HC Deb 27 May 1988 vol 134 cc677-82 1.30 pm
Mr. Neil Thorne (Ilford, South)

It is a great pleasure and privilege to have the opportunity to speak to the House today on the Government's policy towards training pupils in emergency aid in schools, because the matter is closely associated with the St. John Ambulance and because my hon. Friend the Minister of State, Department of Education and Science, who has such a wonderful reputation for care and helpfulness to the community, is to reply to the debate.

The community suffers 20,000 fatalities a year as a result of accidents at home, on the road and at work. That is a salutary fact, but quite a number of lives could be saved if the right action were taken in the first few minutes after the accident. When people are surrounded by others with some basic knowledge of emergency or first aid, their chances of survival are considerably enhanced.

I was astonished, when I started to research this matter, that I could find no requirement to have first aid experience on hand for pupils in schools. I have seen a report by Dr. Jennifer Bennett, senior registrar in community medicine in the Brighton health authority, which says that, as far as she is aware, the civil law states that schools must provide for adequate first aid for pupils. The Department of Education and Science has issued guidelines, saying that all teachers should have a simple working knowledge of first aid and that it is also desirable that some teachers in every school should have specific first aid training.

I understand that the health and safety at work regulations require first-aiders to be available in places of employment where there are more than 150 employees. In a large school, therefore, where there are more than 150 staff, it might he necessary to have not just one first aid post but as many as three to allow for absences and sickness. There is no requirement for a first-aider if there are fewer than 150 employees. Three first-aiders would, I believe, suffice for up to 450 staff, and there should be an extra first-aider for each additional 150 staff.

No such legal requirement exists in regard to children, and that is a major mistake. As the law considers it necessary to have an average of one first aider for every 150 staff, one would expect a still higher proportion to be required in schools.

The Department's guidelines propose that in schools with less than 150 employees there should be an appointed person who is responsible for first aid and is available at all times when employees are present on the premises. Where there are more than 150 employees, a first aider holding a Health and Safety Executive-approved first aid certificate must be appointed. The appointed person is expected to do the following: administer minor first aid treatment, call for an ambulance in the event of serious illness or major injury and if a qualified first aider is not present maintain the contents of the first aid box or boxes. That leaves a large hole in our first aid precautions, particularly for the young. I should like my hon. Friend the Minister to consider that matter seriously and also to examine the need to train the young to look after themselves and others in an emergency.

To encourage the process, St. John Ambulance, under its director, Robert Balchin has introduced a scheme called the "three cross award" scheme which is an excellent example of the way in which we can help ourselves to improve our knowledge. The scheme has many advantages because the learning process starts early. The scheme is said to be designed for pupils from the age of 10 upwarcls, but I believe that there are considerable advantages in starting earlier still. One can teach children as young as six basic first aid skills. We must give young children the confidence they need. In first aid, as in all branches of education, it is confidence that counts. When action is required very quickly after an accident, children can come into their own.

The "one cross award", which is suitable even for six-year-olds, covers the four stages of emergency procedure—the ABC of first aid, which involves checking for breathing, opening the airway, taking the wrist and carotid pulse, checking the level of consciousness and making an emergency phone call. Those are simple matters, which a six-year-old of average intelligence should be able to master. If he does, he is entitled to receive a "one cross award".

The next stage is the "two cross award", which it is entirely possible for a nine-year-old to master. The techniques tackled at that stage are mouth-to-mouth ventilation, external chest compression and how to combine both processes to carry out full resuscitation. It is vital that the techniques are taught correctly and it is therefore important that the teacher should have sufficient knowledge.

The "three cross award'', which is appropriate for pupils of 12 and older, deals with serious bleeding, fractures, shock, burns and scalds and checking for poison. A young person who gained that award would be competent in first aid. All young people should have the opportunity of learning first aid for their own advantage as well as for that of others. In a number of cases, young people have been able to save the lives of adults, including their parents, as a result of the knowledge that they have obtained under the schemes.

There are one or two good examples. The first concerns the village of Bedlinog in Wales, 50 of whose residents—virtually all of them—know first aid. It is just as well that they do, because the young mother of two-year-old Richard Rees was in some panic when her child turned blue and was clearly suffocating. Three first-ciders, Mary Thomas and Pam and Doug Hughes, were able to unblock the child's airways and to keep him alive until the ambulance arrived. In that case, the ambulance had to come a considerable distance., and had they not intervened the child could have died.

Young people have made a positive contribution in many other cases. Louise Mulholland of Hitchin was able to help Rayna Baines, who cut her leg on a glass door and needed about 80 stitches. That young girl stopped the flow of blood, which contributed greatly to saving Miss Baines' life. Had she not had that knowledge of first aid, there might have been a fatality in that case.

Melanie Gates of Charlwood in Surrey helped to save the life of a 70-year-old lady who had fallen on ice and broken her leg and who had lain outside her front door in the cold for about two hours. That young girl implemented her knowledge of first aid and summoned the authorities, which ensured that the old lady was taken safely to hospital.

Michael Annetts of Llanhilleth was able to help Paul Jones who, while playing, was covered in some paint that caught fire. Michael was able to save his friend from suffering serious injuries.

All those cases show us that these days we can do much more than simply dial 999. Many skills are acquired, and we should be imparting the knowledge to young people.

These days we hear a great deal about violence on the football terraces and elsewhere. I like to think that those who learn how to save and protect life are much less likely to become involved in violent behaviour that is likely to maim others. If we could get the message over to all children, we should be going a long way to stopping some of the violence from which we suffer today. That valid and important view was also put forward by Peter Galloway, the assistant director general of St. John ambulance.

There are more than 250,000 accidents every year. They are a serious drain on the resources of hospitals, which are expected to maintain 24-hour-a-day, 365-days-a-year emergency services. We have all experienced the outcry when the accident and emergency services in a local hospital are withdrawn. Vast amounts of NHS time and money are spent on coping with accidents and emergencies.

We should remember that many cases are referred to hospital casualty departments that should be referred to the local doctor. Often people do not understand how serious the injury is, but if they were in possession of more information they could judge what was serious or what could be fairly dealt with by the general practitioner. It would save the Health Service much money.

We should give every possible encouragement to the initiative taken by St. John Ambulance and ensure that our children receive proper first-aid education. We could do so at a modest cost. A video is available for about £15 and the other materials required would not cost more than £5. The modest cost of about £20 per school, which perhaps we could encourage some industries to sponsor, would be a worthwhile investment. I ask my hon. Friend the Minister to consider sending a circular urging all schools to take this opportunity to ensure that the next generation are properly and adequately prepared to cope with emergencies.

1.45 pm
The Minister of State, Department of Education and Science (Mrs. Angela Rumbold)

I am grateful to my hon. Friend the Member for Ilford, South (Mr. Thorne) for raising this important topic. I thank him for his kind words about my responsibility to respond to him.

I hope that I shall provide him with some reassurance that the Government recognise the value of emergency and first aid training for pupils in schools. We have taken account of that matter in our proposals for the national curriculum. We have also taken into account the excellent work being done by St. John Ambulance.

My hon. Friend rightly said that there are 20,000 fatalities a year because of accidents. With sensible first-aid and emergency treatment, people would be able to minimise the number of fatalities that occur every year.

My hon. Friend referred to Dr. Jennifer Bennett and her observations about the law as it relates to schools. At the beginning of September 1987, we issued a guidance note on first aid for schools and colleges. It says: The Health and Safety Executive (HSE) recommends however that employers should consider how their requirements should be met. The general responsibility of LEAs, their schools and colleges, for taking reasonable care of the pupils and students in their charge is enshrined in common law under the 'in loco parentis' doctrine. It follows that, although the above regulations do not specifically cover pupils and students in educational establishments, those responsible have a continuing duty to provide adequately for them and for any visitors on the premises. Where possible, it is sensible to combine first aid arrangements provided for employees with those for pupils, and account should be taken of the likely number of visitors. Some visitors however, such as contractors may themselves be `at work' and may remain the responsibility of their own employers. In this respect it should be noted that the Approved Code of Practice requires written arrangements between employers in respect of contractors and other persons who may be at work, e.g. caterers and other people who come into schools as a result of other policies being introduced.

In general, combining arrangements are welcomed by the HSE so long as they do not dilute the level of provision for employees. DES also supports the need to avoid duplication of provision for staff and pupils in recommending that the contents of all first aid boxes should follow HSE guidelines. It is further recommended that whenever possible the provision of first aid personnel and equipment should take account of both employees and non-employees, based on the criteria in the Approved Code of Practice".

A checklist is attached to the arrangements for first aid provision in schools and colleges. Establishments are invited to consider whether they have an adequate number of trained first-aiders to cover all locations, allowing for staff absences and impending retirements; whether there is an up-to-date list of first-aiders prominently displayed on the notice boards and other strategic locations; whether there are sufficient first aid boxes on the premises, including travelling kits for outside journeys, which are part and parcel of school life; whether there is a designated member of staff who is responsible for checking and maintaining the contents of first aid boxes; whether there is a properly equipped first aid room on the premises; whether there are prominently displayed up-to-date lists of local hospital casualty departments and GPs; whether there is a system for notifying parents and guardians when an accident occurs; whether all treated accident cases are recorded; and whether there is a clear procedure for notifying the appropriate authority of potential hazards. The latter point refers to chemistry laboratories and science laboratories generally. There are other check lists and my hon. Friend can be assured that schools take seriously their responsibilities in relation to members of staff who must be designated and the way in which first aid should be applied.

First aid education is largely a matter for determination by individual schools and, in practice, depends on decisions taken by individual members of staff. Education about different aspects of first aid occurs throughout the curriculum and compulsory years of schooling. It may be considered within the science curriculum, with regard to aspects of human biology and electrical safety and guidance for young people in coping with accidents caused by electrical equipment. First aid education will typically be given through health education, which might be included within a programme of personal and social education, and, of course, within physical education given in the laboratories, on the sports fields and, I hope, in swimming pools. We hope that schools will also provide practical guidance for teachers in a range of different aspects of first aid.

Guidance for pupils in resuscitation techniques is provided in swimming lessons, and the Government recognise the value and importance of that activity. There are some limits to what schools could or should be expected to provide in first aid training for young people. There is no doubt that only a relatively small amount of the curriculum time devoted to such matters can be of long-term benefit to individuals receiving such training and to society as a whole. A small effort in basic first aid treatment provides extraordinarily long-term benefits.

I am aware of my hon. Friend's involvement with St. John Ambulance. I think that all hon. Members appreciate that organisation's voluntary activities on so many public occasions. They may not be aware of the activities of St. John Ambulance in schools, which were outlined by my hon. Friend. For some time, St. John Ambulance has been running a schools project which has been designed to encourage as many young children as possible to remember simple skills of emergency aid. My hon. Friend wisely outlined the possibility of winning a first cross or second cross award for the simple skills that a six-year-old or nine-year-old may be able to master. My hon. Friend drew attention to the fact that the project was launched by Lord Joseph when he was Secretary of State for Education and Science, and we are well aware of the success that the project has had in persuading teachers to utilise first aid and safety skills to the best of their ability.

I should like to refer to the success of the St. John Ambulance three cross award, mentioned by my hon. Friend, which was sponsored by Mr. Robert Balchin, the director general of St. John Ambulance. I understand that since its launch in 1984, 50,000 certificates have been awarded to young people who have been successful in demonstrating knowledge in first aid. That is to be welcomed and St. John Ambulance is to be congratulated on its success in persuading schools to employ the scheme.

I have already referred extensively to the advice issued by my Department concerning first aid for pupils and teachers. I want to reiterate that that does exist and that guidance has been published.

First aid education in schools is not simply a matter for St. John Ambulance; it can be taken on board throughout the curriculum. We believe that those points are recognised within the Government's proposals for the national curriculum. We have identified health and safety education as one of the cross-curricular themes that will be covered by different foundation subjects.

We have already set up a working group to advise on programmes of study and attainment targets in science education. That has had a specific remit to cover scientific aspects of health and safety. In the interim report, which came to the Secretary of State last November, the working group identified scientific aspects of human health and well-being as one of the things that should be covered by science education in secondary schools.

More recently, we set up the design and technology working group and included a similar remit to cover the technological aspects of health and safety education in the workshop and outside school. We envisage that other foundation subjects, especially physical education, will cover health and safety and emergency aid.

I hope that my hon. Friend will accept that at this stage it would be impossible to say precisely what sort of emergency aid education will feature in the national curriculum. So much has yet to be decided and we have to await the recommendations of the various working groups and the consultation processes. I hope that what I have had to say will be of some reassurance to my hon. Friend in terms of the guidance that we have provided for schools in the past and what we envisage will be covered within the national curriculum.

Whatever aspects of first aid education are eventually covered by the national curriculum, I should emphasise that there will be adequate time left over, beyond the subjects that will be taken up by that curriculum, to enable youngsters to obtain additional information. As my hon. Friend said, first aid could be looked at in personal and social development for youngsters.

The Government have emphasised that, in secondary years four and five, at least 70 per cent. of the curriculum time will be devoted to core and foundation subjects, but there will continue to be many important matters dealt with outside the curriculum. We attach considerable importance to that.

Not all schools will necessarily have the expertise to be able to deliver a comprehensive first aid or emergency programme to all pupils. As I have said, they will sometimes have to rely on the expertise of others outside the school to provide young people with that sort of guidance. My hon. Friend will know that many youngsters are encouraged through schools to belong to a number of excellent voluntary organisations—such as the girl guides, the boy scouts and the boys' brigade and the girls" brigade movement, where first aid is something in which youngsters gain expertise. They learn a considerable amount about the process of saving life, minimising dangers to people in the event of an accident.

We shall do what we can within the curriculum and we shall make it plain that there is nothing to prevent schools from joining aspects of the national curriculum with other aspects of emergency and first aid education in a co-ordinating programme of health education. We see this as an important part of what schools are all about. I hope that I have managed to reassure my hon. Friend that the advice issued by the Department about safety matters and our plans for a national curriculum demonstrate the importance that we attach to the issues that he has been kind enough to raise. We fully recognise the possible long-term benefits of emergency and first aid training for young people, which my hon. Friend so clearly demonstrated by the examples he gave of the youngsters who have managed to take action to save lives. I trust that this will be of some help and reassurance to my hon. Friend.