Bills

Automated External Defibrillators (Public Access) Bill

Introduction and First Reading

The Hon. F. PANGALLO (16:49): 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 (16:50): I move:

That this bill be now read a second time.

I rise today to reintroduce the private member's bill I initially put forward in October 2019. I was pleased that the Legislative Council saw the enormous merits—social, health and economic—in passing the Automated External Defibrillators (Public Access) Bill that made these life-saving devices mandatory. Unfortunately, it languished in the House of Assembly because the then Marshall Liberal government did not deem having life-saving devices publicly and readily available to save lives in our community a real priority.

The former Treasurer, the Hon. Rob Lucas, told me that his department had estimated it would cost $18 million to have defibrillators in public buildings and elsewhere in the community. That equates to around 10,000 AEDs. He reasoned that it was uneconomic, but who knows how many lives could have been saved, and the anguish of grieving families avoided, if the law had been in place, not to mention the savings to the healthcare system because of the rapid response in reaching and treating out-of-hospital cardiac arrests.

It begs the question yet again: is saving just one life all about dollars and cents? What does it take to convince a government that life-saving devices like AEDs must be as visible and available as, say, fire extinguishers, which are mandatory in all buildings, and how many times have you had to use a fire extinguisher in your workplace or had a need to access one?

Since I last introduced the bill, the need for AEDs to be within easy reach of where we work, live and play has never been greater. Close calls with cardiac arrests have touched members in this place. Indeed, I am a survivor myself. We would all know of someone who has either passed away because of a cardiac arrest or who has been hospitalised because of it. Cardiac arrest kills 486 Australians every week, and 31 people per day, nationally, experience an out-of-hospital sudden cardiac arrest—only 5 per cent manage to survive.

Much has changed since 2019, and there is even more reason now to support what I am proposing. We had the pandemic, which is not over by a long shot, and the flow-on effect of this unprecedented health crisis resulted in our entire health system being so overloaded that it has gone beyond breaking point, with hospitals overflowing, services being reduced or cancelled, people unable to even see their doctor within a reasonable time frame and ambulances stuck with patients for hours outside emergency departments. People are dying because help cannot reach them on time.

Once upon a time, you could count on an ambulance reaching you within eight minutes. That blew out to 16 minutes, and now it is a frightening lottery. This is not the fault of the South Australian Ambulance Service or the fantastic dedicated and professional paramedics, who are working under the most trying conditions because the system and the government has failed them and the people of South Australia, who have come to expect a first-class First World health service, not one that belongs in a Third World country. We know that South Australians have died because ambulances were delayed in reaching them.

In opposition, the Labor Party made much political capital of this. They have made commendable commitments to greatly boost the numbers of paramedics and ambulances, but it should go further than that. If they have the will, they can also improve survival rates if people cannot be reached by expert care in a reasonable time by at least ensuring there are responders who can have quick access to an AED. Only 3 per cent of out-of-hospital sudden cardiac arrests receive defibrillation by a responder before emergency services arrive.

In early August, a relative of mine came close to dying after suffering a massive heart attack and was left to wait more than two hours for an ambulance to ferry her to hospital. It prompted me to write to the health minister, expressing my concerns at the astonishing delay for a cardiac patient and warning him that a tragedy would unfold unless the situation drastically improved. Sadly, that warning materialised just a week later on 8 August, when a 47-year-old father of two young boys, Andrew Ren, suffered a cardiac arrest on Anzac Highway at Plympton and died while on the side of the road, waiting more than 40 minutes for an ambulance to arrive.

Mr Ren had pulled over while driving after suffering chest pains and, doing the right thing, he called 000 for emergency assistance. Yet, tragically it failed him. Despite the efforts of bystanders who went to his aid, administering CPR and trying to use an AED taken from a nearby hotel, it was far too late by the time the ambulance got to him.

In what are known as the critical steps in the chain of survival—the call for help, the push with CPR and then the shot from a defibrillator—AEDs can lift survival rates from 10 per cent to 89 per cent, but with every minute defibrillation was delayed the chance of Mr Ren surviving decreased by 10 per cent. After five minutes, he had a 50 per cent chance of recovery. When nine minutes had elapsed, his chances were down to 10 per cent. After 10 minutes or more, his hopes would have been grave.

I cannot imagine what thoughts were going through Mr Ren's mind as each minute ticked by and he could not hear an approaching siren. The situation would have also been quite distressing for the others concerned, including the initial bystanders who came to his aid and the paramedics who had been delayed for hours by ramping at the Flinders Medical Centre and who would have been conscious they were in a desperate race for survival. It should never have got to that stage, and I would like to extend the Legislative Council's condolences to Mr Ren's family.

I note that the Premier has ordered an inquiry into the incident. That will not bring back Mr Ren. It will not erase the ongoing pain for his family. Ramping is still happening, ambulances are still being delayed, but at least our Chief Medical Officer, Dr Michael Cusack, who is conducting the inquiry, can identify positive measures that can help others. I would suggest that quicker and easier access to defibrillation should be an important priority.

At the weekend, the Andrews government released a review of the deadly failures in Victoria's 000 system. Thirty-three Victorians died waiting too long for ambulances. We await to find out the situation in this state, but I fear we are headed the same way as Victoria. We cannot allow it to occur here where we become so desensitised and accepting of inordinate delays in getting an ambulance or stricken patient when it is so avoidable.

As I have pointed out previously, South Australians cannot wait another minute. We cannot wait any longer while our government procrastinates, putting the cost ahead of a life. They should not leave their responsibility to the actions of generous volunteers and organisations working in the community.

There are many good Samaritans and corporate citizens who are installing AEDs at their own cost: the Australian Hotels Association, Woollies, Coles, Mitre 10, Bunnings and the Peregrine Corporation, which runs the On the Run petrol outlets. The Adelaide City Council has also rolled out more than 20 in the CBD. There are more than 45 installed around Kangaroo Island, thanks to the efforts of benefactors and the determination of local GP Dr Tim Leeuwenburg and his team on the HeartSafe KI program. Twenty-five per cent of islanders know how to perform CPR. Many more are needed, however, in our community.

Recently, I read a Facebook post proudly posted by the chief executive of Multicultural Youth after raising money to install an AED outside their office near the busy entertainment precinct of Hindley Street. She was motivated to do it because both her grandparents have died from cardiac arrest aged only in their 40s. They would have left behind very young children. AEDs are simple to operate and come with voice-activated instructions to apply them and do CPR—part of the chain of survival. People using them are covered from any legal liability in assisting in life-threatening emergencies under the good Samaritan clause in the Civil Liability Act.

An AED of the type you can see in public areas and around the precincts of Parliament House, in hotels or shopping centres, can cost between $1,600 and $1,800. However, the good news is that the price is not only coming down but since I last introduced this bill Australian innovation and ingenuity has led to the development of the CellAED, a single-use small device that comes loaded with voice instruction and is the size of a larger smart phone, which can fit in a pocket, purse, car glovebox, on buses, trains, trams, as well as in emergency vehicles, and it is deceptively easy to use.

The CellAED has been approved for sale by the Therapeutic Goods Administration and costs just $360. So 10,000 devices (that is, if you needed that many) would cost a grand total of $3.6 million. That is a $14.4 million saving from the modelling done by Rob Lucas. Of course, they would be cost-effective and compliant with legislation. I would like to thank Louise Dawson from Defibs Plus, who flew here today from Melbourne and is in the gallery. She drew my attention to the incredible technology last year.

Thousands of these devices have been sold to New Zealand and are also in the European Union. Today, Louise also introduced me to an incredible palm-size compression device called the Cardio First Angel. Developed in Germany and about to go on sale in Australia for around $200, the non-invasive device is placed on a person's chest and compressed down to perform the CPR technique. Anyone not trained in CPR can use it effortlessly. In conjunction with an AED, it is an invaluable life-saving tool.

I can assure you, I will have both the portable AED and the Cardio First Angel in my vehicles. I can see them becoming commonplace items in first aid kits. But we can immediately kickstart the acceptance and take-up of these devices through this bill. I seek leave to table an information brochure published by Defibs Plus for the benefit of members in this place, just to get a visual understanding of the technology I am talking about.

Leave granted.

The Hon. F. PANGALLO: I was pleased recently to hear Leah Watkins, the secretary of the Ambulance Employees Association, say that she was supportive of this legislation and advocated for the registration of AEDs so that 000 operators could direct persons to locations. Furthermore, Leah and the chief executive of SA Ambulance, Mr Elliott, confirmed that they were working on the introduction of the GoodSAM app, which enables first aid trained people to opt in and their location be tracked and notified in the event of an emergency. GoodSAM operates successfully in Victoria.

Can I point out that among the measures in this bill, the health minister must keep a register of AEDs along with the provision of a smartphone app like GoodSAM to make all relevant information available. The minister would also be required to roll out an information and AED awareness strategy for the public as well as establish a training scheme for AEDs for persons completing first aid training under the Education and Care Services National Law SA or the Health and Safety Act 2012.

The automated external defibrillator bill would start 12 months after the day on which it is assented to by the Governor, providing plenty of time to get the devices and have people trained to use them. AEDs would be mandatory in a wide range of buildings and vehicles, which can also be added through regulation. Stiff penalties will apply for noncompliance. Designated public buildings and places include sporting facilities, schools, tertiary and skills training facilities, corrections facilities, police stations, retirement villages and 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.

An AED will be required in any building used for commercial purposes that exceeds 600 square metres. Prescribed buildings can also be added to by regulation. This does not, however, cover residential homes. Also, the owner of a larger designated or prescribed building or facility, like a large shopping centre complex, must ensure that one AED is installed for every 1,200 square metres of floor space. An example of best practice is in the O'Hare Airport in Chicago, the largest in the US, where there are AEDs positioned every 100 metres. Tokyo has 40,000 AEDs scattered throughout the city.

AEDs will also be required, under this bill, in all emergency service vehicles, including police, CFS, MFS and SES, and on public transport, like trains, buses and trams. Owners of prescribed buildings or facilities will be required to install a sign indicating an AED is nearby, near the AED, and outside near the entrance to the building or facility. I have made an addition in this bill which will impose severe penalties for persons caught damaging or stealing them. However, on a positive note, it seems to be common practice around the world that people do respect the devices, and reports of damage and theft are quite low. Even if they are stolen, inbuilt tracking technology can locate them.

The minister must also establish a training scheme for AEDs for persons who complete first aid training under the Education and Care Services National Law SA or the Health and Safety Act 2012, or any other person prescribed in the regulations. This will then greatly increase the number of people in our community who will have CPR skills. I recently met with the new health minister, the Hon. Chris Picton, and the SA Ambulance chief executive, Rob Elliott, to discuss this bill and they both acknowledge the value and need to have AEDs readily available in the community.

I am hoping that, now they are in government, Labor shows the same enthusiasm for this bill as they did in opposition, likewise my colleagues on the crossbench, and I trust the Liberals will also now consider it favourably. My bill has caught the attention and gratifying support of many organisations and individuals here and interstate connected with heart and cardiac care. They include St Vincent's Hospital cardiac specialists in Sydney and the Yellow Wiggle, Greg Page, who survived a cardiac arrest after being treated with an AED and is now a staunch campaigner with his own national program, Heart of the Nation, which advocates for the installation of AEDs and to maintain a national register as well as being linked to an app.

I cannot speak highly enough of what Greg is doing to educate Australians and encourage governments to do more and be an important part of the chain of survival. Greg has written to the Premier, the health minister and the opposition leader, pleading with them to support this legislation and to be the catalyst for change across Australia. He wrote, and let me quote:

This would be a huge step toward many more people being in the right place at the right time when they have their cardiac arrest—wherever they may be. And that is something you could be very proud of as you lay your head on the pillow each and every night, knowing that many more people have had their loved ones return home because of a decision that you and your government have made.

I have also had inquiries from as far away as South Africa. Dr Shamara Hochstadter in Johannesburg is passionate and determined to save lives and wants to work on introducing a public access defibrillation program to prevent deaths due to out-of-hospital cardiac arrest. Dr Hochstadter wants to begin the conversation on having a legislative process, like this one, in South Africa and now hopes to engage with politicians and medical professionals in that country by using this bill as an example of what can be achieved to save lives.

As a footnote, South Africa is a pioneer in heart surgery, with the world's first human-to-human heart transplant performed in Cape Town in 1967 by the late cardiac surgeon Dr Christian Barnard. I conclude my remarks by asking honourable members in this place to help save South Australian lives by supporting my bill and show how South Australia will lead the rest of the country in being a heart-safe state. I intend to bring this bill to a vote on 16 November.

Debate adjourned on motion of Hon. I.K. Hunter.