be able to stand here and be part of something that could help save people's lives is amazing.

I was disappointed by what the Minister for Health said at the end of his contribution. I was excited when he said, "I have sought and received Government approval." I thought he was going to say, "Come on Senator Quinn; let us push your Bill through." However, he went on to say, "The Health Information and Quality Authority will undertake a health technology assessment of a public access defibrillator programme in Ireland." How many years will that take? Again, as Senator Marc MacSharry said, this is a no-brainer. The Minister said he would think about drafting a Bill when the report came out. The Bill has already been drafted; the work has been done. We need to work together with Senator Feargal Quinn to produce a few amendments and tweak the Bill.

I would have a lot more questions for Senator Feargal Quinn on funding. Senator Marc MacSharry raised the issues of tax write-offs and fundraising. I own and run a small company and some eight years ago I put in place a defibrillator. We updated our training programme only two weeks ago. We have 36,000 sq. ft. and we like to train people in all parts of the building. The defibrillator is to be found only three minutes away from anyone and there are 112 of us in the building. For me, it is a no-brainer for the employees who work eight or nine hours per day. I would like to make it part of the health and work safety programme. There are some ridiculous things we do in health and work safety rules that are not anything like as important as this could be in saving the life of a visitor to one's business or that of one of one's valuable employees. I was so excited to see the Bill today because we did it in our own little company eight years ago. As one of the former Senators said, like a fire extinguisher, this is a must-have.

Senator Feargal Quinn mentioned supermarkets, but I would like this to be broader. What is wrong with all workplaces with a certain number of employees having a defibrillator? We will have to examine the issue of funding. That year we were not particularly profitable. Senator Feargal Quinn mentioned a figure of €1,500, plus some training costs. One can usually obtain a grant towards training. Surely businesses can find that money to protect the health and lives of their employees. We could consider apartment buildings and landlords; there are many other places of which we can think. I am shocked to think that GPs are not trained. Senator Feargal Quinn has my full support and if there is anything I can do to help him push the Bill through, I ask him to call on me.

I welcome the Minister of State, Deputy Michael Ring, and what the Minister for Health said earlier. I congratulate Senator Feargal Quinn on bringing the Bill before us. In the area of health we need these very low-cost, cost-effective measures. Other Senators said many of the things I wanted to say on defibrillators, fire extinguishers and the Heimlich manoeuvre. People died at dinners because we did not know how to do the manoeuvre to prevent meat from clogging their windpipes. Road safety measures reduced the number of deaths on Irish roads from 650 to approximately 160 last year. There are emergency medical technicians in ambulances. There used to be drivers only. Now they perform extremely valuable work, as the Bill indicates.

Senator Feargal Quinn has said there is a 10% reduction per minute in survival rates; therefore, we must take this action within ten minutes typically. I support his goal in respect of the survival rate.

I welcome Senator Colm Burke's support for the Bill. Senator Feargal Quinn's estimated cost to buy a defibrillator is €1,500, €100 to maintain it and €60 to €100 for training. Therefore, Senator Colm Burke's figure of €4,000 per GP might be unnecessarily large. Portugal got there first. Manitoba also got there before us.

The 40% survival rate at Dublin Airport is important. In the Department of Transport, Tourism and Sport there is a sizeable budget for promoting safety on the railways of €13 million or €14 million. Could we use that budget to have defibrillators on trains? With the free travel concession, many elderly people travel on trains and there have been cases involving people who were returning from sports fixtures. If a train is trapped between two stations or out in the country, it is difficult for an ambulance to get to people; they would hardly make it in ten minutes. Perhaps the same could be done in the case of buses. I do not think there is a special bus safety budget, as there is for trains.

When the Minister of State is reviewing this issue with the Minister of State at the Department of Transport, Tourism and Sport with responsibility for public and commuter transport, Deputy Alan Kelly, will they consider having defibrillators in taxis? There is an onerous new requirement that all new taxis must be wheelchair accessible. That adds substantially to the cost involved. A defibrillator would not add much to the cost and could be of value to passengers. The provision in respect of entertainment venues in section 2(v) of the Bill would have covered the Castlebar case Senator Colm Burke mentioned.

The Seanad is at its best today, doing things for society at little cost to the Exchequer. We are helping to reduce sudden cardiac death in a very cost-effective way. I am delighted the Minister will not oppose the Bill. I acknowledge Senator Mary Ann O'Brien's caution but the further study is done. We saw that a while ago on the damage trucks with very few axles do to roads. The Minister of State at the Department of the Environment, Heritage and Local Government, Deputy O'Dowd, indicated that the Department would have to study the issue. The research has been done and all the Department needs to do is download it as Senator Quinn did. There is no need to waste time.

In the current Estimates, the charge per bureaucrat in the Department of Health is set out at not far short of €75,000. That represents 50 defibrillators gone because some guy is conducting a study on behalf of the Minister to prove something that has already been proven before the House. The Minister of State should not bother with the study but should just go ahead and do it. I know that Deputy Ring is enthusiastic, which is why he should go ahead. He will certainly have the support of the House.

I welcome the Minister of State to the House. I would say to Senator Barrett that some of our bureaucrats are well worth €75,000 a year. I commend Senator Quinn on the Bill, which is important and timely. Indeed, some colleagues referred to it with the awful term "no-brainer". The necessity for the widespread distribution of life-saving equipment to make it available to anyone in our communities who needs it is evident. While we do not and could not disagree with that logic, there are logistical difficulties, as the Minister of State briefing indicates at the last page. In the absence of defibrillation, CPR is not always sufficient to save a life and the converse is also true. There are matters which do not appear obvious at once but become so when we consider the logistics.

The categories of premises referred to in the Bill are widespread and well-thought out. I agree with all of them and might add one or two. The costs appear in the general scheme of things to be very affordable at €1,500 to buy the equipment, €100 to maintain it and €60 for training. The training course involves minimal requirements as most modern defibrillators detect electrical charge themselves and do not operate if such a charge exists in the cardiac tissue. They are rather easy to use. I am chairman of my local soccer club, which has a defibrillator which even I know how to use. It shows that it is certainly not difficult. There are certain legal issues to consider. Perhaps, the legislation could provide for stronger indemnification of users. Last year, we saw a young footballer in England suffer publicly and distressingly a cardiac event. The prompt intervention of medical assistance ensured the young man was walking back to take the acknowledgement of the crowd some two months later. If the equipment and expertise had not been available to him, he would probably not have survived. He said so himself.

There are one or two things that might be added to the Bill, though they present their own difficulties. There are suggestions that can be made as to where else we might place defibrillators. The governing bodies of some sporting organisations might not thank me for certain suggestions. We often think when we hear about the use of defibrillators of the high profile cases of young people who die unexpectedly. The Minister of State has reminded us that 5,000 people per year lose their lives due to cardiac events. We must broaden our thinking beyond what is immediately obvious. The governing bodies of sporting organisations might well have a role to play. It was put to me some time ago that it would be a good idea if all referees were trained in the use of defibrillators. What would happen if one had a defibrillator in one's clubhouse on a Sunday morning during which a small soccer match with three or four spectators was taking place? I know such scenarios well. In those circumstances, there might be no one present who is trained in the use of the defibrillator. Lack of knowledge and a fear of doing more harm than good might mean the defibrillator was not used where it could have helped. It would be a good idea to train all referees. It might not be of use during training but when a game is being played, a referee is always present. Perhaps, we could look at that.

The Minister has indicated that he is prepared to accept the Bill, which I welcome. It is a great idea. Like my colleagues, I recognise that there is a complexity attached to this which might require further consideration. As Senator Quinn and Senator Mary Ann O'Brien have said, such consideration would not take a great deal of time. The information is there which is why we should get on and implement it. I commend Senator Quinn and welcome the Bill, which the Labour Party supports fully.

I join colleagues in strongly welcoming the Bill and commend Senator Quinn for bringing it forward. I welcome the Minister of State's remarks that the Bill is accepted in principle. I hope we can move it forward at a faster pace than his initial response indicated. The early availability of defibrillators has been recommended in a number of different reports and much of the research work has been done. We could move forward at a very early stage. There are a number of amendments which could be made on Committee Stage but I see no reason for delay in getting there.

This is a very important Bill. The Health Research Board indicates that up to 5,000 people die every year from sudden cardiac arrest. Those events might not have been fatal had people had early access to defibrillation. Time is absolutely of the essence. The chances of survival for a person who has suffered a cardiac event drops by 10% every minute. Even if a person does survive, the risk of serious brain damage increases. I understand that the response time in Dublin is approximately seven minutes, but it is much longer than that around the rest of the country. The harsh reality is that the absence of defibrillators is costing lives. An ambulance cannot get there in time to save a person. The use of a defibrillator is a simple process. The latest version of the technology will even talk one through all the steps and includes visual and voice prompts to tell someone what exactly they need to do. The technology will not provide a shock unless it is needed. It is incredibly smart technology and very cheap at the price. This is fantastic legislation which deserves support.

We have the research that shows that defibrillators have saved lives. The policy at Dublin Airport of installing defibrillators means that 19 people are alive today who would not otherwise have survived. People of all ages, including an 85 year old gentleman who was saved a few months ago, are still with us because the airport installed the machines and trained its staff. It ensures that within a few minutes' walk of any part of the airport, there is a defibrillator. I know first-hand how important the technology is. A good friend of mine, Seaghan Kearney, is a year or two younger than me and very healthy. He is very fit and plays football a couple of times a week. He was playing football one night with friends and simply dropped to the floor. I was talking to him earlier when I told him I was speaking on the Bill. He said he was very lucky that there was one charge left in the defibrillator in the sports hall where he was playing and that there was a fireman playing who was not there most nights. Seaghan says it is pure luck that he is here. Every day he thanks God there was a defibrillator that saved his life. He said it should not depend on luck and that we should be able to say to people across the country that defibrillators are available. We must make the effort to put them in place.

For that reason, it is important. Seaghan Kearney said there was a defibrillator there but it was of nearly no use to him because it had not been charged. If we introduce a policy whereby there is a defibrillator in every building, we must bear in mind the ACT campaign of the Mater Foundation. The three steps for ensuring defibrillators work is that they are accessible, and not locked away in a press for which no one knows where the key is, that they are charged and that people are trained in how to use them. Otherwise, it is futile and there is no point in having machines if people cannot use them. It is important to ensure there is an education and training strategy.

With regard to costs, this deserves the priority of having funding behind it. The point has been made about the cost to the health service if we do not reach someone in time and people end up in prolonged care suffering serious issues such as brain damage, which would be prevented if we had someone to help them as first responder and to provide CPR or use the defibrillator. We would save money in the health service in the long run. It is simply a matter of prioritisation.

For small businesses under pressure, we need to provide grants. The same applies to sporting organisations. There must be funding behind it. Some companies provide training and the standard varies in respect of the level of support provided afterwards. I would like to see a whole strategy, working with the Mater Foundation, which has done major work on this issue. The foundation knows what needs to be done. There should be a national strategy to train the trainers and ensure people are available, not just through private organisations, to provide training.

Later, we should ensure every transition year student is familiar with this. Senator Gilroy made the point that it is so easy that even he could figure it out. One session with a group of transition year students, who will be the peers playing in the football match, is of benefit. Cardiac arrest affects people of all ages but there is an issue of sudden adult death. Let us make sure that if something happens to a young person, peers are trained in how to respond and have the confidence to respond. What puts people off going to someone's aid is not having confidence and worrying about what may happen. I welcome the fact that the Bill deals with civil liability and that people have nothing to worry about by putting themselves forward. They do not have to worry about legal exposure. I strongly welcome the legislation and I hope the Minister can ensure the Government gives it greater priority to move it forward. We can talk through amendments and ensure everyone is happy. If the Department has concerns, they can be addressed as part of the next Stage. I hope we will not wait a long time to get a signal to proceed to Committee Stage. Every day, lives are being lost for the lack of early defibrillation.

Ba mhaith liom fáilte a chur roimh an Aire Stáit ar ais go dtí an Teach. I acknowledge the presence of members of the Irish Heart Foundation in the Gallery and I welcome them to the House. I am glad to see the Irish Heart Foundation strongly supporting the Public Health (Availability of Defibrillators) Bill. If the legislation is passed, it can provide a powerful legislative platform to ensure that many more lives are saved through bystander CPR and early defibrillation. About half of the 10,000 deaths from cardiovascular disease in Ireland each year are due to sudden cardiac death and 70% of these occur outside hospital, as other Senators stated. CPR training is a major priority of the Irish Heart Foundation, which I welcome, and I understand the foundation oversees the training of approximately 60,000 people each year. I commend the foundation on the initiative. The programme has helped to produce a survival rate, when resuscitation is attempted, of 6.5% according to the latest available research from Ireland’s national out-of-hospital cardiac arrest register. Some 133 lives were saved out of 2,033 patients for whom data were available over a four-year period to the end of 2011.

However, international comparisons show that higher rates could be achieved, particularly when the equipment and training are in place to ensure early recognition, early CPR and early defibrillation. For example, survival rates in Norway, Sweden and Denmark are 13%, 11% and 9%, respectively, while higher rates have been recorded in the Netherlands, where research over a three-year period shows survival rates of 49.6% for patients treated with an onsite defibrillator, compared with 14.3% when no defibrillator was available. We are a long way behind.

The presence of defibrillators in communities creates demand for CPR training that otherwise might not exist. Where training is inadequate or non-existent, as is often the case, defibrillators will not be used and therefore can play no life-saving role. Such situations would concern me. In my last employment, we had regular training and reminders about CPR, which was an advantage.

Legislating to provide more defibrillators is a vital prerequisite to increasing the life-saving role of CPR but this can only be maximised with proper regulation to ensure adequate ongoing training. I cannot emphasise it enough. Whether defibrillators or CPR, the wider population must be able to use them. I am convinced that widening the availability of defibrillators in tandem with certified CPR training will result in considerably more lives being saved in communities across the length and breadth of Ireland. International experts estimate that in optimal conditions, where there is high availability of defibrillators and a high level of people trained in CPR, the survival rate when resuscitation is attempted could be as high as 40%.

Each year there are 5,000 to 6,000 cardiac arrests in Ireland. The report of the task force on sudden cardiac death recommends a person should receive defibrillation within three to five minutes of the arrest occurring. I was at a wedding eight or nine years ago and saw cardiac arrest in a young man of 55 years of age, who was slim and did not drink or smoke. The man was a drummer in a pipe band and the bride was a drummer in a band in Canada, as well as being a nurse. She had friends who were doctors in Northern Ireland and Canada attending the wedding. He hit the ground with the back of his head. There was no sign and someone tore his shirt off and called for an ambulance. Within ten seconds, there were six doctors around the young man. He was lucky because if it happened in a hospital corridor, he would not have had attention so quickly. The ambulance took 20 minutes. I felt for a pulse but he had none for 20 minutes. When the defibrillator was introduced, it transformed the situation.

I went to see him in the hospital in Newry and I could not believe that a half an hour later he was sitting up in bed. Training in CPR is important. If nobody at the wedding had been able to perform CPR he would have died, and he realises that. I cannot emphasise enough the importance of training.

There are defibrillators at different locations in the Leinster House complex and 25 staff are trained to use them, although I have not seen them. I do not frequent the bar but somebody said there was one there. It would be no harm to have training on a continual basis. I commend Senator Quinn. This is a marvellous Bill on which he has done a great deal of work. It is a sensible Bill and both he and Senator Crown have my full support.

I would also like to heap praise on Senator Quinn regarding the Bill he has introduced. I am supportive of this initiative. I understand the Minister for Health wants to conduct a technical assessment but he did not outline a timeframe. I am always concerned when Ministers do not outline a timeframe. Perhaps it could be completed before we return in September and we could then complete the passage of the Bill. I am sure Senator Quinn would give it the summer to allow that to take place.

The Bill represents a powerful legislative platform to ensure many more lives are saved through bystander CPR and early defibrillation. This is important, given that an estimated 10,000 people die each year from cardiovascular disease, of which almost half are from sudden cardiac death. A total of 70% of these deaths occur outside hospital. The survival rate for out-of-hospital cardiac arrest was 6.5% in 2012. This figure can and must be improved upon. International comparisons show that higher rates can be achieved, particularly when the equipment and training are in place to ensure early recognition, early CPR and early defibrillation. Survival rates in Norway, Sweden and Denmark are 13%, 11% and 9%, respectively. Even higher rates have been recorded in the Netherlands, where research over a three-year period to 2009 showed that neurologically intact survival was 49.6% for patients treated with an on-site defibrillator compared with 14.3% where there was no defibrillator. Perhaps this will help the Minister with his research. I fully support the efforts made in this Bill to achieve a survival rate of 40%.

Legislating to provide more defibrillators is a vital prerequisite to increasing the life-saving role of bystander CPR. Like others, I commend the excellent work of the Irish Heart Foundation's Chain of Survival initiative, which comprises four vital links that can save a life: early access; early cardiopulmonary resuscitation; early defibrillation; and early advanced care. In addition to overseeing training in the initiative, the IHF provides significant assistance enabling communities and organisations throughout Ireland to maximise early CPR and defibrillation. The foundation has unrivalled expertise in the practical operation of the efforts we are discussing.

Senator Brennan and others mentioned that the presence of a defibrillator often creates demand for training on how it use it and, therefore, helps to create knowledge. It is important to ensure that through regulations there is adequate, ongoing and certified training. Everybody knows how important it is to regularly update training in the workplace and so on. Knowledge is power. We need to hardwire knowledge of CPR into the public consciousness by including a CPR training module in the school curriculum. This would save many more lives. I am a girl guide leader and we include it in our training. Everybody engaged in youth work and sports should include CPR in training. Young people who aim to be leaders in these organisations should have access to this knowledge. We should share such knowledge, because who knows when we will need to put it into practice?

I raised an Adjournment matter with the Minister for Health last week relating to National Stroke Awareness Week. This year’s focus is on the IHF's Act FAST campaign, which was launched in 2010 to increase public awareness about the early signs of stroke and to encourage speedy medical intervention. During the debate, I referred, in addition to financial assistance, to other supports at the disposal of the State, such as the provision of advertising sites in high-footfall areas of Government buildings and property and consideration of a way to reimburse the 23% the foundation has to pay in non-returnable VAT for the campaign, which is proving not only to save lives and improve quality of life but also to save the State money.

There is also a VAT argument to be made regarding defibrillators. There is an anomaly in our taxation system whereby an individual can get a tax rebate of 23% on the purchase of a defibrillator whereas a sporting organisation or club of volunteers cannot. This needs to be rectified. I appreciate the anomaly is rooted in VAT law but I would like to know what is being considered in the context of existing taxation law to address this issue. I will continue to pursue this issue where the State charges VAT when it is saving money because NGOs, sporting and youth organisations and civil society organisations are doing its job and saving lives in some cases. I commend Senator Quinn on this initiative, which I fully support.

I also commend Senator Quinn on this legislation, which is welcome and very much warranted, given that many thousands of people lose their lives each year due to heart attacks or sudden cardiac death. If the necessary equipment and assistance were more widely available, according to all the expert reports, including that of the task force on sudden cardiac death in 2006, survival rates would be much higher, particularly in the three- to five-minute window after an attack occurs.

The Bill details all the premises in which defibrillators should be made available. The Senator has conducted important research and I subscribe to supporting it, as will every other Member on a cross-party basis. I am working with my local soccer club to hold a fund-raiser in mid-July to purchase a defibrillator. There is no point in going down this road without doing the training and we have engaged the Irish Red Cross to undertake training in August and September with at least 12 club members in order that we can avail of this facility. Every sporting organisation needs to have a defibrillator. We have witnessed in recent years at both semi-professional and professional levels sports people suffering sudden cardiac arrest, which has resulted in loss of life. I am sure the Minister of State will subscribe to that. The GAA has undertaken a worthwhile initiative to fund 1,000 defibrillators through the club system, and that is working effectively.

A number of clubs in my county have obtained the defibrillators, and training was provided. There is no point in having the equipment if there is no training or ability to use it. This is identified in Senator Quinn's Bill.
There is a cost associated with providing defibrillators, although it is not huge. Will the Minister of State consider making a small amount of money available to every sports and community organisation, through the sports capital programme or another programme, to provide at least some assistance in the purchase of defibrillators? It could be for the local community hall or the local athletics, GAA, soccer, badminton, hockey or hurling club, for example. It may be worthwhile to support Senator Quinn's Bill by having the Exchequer match the funding raised by local clubs.
I will not go through the statistics; suffice it to say that every family in the country knows someone who has been affected by heart disease or sudden adult death syndrome. Leaving politics to one side, I believe there is certainly a need to provide this equipment. There is certainly a need to ensure training is available and to support the Bill. I hope that when the Bill is supported this evening, it will not just lie on the shelf of the Government and that it will be passed and implemented. It would be disrespectful for this not happen given the amount of work Senator Quinn has put into it. I commend him on the work. It is an honour to be able to say a few words on the Bill this evening.

The Minister of State is very welcome to the House. With a name like Harte, it is appropriate that I speak on this subject today. In Letterkenny, there is a road named after my father that the locals call the "Harte bypass". I fully support the Bill.

In France last summer, I noticed a defibrillator beside the gendarmerie station in the square of a small village. That is the model we could use. The French would not agonise over health and safety; they have done as I described and they provide training. We sometimes get tied up with health and safety and then start thinking about defibrillators. We should be pushing for them first as the training would follow.

In areas that attract tourists, areas of Dublin such as Grafton Street and St. Stephen's Green, Market Square in Letterkenny and towns with sizeable populations, there is a likelihood that someone will collapse from a heart attack. A defibrillator would save his or her life. Defibrillators would not exist if they were not of any use. Everyone knows people with heart-related problems. I had a stent inserted after running a marathon. I believed running would keep me fit but I collapsed three weeks later, although not from a heart attack. Had I had a heart attack in an area such as the square in France, I would have been saved. If, God forbid, I had one in west Donegal or on the street in Letterkenny, I probably would not survive. There is a role for defibrillators and legislators have a role to advance the agenda.

Sports clubs, including local soccer and GAA clubs, provide defibrillators, as Senator Ó Domhnaill said. Every club in the country should have access to a defibrillator. The Government should provide a subsidy or encourage local communities to fund their provision. A local five-a-side club asked me whether I could help out in obtaining a defibrillator. The cost is approximately €2,200. Senator Quinn may correct me if I am wrong.

Even less. It would not be a lot of money if the club raised €1,000 and the local authority, HSE or Department chipped in also. It is important that we have the facility because, without such primary care, an increasing number of people would be dead or suffer from heart attacks causing severe damage.

Having spoken to a local cardiologist in Letterkenny, I learned there are not as many heart attacks as there were years ago because of intervention, such as stents, and better lifestyles. However, when a heart attack does happen – it can happen to both young and old – a defibrillator is invaluable. The cardiologist said heart disease is very much a genetic phenomenon and that the problem with the gene pool is that there is no lifeguard. Many people walking around today are quite fit and healthy but they may have an underlying heart condition that will not be detected until they collapse in the street. The first 30 minutes are so important to survival. By the time an ambulance reaches west Donegal or south Kerry, it is probably too late. This is why defibrillators are required. I am sure that all French and other European towns have a defibrillator. One could not miss one in the square. If somebody does collapse, there is always someone in a crowd of 100 people who has CPR training or who is a doctor or nurse. One can be sure that someone will have the necessary experience. There is no point in placing a defibrillator on top of a mountain but it is very important that they be in busy areas where people congregate.

I fully support the Bill. We have a new supporters club and we are talking about raising money for charity. This may be one area in which money could be raised. It could be given to schools for clubs, which could raise the remainder themselves.

I welcome the Minister of State to the House. I commend Senator Quinn on introducing practical legislation. He has had a good run in recent weeks, bearing in mind his Bill that passed through the Dáil and the Seanad Bill that progressed through Second Stage. The latter Bill, or a similar one, was introduced in the Dáil by some Independent Members. The Bill before us is important and practical and should be supported. It makes a great deal of sense to have defibrillators at specified public locations and it can save lives.

The Bill is very well drafted. Obviously, we may have issues of concern in regard to some aspects. While the Minister of State may have concerns, I hope the legislation will not be held up just because it has been produced by somebody outside the Government. That tends to happen at times. I hope the Bill will be given due regard, that we can ensure it will receive the attention it deserves and that it will be passed in both Houses.

Any Bill that seeks to improve safety and save lives, where possible, by putting in place appropriate equipment should be considered. The Minister of State may be interested to learn that I am working on an initiative in this regard concerning the fishing industry. He may know about the recent horrific tragedy off the coast of Waterford. We have had far too many tragedies off the coast of the south east and elsewhere. This highlights the need to improve safety and to have personal location beacons for fishermen to wear. The beacons have GPS and can be worn as wristbands, or they can be integrated into life jackets. These are practical measures that we should be considering. There are new technologies that should be embraced. It makes perfect sense.

When I was a member of Waterford City Council, I tabled a motion very similar to this legislation. The State should lead by example. All local authorities and State agencies, bodies and buildings should have defibrillators. It makes perfect sense, and we need to set an example. There is little point in legislators saying every organisation should have defibrillators if we do not have them.

Every time one passes the Members' restaurant one of the first things one sees is the machine. We lead by example. Every State body and organisation and public office should have the equipment.

Sudden adult death syndrome and sudden cardiac arrest are issues with which the general public has become increasingly familiar in recent years. In particular, in Ireland we can all recall the very tragic loss of Tyrone football captain Cormac McAnallen several years ago. More recently we saw the collapse of midfielder Fabrice Muamba during a soccer match in Britain who, thankfully, recovered. Many others have not been so fortunate. We can all recall stories, often of young men and women, who have passed away while playing sport and many others who died suddenly from various forms of cardiac conditions when in public.

It is important that, where possible, that the equipment is available. It is important not to forget that while we have seen tragedies, the availability of the equipment has saved lives. There are many examples. A study was done when defibrillators were installed in Dublin Airport, for example, which found they saved lives. I understand 119 lives were saved over a number of years because the equipment was available and those who needed it were able to access it. It saved the lives of tourists.

An airport is a busy place and a lot of people come and go. To save any life is hugely important but to save over 100 lives over, I understand, a three-year period is an important figure for us to bear in mind. Earlier this year reported that 19 lives had been saved in Dublin Airport in a single year as a result of the introduction of the machines ten years ago. In 2012 three lives were saved, including an 85 year old man who had returned with his family and who thanked emergency services.

The Irish Heart Foundation estimates that sudden cardiac death kills more than 5,000 people in Ireland each year, including approximately 100 people aged under 35. Although the survival rate of out of hospital cardiac arrest is approximately 7% in Ireland, it should be noted that 123 people were saved as a direct result of having the equipment nearby in the 12 months prior to October 2012.

All the technical arguments have been made, as well as calls for why this should happen for practical reasons. I appeal to the Minister of State and the Minister for Health to take the Bill on board and progress it through the Dáil and Seanad. Let us examine it on Committee Stage and iron out any issues. Let us make sure we pass the Bill and make it law. We may need to give support to sporting organisations. A sum of €1,200 is a small amount of money when one considers it could save lives. All sporting clubs and organisations are struggling and there are competing demands. We should consider whether grant support is a possibility. I ask the Minister of State to support the Bill and progress it through both Houses.

I express my appreciation to the Minister of State and the Minister for Health, Deputy Reilly, for accepting the Bill, and to everyone who has spoken. It has been an eye-opener to hear the words and experiences of others.

The Bill would not have come about if I had not gotten a lot of help. I am delighted to see some members of the Irish Heart Foundation are here. I commend Chris Macey, Sarah Cane and Gearóid O Man. They have been very supportive of the Bill, as was the Bills Office which gave me a great deal of help. Brian Hunt put his heart and soul behind drafting the Bill and my assistant Anne O Broin played a very large part in this. It would not have been enough without the wholehearted support we have had today. I greatly appreciate all of those who have contributed.

The ideas which have come from so many Members will help a great deal in making the Bill capable of being enacted as early as possible. Senator van Turnhout said we should make sure that during the summer, all the references the Minister made to having assessments done will be completed and, it is to be hoped, by September we could get it moving. It is a non-contentious Bill and has 100% approval. We need to make sure it is passed on that basis.

I have a daughter living in France who mentioned to me that there is a sign indicating the presence of a defibrillator outside every town hall and gendarmerie. A central piece of law did not introduce that policy, rather, each individual town decided on it with the enthusiasm of the townspeople. It is possible to have them in commercial businesses. If one shop has one and its competitor does not, it is an added advantage. The cost is comparatively small; I understand it is approximately €1,500 initially and €100 per year to maintain. People have to be trained, which costs between €60 and €100 per person. The cost of equipment and training six people would be approximately €2,000.

An employee in one of my supermarkets was 25 years of age, fit, healthy, energetic and in the gym on his day off when he died. I do not know whether a defibrillator was available but if there was it did not get to him quickly enough. I went to the funeral and met his parents and brothers and sisters. Senator Power spoke of the young man in a club she attended.

There is an urgency about the Bill. The Construction Contracts Bill was initiated three years ago, and went through the Seanad and most Stages in the Dáil. The Minister, Deputy Reilly, showed enthusiasm for this Bill. It will move and will be passed very quickly. The Minister said he would not oppose it. He will act with speed and commitment, and it will become law. Whether this Bill or another system is put into operation, the fact it has been discussed on Second Stage today is positive. Let us make sure we can get it to Committee Stage as soon as we can.

There have been many helpful contributions. Senator van Turnhout referred to the VAT anomaly, of which I was not aware. We have learned a great deal. I appreciate those who have supported the Bill. It is a reminder of the value of this House that it is possible to introduce legislation. This is not contentious and has broad support. The Irish Heart Foundation is very supportive of the Bill and its potential to save lives. The sooner we can enact it the better.

I do not think cost is a significant concern because it is comparatively small, in particular when compared with the value of a life. As a country we value the lives of our citizens and this is something we can do. There are some public private partnerships in place. I refer to the dublinbikes scheme which has done well. Defibrillators could be made available in exchange for advertising space or through sponsorship. There are innovative ways to introduce them. Manitoba was mentioned as one of the first regions to do something about this issue. We can learn a lot from what has happened. In looking at the next step, we do not have to invent something new or spend a lot of time on commercial considerations.

Question put and agreed to.

When is it proposed to take Committee Stage?

Committee Stage ordered for Tuesday, 25 June 2013.
Sitting suspended at 6.40 p.m. and resumed at 7 p.m.