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Legislative Council - Fifty-Fourth Parliament, First Session (54-1)
2019-10-16 Daily Xml
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Automated External Defibrillators (Public Access) Bill

Introduction and First Reading

The Hon. F. PANGALLO (17:10): 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 (17:11): I move:

That this bill be now read a second time.

Coincidentally, on world Restart a Heart Day I introduce my private member's bill, the Automated External Defibrillators (Public Access) Bill 2019, which is aimed at saving the lives of over 2,000 South Australians and potentially people visiting our great state each and every year. For many South Australians, when we think of a threat to our lives we sometimes think of bushfires, days like the terrifying Ash Wednesday fires in 1983, an inferno that killed 28 South Australians.

This parliament did something about that threat: our fire protection laws, which passed in the 1990s, demand that buildings and communities have all the equipment and training they need to stop the outbreak and spread of fire. These laws have greatly minimised lives being lost. I am relieved to tell you that the latest figures show that the rate of death from fire is falling. Based on figures for 2008 to 2014, it is about 10 per year in South Australia. That is still high, but parliament saw the threat and did something about it.

However, there is another threat to life here 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. Cardiac arrest kills an estimated 2,045 South Australians every year. The Council of Ambulance Authorities informs me that more than 30,000 people suffer cardiac arrests in Australia each year. Tragically, fewer than 10 per cent of those struck down manage to survive.

Why do we accept these deaths? Possibly because we do not think there is anything we can do about it and partly because we have had an ad hoc approach to the provision of AEDs, relying on one-off grant programs, sporting club and other voluntary organisations fundraising efforts, 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 wanting. I give some credit to the state government, which provides a grant to local sporting clubs to purchase a defibrillator through the Office for Recreation, Sport and Racing's Active Club Program.

Sadly, during the latest round of the Active Club Program no clubs applied for such funding for an AED, so 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 the automated external defibrillator, the AEDs as they are commonly known, widely accessible. AEDs are proven to save lives. It has been proven that the availability of an AED can dramatically lift survival rates from 10 per cent to 70 per cent of people who suffer cardiac arrests.

St John Ambulance tells me that if someone has a sudden cardiac arrest right here 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. With every minute that defibrillation is delayed, the chance of survival decreases by 10 per cent. The chain of survival falls apart 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, then you can say, 'Good night nurse, good morning Jesus,' 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 is quite a physically challenging procedure to undertake as a non-professional. We need AEDs in places we live, work and play, and we need them now.

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 Hurley, has been encouraging all workplaces, public buildings, community centres and schools to undertake CPR training and to install more AEDs.

St John Ambulance and the We are Australian Hearts organisation approached me to introduce a bill that would ensure South Australians are within three minutes of an AED in the event of a heart attack. I am pleased to acknowledge members of those organisations in the gallery today, and I thank them for their expert input and support in developing this bill.

In developing this bill, I was somewhat surprised to learn that in Australia we do not 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, or not, are readily available when needed. In the meantime, lots of companies in South Australia are already doing the right thing. I know that Coles is rolling them out across their supermarkets and Bunnings is equipping all their warehouses.

One great South Australian company which is also taking this seriously is Peregrine Corporation. It is aiming to put AEDs in 40 of its business sites by the end of December 2019 because it knows the difference it makes. The Peregrine Corporation knows what it means when there are no AEDs around. 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, can even get to metro locations in under 10 minutes, and there was no AED nearby in the community. A good South Australian was lost that day because there was no AED nearby.

Another of its staff, Dan Lowe, who I believe may be in the chamber today, learned 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 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 life-saving move, the gym had invested in an AED, and with the help of four other gym goers, who Dan now calls his angels, the HR specialist survived. I met with Dan recently, and he articulated what happened very succinctly:

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 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.

The critical importance of AEDs to survival from a cardiac arrest is illustrated by people like Kybybolite footballer, 22-year-old Max Schinkel, who is also lucky to be alive after collapsing on the oval after training in Loxton. Fortunately, his teammates administered CPR and an ambulance arrived with an AED within 10 minutes, with Max since becoming a big advocate for AEDs being available not just in ambulances but in all public places.

Honourable members here know that I give the AHA and Clubs SA criticism where I think it is due. On this occasion I give praise where it is due. Their grants program has led to the installation of 208 defibs 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 to you. Another 104 AEDs will be installed by the AHA member hotels by February 2020.

Some local governments are doing the right thing too, like Adelaide city council. Councillor Phillip Martin initiated the project 'Saving a life is "shockingly easy"'. Along with 25 AEDs throughout the CBD will be distinctive public art signage designed by Daniel To and Emma Aiston, 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 the 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.

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 get struck down by a cardiac event and not just if they happen to live or work near a business or a council that is doing the right thing. After filing a freedom of information request with the Department for Education, I was astounded when they could not tell me if any of our public schools had an AED installed.

We need AEDs in places we live, work, learn and play. Every business and government needs to do their bit to fit out existing buildings when they build new facilities. It cannot be done by chance, good intentions or as piecemeal projects, as laudable as these are. 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 of sporting and other benevolent individuals or organisations.

AEDs are relatively cheap, at approximately $1,600 per unit, require no training and can be used by anyone in the community. There is 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, which of course includes CPR, to receive training in AEDs as part of that training.

The bill I am putting forward 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 that there is clear signage, just like we expect for fire or other life-saving equipment. Once this bill becomes law I know it will save lives because we have seen it happen across the state already, especially in places like Kangaroo Island.

UK born and trained Dr Tim Leeuwenburg has been a rural doctor on Kangaroo Island for the past 15 years, and it was a pleasure to catch up with him last week. He noticed that there was a high incidence of cardiac arrest on the island. In some cases, it could take up to 17 minutes for paramedics to reach a person who had suffered a cardiac arrest. Tim instigated the HeartSafe KI program on the island, and 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 Heart Safe Communities.

Tim's team includes his wife Trish and paramedic Mick Berden, and they maintain a database of available AEDs and people trained in hands-only CPR and the use of an AED. The program works in conjunction with the GoodSAM smartphone app, which shows locations of AEDs and those trained in their use. It was not long before they started seeing lives saved.

Lawn bowler John Vigar, aged 71, became the first life saved on the island by an AED three months after it was installed at the Kingscote Bowling Club in 2017. John tells everyone today not to hold back on giving CPR, even if it means breaking a few ribs, and he begs communities to get accessible AEDs too.

Today, I commend my bill to you all, to ensure AEDs are installed right across the state. 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 and, most importantly, that there is the maximum chance that someone will know where the AED is, or how to locate one, using a modern smartphone app and the 000 number.

This bill aims to vastly improve the accessibility of AEDs, to try to emulate places such as Tokyo, which has 40,000 AEDs, and O'Hare Airport in Chicago, which has one AED every 100 metres. In Singapore, they are in every taxi. Seattle in the US has them on every street corner, thanks to the generosity of an AED manufacturer.

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 every year. To get to the technical detail of the bill, the Automated External Defibrillators (Public Access) Bill does the following:

it commences 12 months after the day on which it is assented to by the Governor. This is to give sufficient time to plan for and implement the provisions of the legislation;

defines that an AED is a defibrillator. They restore normal heart rhythm and can be used by untrained personnel. The definitions 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 by regulation;

defines a designated building or facility. There is a comprehensive list, including public buildings and facilities; sporting clubs; schools; tertiary and skills training facilities; corrections facilities, including 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;

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 are defined as over $100,000) are commenced after the relevant day on a building that will exceed 600 square metres. These prescribed buildings can be added to by regulation. This does not cover residential homes;

the act binds the Crown, but the Crown cannot prosecute itself;

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 that it is an offence to not do so, with a penalty of $20,000;

ensures that AEDs are also required in emergency service vehicles, and the relevant authority or owner is responsible for compliance. It is an offence to not do so, with a penalty of $20,000;

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 to not do so, with a penalty of $20,000;

prescribes that if an AED is installed inside a building or facility, the owner of the building or facility must install a sign indicating an AED is nearby near the AED and outside the entrance to the building or facility, and, if an AED is installed outside a building or facility, then the owner must install a sign saying that an AED is nearby; and

if an AED is installed in a vehicle, the relevant emergency authority of the prescribed owner is responsible for doing so, and to not do so will incur a penalty of $2,500.

that the responsible minister is the minister responsible for the Health Care Act 2008;

that the minister must 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 a website;

the designated entity with respect to the building, facility or vehicle in which a 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 also 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;

that 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; and

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 saying that I am a heart attack survivor at a relatively young age. I was one of the lucky ones, and I owe my life to the brilliant staff in the cardiac unit at the old Royal Adelaide Hospital and my own cardiologist, Dr Joe Montarello. I did not need CPR or a defibrillator. I had a stent, which has been working smoothly for 26 years, and I have made a complete recovery, according to Dr Montarello. Sadly, far too many do not, so I ask 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 sudden cardiac arrest cannot wait another minute, and I know their families will be eternally grateful if we save just one of these 2,045 people suffering cardiac arrest in South Australia each year. I look forward to summing up the debate after the bill has been through the committee stage.

Debate adjourned on motion of Hon. T.J. Stephens.

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