Bills

Automated External Defibrillators (Public Access) Bill

Introduction and First Reading

The Hon. F. PANGALLO (15:58): Obtained leave and introduced a bill for an act to require the installation and registration of automated external defibrillators in certain buildings, facilities and vehicles and for other purposes. Read a first time.

Second Reading

The Hon. F. PANGALLO (16:00): I move:

That this bill be now read a second time.

I rise today to introduce my private member's bill, the Automated External Defibrillators (Public Access) Bill 2020, which I introduced last year on World Restart A Heart Day. The bill is aimed at saving the lives of over 2,000 South Australians and potentially thousands of people visiting our great state each and every year.

For many South Australians, when we think of threats to our lives we are most likely to think of bushfires—days like we have recently experienced in the Adelaide Hills and on Kangaroo Island, and the terrifying Ash Wednesday fires in 1983. I am sure our fire prevention and protection responses will be thoroughly reviewed at a national and state level following the catastrophic bushfires we have experienced in South Australia this summer, and I look forward to the parliament acting on the recommendations and reforms forthcoming from those inquiries.

Fire protection laws which passed in the 1990s have, for many years, required that buildings and community facilities have fire equipment like smoke detectors, automatic sprinklers, fire extinguishers and appropriate training to stop the outbreak and spread of fire. These laws have no doubt stopped, to a large degree, lives being lost, although, of course, one life being lost to a fire is one life too many. Deaths from fires are too high, with an average of 10 people per year losing their lives from a fire, but parliament, to its credit, saw the threat and did something about it so that today fewer South Australians are dying from fire than they were a decade ago.

However, there is another threat to life in South Australia that we have not addressed in any systematic or strategic manner, not just in South Australia but nationally, as I believe this is the first legislation of its kind in Australia. Not a week passes by when I happen upon incidents involving heart attacks. They are either life saving, life changing or sadly, in so many cases, life ending, when they could have been avoidable if help or equipment was readily available.

One of the most recent and uplifting stories of survival against the odds was the collapse from cardiac arrest of Greg Page, the famous yellow Wiggle, while he was performing on stage in front of his adoring young fans on 17 January for bushfire relief at the Castle Hill RSL. Lucky for Greg, quick-thinking nurse Grace Jones was on hand in the audience. She immediately recognised that he was in trouble. He had no pulse and no sign of breathing. His heart was in a non-productive rhythm condition known as ventricular fibrillation. She rushed to his side, performed CPR and applied an AED that happened to be there, shocking his heart back into a normal rhythm. It saved his life.

Greg says that he is eternally grateful to the people who stepped up and used their training and skills to save his life: Grace, Kim Antonelli, Steve Pace and Therese Wales. He has now resolved to learn CPR too. He also says that it has brought to light the importance of the availability of AED machines in public places, workplaces and potentially in homes, which my bill intends to do, and more. Let me quote Greg:

These machines should be as readily available as fire extinguishers, fire blankets and smoke detectors…as is the case with all these other preventative measures…It's hoped that they're never needed, but with more awareness and more availability of these life-saving practices throughout our community we can all rest assured that many more lives can be saved, just as mine was. And for that, I'm eternally grateful.

I reached out to Greg recently to inform him of this bill and my desire that this legislation be adopted in other states. He was unable to make it here today; however, he is extremely supportive and I will soon travel to Sydney to catch up with him and discuss an awareness campaign I wish to roll out to all MPs in all our parliaments.

Another amazing survival story I would like to share with you all today is that of one of my journalist colleagues, whom I am sure you have either met or whose fine work you have read in The Advertiser, Miles Kemp, one of the paper's most senior staff, who is married to a family friend of ours and former MP and Labor government minister, Grace Portolesi. Miles was travelling on a bus one night in January. He overshot his intended stop and, as he alighted at the Paradise Interchange, collapsed from a suspected cardiac arrest. Two passers-by sought help from a security guard at the interchange. Thankfully, the former Czech soldier knew how to perform CPR. He worked on Miles for a good eight minutes before an ambulance arrived. They worked hard to resuscitate him using CPR and then bursts of an AED.

Grace told me Miles's heart had stopped beating for nearly 20 minutes and that it was touch and go whether he would make it. He did make it and, incredibly, in one of those rare instances, Miles suffered no major heart or brain damage, although his journalistic colleague and mate, Caleb Bond, jokingly questions that. I visited Miles in the Royal Adelaide Hospital, where I also met his charming and relieved mum. He recounted his good fortune in having a good Samaritan on hand and the brilliant efforts of the ambulance crew and, of course, the cardiac specialists at the Royal Adelaide Hospital. He has recovered and is back on the beat.

Time is vital in situations like this. The sooner someone is treated with a defibrillator the greater the chance of survival. For every minute treatment is delayed, the chance of recovery is reduced by 10 per cent. This bill also aims to have these devices fitted on public transport and at major interchanges. I was also made aware of a recent news item on Channel 9 about a courier van driver who had crashed his vehicle after a hard episode and was saved only because of a passing motorist who carried an AED in his car. I intend having one in my car. I have also raised the matter with the South Australian Taxi Council. Imagine having a network of 1,000 plus AEDs on our roads, much like they do in Singapore.

I would also like to acknowledge the presence here today of Lisa Kelly and her courageous daughter, Mandy, who are with us. Lisa is with an organisation known as Australian Hearts, a strong advocate body for AEDs in our community. I first met Lisa when she flew in from Sydney on the day I introduced the bill last year. She too has a compelling but heartbreaking backstory. Her 39-year-old husband, Brent, was exercising in Sydney's north-west with Mandy in 2017 when he suffered cardiac arrest. Had an AED been available in the park, Brent may well have been saved. Lisa has now made it her life's mission to get as many AEDs in the community as possible.

After making a plea in an email to radio announcer Ray Hadley in 2018, Mr Hadley lobbied the New South Wales government to commit $4 million over four years to help grassroots sports clubs purchase the devices. More than 430 defibrillators are being rolled out across New South Wales in the first round of the program. Lisa invited me to speak at the Australian Hearts Under the Stars gala fundraiser in Sydney last November, where I met Lisa's delightful kids—Mandy, Byron, Georgie and Joel—along with members of her wonderful and supportive family, board members of Australian Hearts, Associate Professor Jamie Vandenberg of the Victor Chang Cardiac Research Institute and former New South Wales premier Nick Greiner.

While in Sydney, I also spoke with an Officeworks manager, originally from South Australia, who proudly informed me that the company had rolled out nearly 150 AEDs in their New South Wales stores. Their parent company, Coles, is doing likewise in its supermarkets. A rising number of businesses seem to be recognising the value of having these devices in public places. However, we do need to encourage more to follow suit.

Mandy delivered such a heart-wrenching yet eloquent speech about the last hours she spent with her loving dad and how she desperately sought help from nearby strangers to save him. She spoke of how she held his hand to tell him how much he was loved by his family, while waiting for what Mandy says was an eternity for the ambulance to arrive. They applied an AED and rushed him to hospital. Mandy felt like this was a surreal dream. She never once thought that her fit and energetic dad would die. Mandy demonstrated enormous courage and maturity on that day in 2017. With her distraught grandfather she had to break the news to her siblings and other family members. Brent would be so proud of her as well as of his wife, Lisa, who works tirelessly in building his lifesaving legacy, the Brent Kelly Foundation.

In undertaking a wideranging consultation to develop this bill, I had the pleasure of meeting with a number of heart attack survivors who owe their lives to AEDs—people such as Daniel Lowe, who is also in the chamber today, who learned firsthand the difference it makes when there is an AED nearby. The Onkaparinga Hills father of three, aged 39, owes his life to an AED and to those who acted quickly to use it. Dan collapsed and died for 12½ minutes while doing a workout at Orangetheory Fitness in Hawthorn three years ago. In a lifesaving move, the gym had invested in an AED. With the help of four other gym goers, whom Dan calls his angels, the HR specialist survived. I met with Dan recently and he very succinctly articulated what happened. He said:

I wouldn't be here today without the defibrillator, and the heroic efforts of my angels, I would have died there and then—it's as simple as that. It turned out that I had an electrical defect of my heart, which I was totally unaware of at the time. I was at my gym doing a regular workout. Without any warning signs, I collapsed and 'died' for 12.5 minutes before being brought back to life. I don't remember anything about it—but I know I wouldn't be here if not for the gym having an AED—and my wife would be a widow and my children wouldn't have a father.

These are just some of the stories of joy and despair wrought by heart attacks. It is incredible to realise that we can do something so worthwhile in our community and at such small cost. The Council of Ambulance Authorities informs me that more than 30,000 people suffer cardiac arrest in Australia each year. Cardiac arrest kills an estimated 2,045 South Australians of all ages and fitness levels every year. Tragically, less than 10 per cent of those struck down manage to survive.

Why do we just accept these deaths? It is possibly because we do not think there is anything we can do about it. Partly, it is because we have had an ad hoc approach to the provision of automated external defibrillators—AEDs, as they are more commonly known—relying on one-off grant programs, the fundraising efforts of sporting clubs and other voluntary organisations, a patchwork of local government and industry initiatives and other well-meaning but inadequate efforts to try to get AEDs into locations where they have been shown to be needed and wanting.

I will give some credit to the state government, which provides a grant to local sporting clubs to purchase a defibrillator through the Office of Recreation, Sport and Racing's Active Club Program. However, I was disturbed to find out that during the latest round of the Active Club Program, few, if any, clubs applied for such funding for an AED. I am pleased to say there is something more strategic and effective that we can do about it and it is surprisingly simple: it is making AEDs widely accessible.

As I have pointed out, AEDs are proven lifesavers. It has been proven that the availability of an AED can dramatically lift survival rates for people who suffer cardiac arrests from 10 per cent to 70 per cent, an incredible statistic. St John Ambulance tells me that if someone has a sudden cardiac arrest right here in this chamber—heaven forbid—and we are able to get an AED onto that person within a minute, the chance of survival is 90 per cent, especially if it is combined with CPR, what is called the 'chain of survival'. But for every minute defibrillation is delayed, the chance of survival decreases by 10 per cent.

The chain of survival response begins to fail if people have to wait for CPR or an AED. If a South Australian in cardiac arrest has to wait five minutes for an AED to be applied, that person has only a 50 per cent chance of recovery. If the wait is nine minutes, then it is a 10 per cent chance of recovery. If it is 10 minutes or more, your chances of recovering are next to nil, which leads me to my point: South Australians cannot wait another minute.

We cannot put pressure on ambulances to be faster and we cannot train enough people to be expert in CPR, which can be quite a physically challenging procedure to undertake as a non-professional. However, we can ensure that AEDs are in the places we live, work and play, and we can do this right now for a relatively low cost. You do not need any special training or expertise to use an AED; anyone can use it.

The bill I put today will save lives because AEDs save lives. Mine is just one voice among many who are unanimous in agreement about what is needed. The Australian Institute of Health and Safety recently called for more AEDs to be installed in workplaces. The Governor-General, General David Hurley, has been encouraging all workplaces, public buildings, community centres and schools to undertake CPR training and to install more AEDs.

With the support of St John Ambulance—and I welcome Steve Yeo here today—the We Are Australian Hearts organisation, the Brent Kelly Foundation and survivors of heart attacks who owe their lives to the actions of passers-by administering CPR or an AED, I drew up this bill that would ensure that South Australians are within three minutes of a defibrillator. Many survivors of heart attack who owe their lives to the actions of passers-by administering CPR and/or an AED have urged me to pursue and develop this bill.

In developing this bill, I, a heart attack victim myself, was somewhat surprised to learn that in Australia we do not already have legislation or consistent funding arrangements to ensure that AEDs, these vital life-saving devices that have been proven time and again to be critical to surviving a heart attack, are readily available when needed. We cannot put a price on saving a life but, frankly, the cost of a TGA-approved AED at around $1,600 to 2,000 is a small price to pay considering these devices have a long lifespan, require very little maintenance and require virtually no training to operate.

In the meantime, lots of companies, clubs, councils and businesses are already doing the right thing in South Australia. I know that Coles and Woolworths are rolling them out across their chains of supermarkets and Bunnings is equipping all its warehouses. One great South Australian company that is also taking this seriously is the Peregrine Corporation, which coincidently employs Dan as one of its HR specialists. It was aiming to put AEDs in 40 of its business sites by the end of December 2019, because the Peregrine Corporation knows and cares about the difference an AED can make.

The Peregrine Corporation knows the implications of this because a couple of years ago one of its key staff, a man in his 50s, experienced sudden cardiac arrest at home, right here in the metropolitan area of Adelaide. There is almost no chance that an ambulance, even on a good day, could get to metro locations in under 10 minutes, and there was no AED nearby in the community that this person could access. A good South Australian was lost that day because there was no AED nearby.

Honourable members know only too well that I give the AHA and Clubs SA criticism where I think it is due. Well, on this occasion I give praise where it is due. Their grants program has led to the installation of 208 AEDs at clubs and hotels in regional locations across the state and all of them are registered with emergency services, so if you call 000 they can tell you about the AED nearest you. Another 104 AEDs will be installed in AHA member hotels by the end of March.

Some local governments are doing the right thing too, like Adelaide city council. Councillor Phillip Martin initiated the project titled 'Saving a life can be shockingly easy'. Along with 25 AEDs throughout the CBD come distinctive public art signage, designed by Daniel To and Emma Aiston, to ensure that as many people as possible know where to find them—a smart move, because there is no point having AEDs in public places if people do not know where they are.

Adequate signage on the outside of buildings and at the exact site of an AED is something my legislation ensures. I hope to see a lot more of Daniel and Emma's signage for AEDs, as it is distinctive and highly visible, especially at night. There is one by the River Torrens at the Popeye wharf near the rotunda; it is quite a distinctive sign and easy to see.

The Adelaide city council initiative is good news for people who work in the CBD, but I want to make sure that every South Australian has a second chance at life if they ever get struck down by a cardiac arrest, and not just if they happen to live or work near a business or a council that is doing the right thing. We need AEDs in the places we all live, work and play. Every business and government needs to do their bit to fit out existing buildings and when they build new facilities. It cannot be done by chance, good intentions or as piecemeal projects, as laudable as these are.

I was pleased to be advised by the federal Minister for Health, Mr Greg Hunt, that he had committed $2 million in 2019 to ensure that AEDs were in all men's sheds and $1 million to share the cost of AEDs fifty-fifty with caravan park operators. This bill is designed to ensure that the availability of an AED is not dependent on the generosity and actions of volunteers or the fundraising efforts or grant application writing skills of sporting and other benevolent individuals and organisations—although, of course, I encourage them to apply for grants that are available.

There is also no legal impediment to using an AED, and the Civil Liability Act 1936 good samaritan clause safeguards individuals who provide assistance in a life-threatening emergency. The training component of this bill simply provides for those who would otherwise be required to complete first aid training to receive training in AEDs as part of that training, although of course AEDs are able to be operated by untrained personnel as well.

The bill I am introducing today requires all new buildings over a certain size and all major works over a prescribed value to have a publicly accessible AED installed. It demands there is clear signage, just like we expect for fire equipment.

Once this bill becomes law, I know it will save lives because we have seen it happen already in places like Kangaroo Island. UK born and trained Dr Tim Leeuwenburg has been a rural doctor on KI for the past 15 years. He noticed that there was a high incidence of cardiac arrest on the island. In some cases, it would take 17 minutes or more for paramedics to reach a person who had suffered a cardiac arrest. Tim instigated the HeartSafe KI program on the island. Today, there are now more than 40 AEDs installed, with 1,200 islanders—that is, one in five of them—trained in CPR. KI is now one of Australia's leading HeartSafe communities.

Tim's team includes his wife, Trish, and paramedic Mick Berden, who were unable to attend today. They maintain a database of available AEDs and train people in hands-only CPR and the use of AEDs. The program works in conjunction with the GoodSAM smart app, which shows locations of AEDs and also those trained in their use. My bill similarly requires the minister to ensure there is a website and a smart phone app that will show the location of AEDs.

On Kangaroo Island, it was not long before they started seeing lives saved. Lawn bowler John Vigar, aged 71, became the first life saved on the island from an AED three months after it was installed at the Kingscote Bowling Club in 2017. John tells everybody today not to hold back giving CPR, even if it means breaking a few ribs. He begs other communities to get accessible AEDs, too. Today, I commend my bill to you all to ensure AEDs are installed right across the state. As I said, South Australians cannot wait another minute.

This bill clearly legislates the provision of AEDs in a wide range of settings to ensure that, at any critical moment, an AED will be ready and available to use. Most importantly, there is the maximum chance someone will know where the AED is or how to locate one using a modern smart phone app and the 000 number. This bill aims to vastly improve the accessibility to AEDs, to try to emulate places such as Tokyo, which has 40,000 AEDs. O'Hare airport in Chicago has one AED every 100 metres. All public and private schools in Cincinnati in the US have AEDs for children and youth who are affected by sudden cardiac arrest. In Cleveland, Ohio, all front-line fire trucks have AEDs, effectively doubling AED availability at incidents they attend.

South Australians are dying from sudden cardiac arrest and they simply do not have to. We do not have to accept 2,045 South Australians dying from cardiac arrest and associated heart issues every year. To get to the technical detail of the bill, the automated external defibrillator bill does the following. It commences in 12 months after the day on which it is assented to by the Governor; that is to give sufficient time to plan for and implement the provisions of the legislation. It defines that an AED is a defibrillator. The AED must be approved by the TGA. They restore normal heart rhythm and can be used by untrained personnel.

The definition section is self-explanatory and is to ensure that a wide range of buildings and vehicles are included in this legislation. They can also be added to by regulation. It defines a designated building or facility. There is a comprehensive list, including public buildings and facilities, sporting facilities, schools, tertiary and skills training facilities, corrections facilities including police stations, retirement villages, aged-care facilities, residential parks such as caravan parks, casinos and theatres. To be clear, this section also uses the definitions of 'public building' and 'facility' consistent with the building code. These can be added to by regulation as well.

The bill defines a prescribed building as a building on land used for commercial purposes if it is constructed after the relevant day or major works, which is defined as over $100,000, and on the relevant day after they have been commenced on a building that will exceed 600 square metres. These prescribed buildings can also be added to by regulation. This does not cover residential homes. The act binds the Crown, but the Crown cannot prosecute itself.

The bill also entails that an owner of a designated or prescribed building or facility must ensure that one AED is installed for every 1,200 square metres of floor space and it is an offence to not do so, with a penalty of $20,000. The bill ensures that AEDs are also required in emergency service vehicles and buses over 14 seats, trams, trains and larger commercial buses. It is the relevant authority or owner who is responsible for compliance. It is an offence to not do so, with a penalty of $20,000.

The bill identifies that a designated entity—and this is clearly defined—must ensure that the AED is properly maintained and tested at least once every 12 months. It is an offence not to do so, with a penalty of $20,000. The bill prescribes that, if an AED is installed inside a building or facility, the owner of the building or facility must install a sign indicating that an AED is nearby near the AED and outside near the entrance to the building or facility. If an AED is installed outside of a building or facility, the owner must install a sign saying that an AED is nearby. If an AED is installed in a vehicle, the relevant emergency authority or the prescribed owner is responsible for doing so and to not do so will incur a penalty of $2,500.

The responsible minister is the minister for the Health Care Act 2008. The minister must also keep a register of AEDs. The AED register must have the AED's location, times during which it is accessible and information prescribed by the regulations. This must be published by the minister on the website. The designated entity, in respect to the building facility or vehicle in which an AED is installed, must provide this information to the minister, if already installed, within two weeks of the relevant day, or in other cases within two weeks of the installation, and notify the minister of any changes. To not do so is an offence with a penalty of $2,500. The minister must also make this information available on a smart phone compatible application. The app must provide directions from the location of the operator of the app to the AEDs.

The minister must develop and implement a strategy to inform the public about AEDs. The communications must also include information about location and registration of AEDs, the need to install signs and the fact that a person does not need to be trained to use an AED. The strategy must be implemented as soon as practicable after the relevant day and continue to be promoted for five years hence.

The minister must establish a training scheme for AEDs for persons who must complete first aid training under the Education and Care Services National Law (South Australia) or the Work Health and Safety Act 2012 or any other person prescribed in the regulations. They must be provided with training within three years of the relevant day and then within three years after this. The Governor is given regulatory powers as necessary or expedient for the purposes of this act. You can see the list of standard regulatory powers given.

I conclude my remarks by asking honourable members in this place to help save South Australian lives by supporting my private member's Automated External Defibrillators (Public Access) Bill. I know that South Australians dying from cardiac arrest cannot wait another minute, and I know their families will be eternally grateful if we save just one of those 2,045 people suffering fatal cardiac arrest in our state each year. I commend this bill to the chamber.

Debate adjourned on motion of Hon. D.G.E. Hood.