 The final item of business is a member's business debate on motion 8301, in the name of Johann Lamont, on St Andrew's first aid. This debate will be concluded without any questions being put with those members who wish to speak in the debate. Please press the request to speak buttons now, and I call on Johann Lamont to open the debate. Ms Lamont, please. Thank you very much, Deputy Presiding Officer. I start by thanking colleagues from across the chamber for the very significant level of support for this motion and for attending tonight's debate. I would also like to thank St Andrew's first aid, the British Heart Foundation and all those other organisations and volunteers who day and daily bring first aid to our communities, allowing events to take place and giving support to a range of groups right across our communities. This motion was submitted following the publication of the Scottish OHCA data linkage project, which looked into survival rates from out-of-hospital cardiac arrest in Scotland. It sounds like a dry report, but it speaks volumes about inequality in Scotland. The report, which was delivered jointly by the University of Edinburgh and the Scottish Government, and supported by the Scottish Ambulance Service and National Services Scotland, found that survival rates in Scotland following out-of-hospital cardiac arrest are estimated between just 6 and 8 per cent. With the European average sitting at 10.2 per cent, this figure put Scotland among European countries with the lowest survival rates. The findings of the report added further weight to the continued efforts of St Andrew's first aid to ensure that people across Scotland are equipped with vital life-saving first aid skills. The first paragraph of the report reveals the scale of the problem here in Scotland. Around 3,000 patients each year will have resuscitation attempted after a sudden cardiac arrest in the community, but only around 6 per cent will survive to hospital discharge. In the best-performing comparable settings around the world, survival is as high as 25 per cent. The report has identified a number of factors that indicate a very real link between areas of social deprivation and a person's chances of surviving and out-of-hospital cardiac arrest, which can affect people of all ages at any time. The report revealed that those living in the most deprived areas of the country were twice as likely to suffer an OHCA as people living in more affluent areas, 28 per cent against 14 per cent. Furthermore, those from the most deprived areas were 43 per cent less likely to survive a cardiac arrest than those from more affluent areas. Other factors that are identified in the report, with the average age of OHCA victims in areas of deprivation, are seven years lower. Bystander CPR was attempted in just 40 per cent of cases recorded by the Scottish Ambulance Service before they arrived. That is lower than in some parts of England. For example, in London, it is 60 per cent of recorded cases. People from the more deprived areas are less likely, around 38 per cent, to receive bystander CPR, compared to more affluent areas, at 45 per cent. Surely, Deputy Presiding Officer, if it were mandatory for people to have even basic first-aid skills, those factors could be greatly reduced. It is a simple solution. More lives could be saved if more people had the skills to help to save others. St Andrew's First Aid is now calling for more to be done to reduce the statistics that I have cited and to increase levels of first-aid skills in Scotland. That simple approach would deliver widespread benefits, literally saving lives. There are additional benefits that first-aid training would bring, which I would like to highlight. Last year, a report by the British Red Cross found that first-aid training could help ease the pressure on accident and emergency departments. The report stated that more than a third of people surveyed attended accident and emergency departments because they were, quote, worried and did not know what to do. People expressed a desire to use A and E services appropriately but found it difficult to know whether a health problem was severe enough to need urgent care. A central case to this evening's debate, the report highlighted that healthcare professionals themselves state that most patients have not attempted first aid before coming to hospital. By equipping people with the proper skills and training more first-aiders, we can begin to turn the tide on the issue. Education is paramount in addressing the problem. In one region of Glasgow, St Andrew's First Aid has been working in partnership with a number of secondary schools to improve and increase levels of first-aid skills among young people. In the north of the city, almost 400 young people have been first-aid trained. In turn, those pupils will show quite case what they have learned to their fellow pupils, passing on vital skills and knowledge. The feedback that St Andrew's First Aid has received from the schools has been overwhelmingly positive, with reports that people grow in confidence and learn to use their initiative in different ways than before. That is not just applied to first aid, but it applies to all of the studies and extracurricular activities. Although the programmes are centred around the teaching of first aid, the skills that people learn are transferable and can set them up for everything, taking them through school and beyond. In a year of young people and the appointment of St Andrew's First Aid as the official first-aid provider for the European Championships being held in Glasgow in August, perhaps the Scottish Government can look at what opportunities may arise around encouraging young people to volunteer and take up the opportunity to learn how to save a life. Life transforming for them and life saving perhaps for others. A virtuous circle if ever there was one. The findings of the report have provided a firm starting point from which we should be urging for more to be done to improve survival rates and address the shortage of first aid skills held by individuals that could literally save lives and put to an end the most horrible example of a postcode lottery. More likely to die and less likely to be saved. It is common sense to equip people with the simple skills that they need to save a life and everyone will benefit. Aileen Campbell, the minister, had already agreed to meet me and I look forward to further exploring how we make sure that people from the most deprived areas have a better chance of survival and that more people are equipped with life saving skills. The campaign by St Andrew's First Aid addresses some of the most challenging issues faced by people living in Scotland's deprived areas today. I sincerely hope that the Scottish Government will work collaboratively with St Andrew's First Aid and others so that we can see Scotland become a nation of skilled first aiders. In conclusion, we all understand the massive challenge on-going health inequalities present to us all. It can be overwhelming—so many causes, so many potential solutions. We ought not to be overwhelmed in action, however. Equipping us with the skills of First Aid and understanding that those skills are already unequally distributed across the population is one part of a big picture. However, it is one part that we can act on right now. I seek the minister's assurance that she understands and will act. Thank you, Ms Lamont. I call Brian Whittle to be followed by Tom Arthur. Mr Whittle, please. Thank you, Deputy Presiding Officer. I congratulate Johann Lamont for bringing that debate to the chamber. It also gives me a chance to thank all the volunteer first aiders who turn up at so many events that we all take for granted. I was at the Scottish indoor athletics championships at the weekend, and there were the first aiders, a permanent fixture, ready trackside to pick us fragile athletes up when we break. I want to take the opportunity today to let them know that they are noticed, their commitment is recognised and we thank them for the service that they provide. Speaking directly to Johann Lamont's motion, where she highlights the disparity in incidents and survival rates for cardiac arrest between deprived areas and more affluent areas, it strikes me that the place to start would be in the school classroom. I know that I learned basic first aid when I was at school, and as a life skill I would suggest that it is very important on so many fronts. The obvious one is that it is the ability to positively intervene in a medical emergency, that basic understanding of emergency procedures that can save lives, as has already been highlighted by Johann Lamont. I think that this is particularly pertinent given the recent pressures on our accident and emergency departments and their primary care services. The British Red Cross survey of accident and emergency attendees, as has been said, found that a third had attended accident and emergency because they were worried and didn't know what to do, with health workers further saying that most patients hadn't attempted first aid before coming to hospital. That same research found that nearly 60 per cent of pre-hospital deaths from injury may have been prevented had first aid been carried out before the arrival of the emergency medical services. They want to say that injury may have been prevented had first aid been carried out before the arrival at A&E. For me, one of the most starkest revelations in that research found out that three out of four parents in the UK would not be able to save their baby from choking. If there was ever a statistic that should grab our attention, surely it's that one. I am sure that if mothers and fathers were to be asked the question, they would overwhelmingly want to have that skill in their parenting toolkit. Patients seem to struggle to assess severity of health problems and I don't know where best to get help. First aid has been described as a lost skill and this has to have a direct impact on delivery of emergency services. At a time when the preventable health agenda is getting more oxygen, it would seem to me that introducing or reintroducing basic first aid training in schools could be a significant element of that preventable health agenda. I have even spoken to schools that teach pupils to recognise the telltale signs of students struggling with conditions such as hypoglycemia associated with diabetes and what they should do in those situations. I believe that it can be very empowering to have that kind of skill at your disposal, that confidence to intervene when that situation arrives. I also think that having friends and fellow students around you that have an understanding of your condition through that education must also be a comfort as well as that idea that with the general understanding perhaps you can tackle that potential feeling of isolation, that the lack of understanding from your peers can bring. We hear a lot about stigma, which is borne out of ignorance in many cases and I think that the potential consequence of that kind of approach could be to normalise those kinds of health-related issues. The school education will in itself not tackle the disparity between the incidents of conditions such as cardiac arrest between the more deprived communities and those that are better off. However, it would certainly have the potential to increase survival rates no matter where those issues occur. By definition, given that the occurrences of those conditions are higher in the more deprived areas, the impact of universal training in schools should be felt to a greater degree in the worst-affected areas, i.e. the most deprived areas. I once again thank Johann Lamont for giving us the opportunity to speak on this topic in the chamber and to thank those first-age volunteers who are all too often taken for granted. Today we have the opportunity to say to them that their contribution to our wellbeing is valued. Perhaps it is time to look at how the opportunity to learn those life skills is brought out to the wider community, and I suggest that the place to start is the school classroom. Thank you very much, Mr Whittle. I call Tom Arthur to be followed by John Scott. John Scott would be the last speaker in the open debate. Thank you, Presiding Officer. I would like to begin by congratulating Johann Lamont on securing this debate. I thank her for bringing this important issue to the chamber. I do not think that any of us who have not, at some point in their life, or through family or friends, have even directly been touched by heart disease and potentially out-of-hospital cardiac arrest. I should declare an interest before proceeding. All of my staff in my constituency office received their first-age training and their first-age certificate from St Andrew's. I myself attended a course five years ago, which I found, and I think that Johann Lamont's remarks about, and I think that Brian Whittle might be touching this, about how enriching an experience first-age training can be. I found that. My only regret is that that was five years ago, and I am more than a little out of date. I thank Johann Lamont for securing this debate in another way, because it is certainly reminding me of my need to go back into not only being fresh but to re-learn a lot of my skills. I think that, like Johann Lamont, I was really quite taken aback by the numbers. I know that Johann Lamont should have represented Pollock previously, she represents Glasgow, and she represents Renfisher South, a constituency that has. Very affluent areas, but also areas of some deprivation as well. I am aware on a sea first hand and on a daily basis some of the gross health inequalities and general social economic inequalities that exist. When we are looking at people from the most deprived areas, they are 43 per cent less likely to survive than those from the least deprived areas. That is a call to action for all of us. I commend the Scottish Government for engaging with the issue with the 2015 document, The Strategy for Scotland. I think that to be aiming to have 500,000 people who are CPR trained is a laudable aim. What I was particularly struck by a very positive statistic is that it is contained within the 2015 strategy that suggests that a defibrillatory shock to the hearts within three to five minutes of collapse can produce survival rates as high as 75 per cent. When we are in a situation in which survival rates are barely one in 20 between six and eight per cent, and we know where outstanding practice sayings are, places like Seattle, there is a 25 per cent success rate, we know that if we undertake the action to make sure that more people are equipped with these CPR skills, we can make a real fundamental difference. Brian Whittle spoke about universal application. I was struck by the strategy in Denmark, where it seems to be with the greater uptake of CPR training—it became a mandatory part of doing one's driving licence. We see the data that suggests a direct correlation increase in CPR by-stander interventions. Of course, that is such a key part of the chain of survival. There was another point that I really want to pick up from John Lamont, speaking about accident and emergency departments and relieving the pressure. Any of us who have had conversations with clinicians at all levels, we do know about some of the challenges, for example, with the worried well and the unworried unwell, and some of the pressures that that can contribute. People have been more empowered, equipped and confident to make decisions before going to A&E. First day training more broadly can play a very significant part in that. People will have the knowledge to use intermediate steps before going to A&E, such as making an appointment for a GP or going to their pharmacist. That is about empowering individuals, and that relates very powerfully to the whole realistic medicine agenda, which is ultimately about empowering patients. I am not thinking about patients but about citizens. I think that there is no more way to be an empowered, confident citizen than to have the skillset to deliver CPR into safe someone's life. I encourage everyone in here who has, and I will certainly do it myself, if you need to update your first day training and if you need to do it, it is a great thing to do. Take that message and spread it far and wide. I begin by congratulating Johann Lamont on securing this debate tonight on St Andrew's First Aid. Can I also acknowledge the good work done by St Andrew's First Aid and, by definition, thank the First Aiders for all the good work that they do, not just in my constituents of air but right across Scotland? St Andrew's First Aiders are also volunteers, and they are at the front line in providing often life-saving First Aid at many public events across Scotland. Their presence at major events is enormously reassuring both for the public and the organisers of major public events. Our thanks to the British Red Cross for their briefing for this debate, in which they highlight that 59 per cent of hospital deaths from injury may have been prevented had First Aid been carried out before the arrival of the emergency services, and that only 37 per cent of people attending A&E with conditions where First Aid could have helped had received any approved First Aid before the arrival at an A&E unit. Further, a third of people presenting at A&E units do so because they are worried and do not know what to do. By going to A&E, they can clog up the service, particularly in winter, when they had no need to be there. There is a need for us all to be better educated, as others have said about First Aid. Myself included. That was dramatically brought home to me during a Christmas day lunch some years ago in my farm at Ballantrae, when my father choked in a piece of turkey. Unable to breathe, he turned blue very quickly, and none of us knew what to do apart from my daughter, who got my father to the kitchen sink, performed a heimlich manoeuvre, up and out came the turkey and Christmas day continued without a further hiccup. That my daughter saved my father's life, that Christmas day is beyond doubt. As we were 36 miles from the A&E unit at Eir, with the nearest ambulance perhaps 20 to 30 minutes away, of course I used my own family circumstances to illustrate the point that having First Aid skills, while vitally important in an urban environment, are even more important in a rural one, and so the need for educating our children in First Aid or bluntly survival techniques become greater as the distance from A&E units increase. Turning out the results of the out-of-hospital cardiac arrest data linkage project, I would congratulate the author of this report, or the authors, on the stark clarity of it and that it is very disturbing conclusions. It concerns us all that historically of the approximately 3,000 people in Scotland who had an out-of-hospital cardiac arrest every year, only 180 survived to hospital discharge. Bad enough, but worse still when compared against the best survival rates worldwide, where out of a similar cohort of 3,000 people, 750 survived. We welcome the ambitious collaborative effort that was launched in 2015, and now on-going to improve the survival rate, hopefully to 1,180 survivors out of the 300 victims of the OHCA annually by 2020. Perhaps we can look forward to an update from the minister tonight on how that is going. In the meantime, we have to confront the findings of the report to emphasise the need for improvement, because it is not acceptable that only one in 17 people who have an OHCA survive to leave hospital. It is not acceptable that those who live in rural areas have a still further reduced chance of survival 30 days after an OHCA. It is not acceptable that people living in our most deprived areas are twice as likely to have an OHCA as those living in better-off parts of our community. As Johann Lamont said, it is not acceptable that the average age of those who have an OHCA in deprived areas is seven years lower than the average age of those who have an OHCA in better-off areas. That probably goes a long way towards explaining my life expectancy, and the most deprived part of my air constituency is seven years less than in the better-off areas. It is not acceptable that, up to the age of 85, men are much more likely to die from an OHCA than women. Although that might be a matter of simple physiology, I certainly, as a man, would like to know the reason why that is the case as I was unable to find an explanation in the report. Minister, perhaps you can tell us. I again thank First Aiders wherever they are for their selfless life-saving volunteering. I encourage the Government to increase population resilience and positive OHCA outcomes by supporting the delivery of education in schools, colleges, universities and later life of First Aiding techniques. I look forward to the minister responding to the many questions raised in the debate. Thank you, Mr Scott. I call on Maureen Watt, close for the Government. Minister, seven minutes are there abouts, please. Thank you very much, Presiding Officer. I thank Johann Lamont for the opportunity to consider in this Scottish Parliament how we can all be ready to save a life. I also recognise the excellent work of St Andrew's First Aid in Scotland delivering expertise with enthusiasm. First, we should highlight today's health figures, showing that the rate of people dying from heart disease has reduced by 40 per cent in the past 10 years in Scotland, and the gap in inequalities has narrowed. Additionally, the rate of new cases of coronary heart disease has decreased by 27 per cent. I thank all those working across NHS Scotland and beyond to tackle heart disease and recognise the real results that they are delivering. Through our out-of-hospital cardiac arrest strategy for Scotland, which has minister for public health, I launched in 2015, we aim to increase the survival rate from out-of-hospital cardiac arrest. Equipping people with skills to save a life is fundamental to our bold aim to save an additional 1,000 lives by 2020. Our strategy was developed and is implemented in partnerships with stakeholders who are already working hard to improve cardiac arrest survival, such as the blue lights services and health services and voluntary organisations, including St Andrew's First Aid. We all know that it is the right action in the minutes immediately following a cardiac arrest, calling 999 and starting CPR is where we will have most gains in life saved. Bystanders CPR can increase survival after out-of-hospital cardiac arrest by two or three times. Without it, survival chance drops by 10 per cent every minute, and that is why bystanders CPR is the first priority for the strategy. CPR is incredible as a life-saving skill that anyone can learn. Our commitment is to equip half a million people with CPR skills by 2020 and create a nation of lifesavers. For this, we are driving a co-ordinated national approach, asking the people of Scotland to join us to be ready to save a life. The organisations that have come together in partnership as Save a Life for Scotland are increasing opportunities to learn CPR and raising awareness of cardiac arrest. The model is unique internationally and builds on existing work by services, communities and individuals. Notable achievements by Save a Life for Scotland partner organisations in spreading CPR learning are working directly with many schools across Scotland to support CPR education. Also, a CPR pack of resources for schools developed with Education Scotland is available for their glow website. Many contributions tonight have urged more first aid training and CPR training in schools. Under curriculum for excellence, schools have already the flexibility to provide emergency or first aid training, and it is up to individual schools and local authorities to decide if and how best to deliver it. Fulton MacGregor. I thank the minister for the intervention, and it was on that point. I wonder if she will join me in celebrating the work of four nurses that wish an emergency department who have set up a Keep to the Beat service, Caroline Michelle and the two Fiona's, where they are going round schools in North Lanarkshire and South Lanarkshire teaching CPR to young people in some of the most deprived areas. They have just recently been recognised by the health board for doing that. That is excellent. I am sure that it is being replicated across the country, and Johann Lamont herself highlighted what is happening in a number of schools in Glasgow. There is also a successful social media campaign, which was run by Young Scott, a CPR livestream video, where young people learn CPR with a Scottish Ambulance Service paramedic. That was Young Scott's most successful video to date, with over 43,000 views. Scotland's fire and rescue service is opening its 350 community fire and rescue stations for use as training videos using call push rescue kits provided by the British Heart Foundation is also a way of learning CPR. We are delivering CPR learning to the Scottish public in shopping centres, railway stations and leisure centres and with community groups. I spent one cold day outside the museum on the mound highlighting the out-of-hospital cardiac arrest strategy. Johann Lamont? I understand that schools are under pressure, and there are a lot of pressures on them in terms of delivering the curriculum and so on, but would you acknowledge that seeking simply volunteers to come and learn will mean that disproportionately young people in poorer communities are less likely to access that? The most obvious vehicle is schools and what conversations might she have with her colleagues in education and education ministers to look at how we can create incentives for schools in those deprived areas to take up the opportunities to get their young people trained in first aid? I would not necessarily agree with the member. Fulton MacGregor highlighted that there is good work going on throughout our schools throughout our communities, and it is not necessarily the case that more deprived communities are left likely to have those opportunities. However, I take on board what the member has said. We have had lots of high-profile events at things like the Royal Highland Show, Edinburgh Military Tattoo, and being at the Royal Highland Show can meet the rural community and highlight to the rural community how important that is. Obviously, with the European Championships that have been mentioned and the year of young people this year, we have opportunities to continue to promote first aid and out-of-hospital CPR, as well as we continue to develop our active online and social media presence as a portal for information. Tom Arthur mentioned communities and community groups. I would like to commend all the community councils and community groups who have provided defibrillators in their communities. I would also like them to make sure that they register them with the Scottish Ambulance Services, so that, once you dial 999, Scottish Ambulance Services can tell you where the nearest defibrillator is. To date, the Save a Life for Scotland partners have equipped already 200,000 people with CPR skills. Having launched the campaign in 2015, I am particularly proud of that, and I want to thank all the partners and people involved, including, as I said, St Andrew's First Aid for this achievement. To achieve that, we have listened, used evidence and made learning CPR easy, accessible and free. We have distilled down the key requirements so that CPR can be learned in a short time. We know that survival from out-of-hospital cardiac arrest is worse in more deprived areas and one reason is lower rates of CPR. We are seeking to narrow this gap and Save a Life for Scotland partners are proactively working in these communities. For maximum effect, Save a Life work through organisations already established and incredible is key. For example, the successful CPR week in North Edinburgh, where, with the excellent essential contribution of community shop volunteers, over 200 people in the community took time to learn CPR. Building on the Save a Life are in active discussion on CPR learning with some of the least well-off communities in Dundee and Glasgow. A higher incidence of out-of-hospital cardiac arrest is a result of broader population health patterns related to deprivation. As the chamber will know, we are taking action on supporting people to live healthier lives with our tobacco policies, alcohol framework and diet and obesity consultation. Health inequalities are a reflection of wider social inequalities and one of our biggest challenges. We are taking action to address the underlying causes, tackling poverty, supporting fair wages, supporting families and improving our physical and social environments. We are measuring progress and impact of the strategy and developing an evidence base for future plans. I thank everyone who has learned CPR. If you have not already done so, please get involved. I commend Tom Arthur for having taken the first aid course and his staff, too. I remember doing a first aid course in this place. My partner was Annabelle Goldie and putting each other in the recovery position was quite interesting. I think that we should all be ready to say, let's do it and have the power to save lives in our hands. Thank you. That concludes the debate. I close this meeting.