Dáil Éireann Debate, Tuesday - 22 June 2004
8 Mr. J. Bruton asked the Minister for Health and Children if he has plans to ensure that portable defibrillators are available and accessible to persons in rural communities, large offices or commercial buildings; and if he will make a statement on the matter. [18449/04]
View answerThe cardiovascular health strategy, Building Healthier Hearts, which was launched by the Taoiseach in July 1999, refers to the need for early cardiopulmonary resuscitation, defibrillation and the provision of equipment and training to health professionals, particularly GPs in rural areas.
The most disadvantaged in gaining access to early intervention and treatment through all the links of the survival chain are those resident in rural communities, due to the fact that they are furthest away from hospital services. In recognition of this, a number of geographically large health boards have introduced projects to facilitate early response to chest pain or suspected coronary attack for people in isolated areas. Many health boards have developed programmes to train either professionals or members of the public in first responder skills. Many boards have purchased defibrillators for use by GPs.
Other initiatives have been taken. In the North Eastern Health Board area in 2002, 700 school children were educated on what to do in the event of a cardiac emergency. The Western Health Board introduced Community Action in Response to Emergency, a project that trains members of the public in first responder skills. In the north west, the existing Donegal pre-hospital project, referred to in Building Healthier Hearts as a model for other boards to follow, was expanded through the purchase of equipment and extended to Sligo and Leitrim. The Southern Health Board developed a first responder scheme in Dingle.
A start has been made in the provision of defibrillators in public places, including Dublin Airport and Blanchardstown shopping centre in the Eastern Regional Health Authority area. In Blanchardstown shopping centre, 22 customer care staff were trained in the use of an automated external defibrillator, five of which are placed strategically around the centre. Staff are retrained every 90 days at James Connolly Memorial Hospital, Blanchardstown. The lessons from this public access defibrillation pilot project will be examined to inform further developments in this area.
Notwithstanding the immediate and obvious benefits of the provision of defibrillators in public areas, it is also essential to have sustained services in place. All ambulances are now equipped with defibrillators and most ambulance staff have received appropriate training in the area. Six community resuscitation training officers and 21 hospital-based training officers have been recruited by health boards, improving the resuscitation skills of staff working in the community and hospitals.
I will ask a very brief question as my colleague, Deputy Timmins, who has a specific interest in this issue, wishes to contribute. From the Minister's point of view — I recognise that work is ongoing around the country — the main way in which the Minister can facilitate, encourage and support this system, which operates on a voluntary basis in some areas, is through the introduction of good Samaritan legislation, which is required to protect individuals who offer this kind of treatment. Will the Minister consider that?
I consulted the Pre-Hospital Emergency Care Council on liability issues for participants in first responder schemes and it has provided some observations. It sought legal advice on the exposure of an individual to litigation. It is now examining how best to disseminate that information to assist those participating in or considering establishing first responder schemes. I do not, therefore, believe we need a good Samaritan act. The Pre-Hospital Emergency Care Council has been a major catalyst in rolling out the first responder scheme and in informing best practice across the country. If it suggests it is necessary, I will be open to introducing legislation. However, it has not so far done so.
Is the Minister aware that many communities have bought defibrillators in recent months? In Wicklow ten such machines have been purchased by various communities. On the issue of insurance, the difficulty is that they might not be able to join in the first responders mechanism because they will not have enough volunteers in the community. I ask the Minister to keep an open mind regarding good Samaritan legislation. Will he initiate discussions with the Minister for Justice, Equality and Law Reform regarding the possibility of holding these machines in Garda stations if there is no other suitable place within the locality? In addition, will he examine, with the Minister for the Environment, Heritage and Local Government and the county managers, the possibility of including in county development plans a requirement that, where a development exceeds a certain size and attracts many people, such as the Blanchardstown shopping centre, the airport and Croke Park, these machines be available?
Yes. That is a constructive suggestion. I will work with the Deputy and the agencies he mentioned in requesting that.
It is extremely important that defibrillators are being provided. The Minister stated that they are in all ambulances, but the difficulty is in getting the ambulance to the person, particularly for treatments other than those related to heart problems. The Western Health Board area is unique in terms of the distance of bases from people. To achieve a proper standard of care, it is necessary to reach the person within the golden hour, but that is impossible in the Western Health Board area. Three bases are badly needed. Will the Minister address that problem, because no matter how many defibrillators there are, they are no good in an ambulance if the ambulance cannot get to the patient within the required time?
There has been a dramatic improvement in the ambulance service in recent years compared to four or five years ago. I continue to prioritise investment in ambulance services. The Department has approved training for the emergency medical technicians advanced programme which will train EMTs to the level where they can administer other drugs, particularly thrombolytic drugs, in cases of heart attack. That will require legislative change which it is hoped will be brought to a conclusion very shortly, following legal advice we have received.
