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Legislative Council - Fifty-Fourth Parliament, Second Session (54-2)
2020-10-15 Daily Xml
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Automated External Defibrillators (Public Access) Bill

Second Reading

Adjourned debate on second reading.

(Continued from 4 March 2020.)

The Hon. J.E. HANSON (15:53): I rise to speak on the Automated External Defibrillators (Public Access) Bill 2020 and indicate that I am the opposition's lead speaker on this bill. In regard to this bill, I foreshadow that I do have an amendment, which I am presenting, and I will address that at the back end of my comments.

We know that with immediate assistance somebody suffering a cardiac arrest can survive. Widespread public access to automated external defibrillators (AEDs) is a crucial way that we can prevent deaths by cardiac arrest. An AED, according to the Heart Foundation, is a portable electronic device that diagnoses life-threatening abnormal heart rhythms that can cause a cardiac arrest. An AED might be able to treat these abnormal heart rhythms by giving an electric shock to effectively restart the heart to its normal rhythm and that is known as the defibrillation.

There is a crucial fact about AEDs that is not universally known. Indeed, if you go out and put this past most people and you ask them to have a shock, they will probably be somewhat resistant. The fact is an AED cannot actually do any harm to someone who is unconscious. The device only distributes an electric shock if it is required.

AEDs are extremely user-friendly and they guide users every step of the way in administering them. Despite their ability to prevent death by a cardiac arrest, AEDs are not widely prevalent in South Australia. Even where they are prevalent, there is not always prominent signage to make people aware of their existence.

In summary, the bill Mr Pangallo has introduced is a bill that seeks to roll out the installation of AEDs across a large range of buildings in South Australia. The bill requires various types of public buildings and all new large commercial buildings to install a publicly accessible AED with clear signage. The bill also requires all emergency service vehicles, trains and any other vehicle prescribed by the regulations to install an AED.

The buildings that will be required to install AEDs within 12 months of enactment of the legislation will include, for instance, sporting clubs, schools, aged-care facilities and other government buildings. In addition, all new renovated large commercial buildings will be required to install one AED for every 200 square metres of their floor space. There is a penalty of $20,000 for noncompliance with these requirements.

The bill further imposes on the health minister requirements to establish a public AED register, create an app for locating AEDs, implement a public awareness strategy for AEDs and establish an AED training scheme for individuals required to complete first-aid training under the legislation.

Our position is that we support the need to expand AED access across our community. We welcome and commend the Hon. Frank Pangallo on bringing this legislation to the council. We also appreciate him holding what I understand was a very entertaining briefing for members of parliament yesterday, attended by St John's Australia and advocates Greg Page and Ironman Guy Leach. Unfortunately, I missed my photo with the Yellow Wiggle, Frank. I am very disappointed, mate, but that is okay, it is alright, I am getting over it. I do not need to mention it on Hansard. Oh, I have.

I note that in Parliament House we have multiple defibrillators available for members of parliament and staff. The simple fact is, if it is good enough for us to have access to these life-saving machines, then in reality it should be good for others who are in buildings around our state that are not parliament.

We do recognise that there is a cost involved in the legislation for community groups and other organisations in the community, but we have concerns that without support there would be a cost. We believe the government should be providing assistance for implementing this legislation, not simply relying on community groups to do that alone.

We are therefore moving some amendments that will require the Minister for Health and Wellbeing to report back to both houses of parliament. The minister should report on how the government plans to support affected organisations with the installation of AEDs, as required by this legislation. The minister should outline what support will be provided, how the community groups and others will be able to access that support and what the total quantum will be that is provided.

We are open to other amendments or considerations in the detail of the legislation, and ultimately we will support its passage through the council. Because of this impost on affected organisations, we want to ensure that the government is actively involved in assisting those affected by the implementation of this legislation and ensure that they are accountable in parliament essentially for how well they do or do not do.

We congratulate the Hon. Frank Pangallo for his advocacy of this important topic and bringing this legislation to parliament, albeit he did not introduce me to the Yellow Wiggle. We hope that the council will support our amendment and the government will support funding to provide these AEDs and make them available. As I said, we are open to considering any further amendments or consideration the government or other members may wish to contribute.

The Hon. M.C. PARNELL (15:58): I would like to start as well by congratulating the Hon. Frank Pangallo for bringing this bill to the chamber and also for hosting a very informative session yesterday morning about CPR and AEDs. As has been mentioned, two special guests were Mr Greg Page, better known as the original Yellow Wiggle, and Guy Leach, former Australian Ironman champion. Both had valuable stories to tell, one as the survivor of a heart attack who benefited from the availability of a nearby AED machine, and the other as a first responder who did not have access to an AED and whose friend might possibly have survived had a machine been available. The survival rate in cases where an AED machine is available can be around 70 per cent compared with only 10 per cent of cases where only CPR is available.

In general discussion afterwards with Guy Leech I mentioned to him that I was a regular participant in parkrun (or at least I was before the COVID pandemic shut down events such as that) and I pointed out that there is now always an AED machine at the start of each event, down on the banks of the River Torrens, and he reminded me that that was one of his initiatives. He was the one who got the AEDs into the parkrun movement. I think that is an excellent initiative, and I congratulated him for that.

These events get hundreds of participants and they mostly are not elite athletes; they are mostly just ordinary folk who are keen to keep fit. However, even so, strenuous exercise and strenuous activities are two-edged swords. They keep us fit and they keep our heart healthy, but they do impose stress and so having the security of knowing that there is an AED machine nearby should be encouraging to all participants, even those who are out of shape. I did make a mental note at the time to check whether the other three running clubs that I am a member of also have AED machines at their events; that is, the South Australian Road Runners Club, Trail Running SA and Ultra Runners SA.

It is now a matter of public record that I had my own heart issues last year which resulted in me spending Easter in hospital and receiving a quadruple heart bypass. My condition emerged not long after starting a 10-kilometre run but, luckily, I was less than a kilometre from home, and I was able to walk home and get a lift down to Flinders Medical Centre, which is only five minutes from my home. I say that because proximity to assistance is certainly a great advantage in cases where time is of the essence, particularly matters of the heart.

In fact, Guy Leech's defibrillator distribution business is known as Heart180, recognising the importance of getting an AED machine to a patient within 180 seconds, or three minutes, of a heart attack. It is a bold and ambitious plan but it is certain to save lives. I point out that my particular episode was not dramatic. I was able to walk home and get driven to hospital, no ambulance required, but the point is that being close to help can make all the difference.

I received an email on Monday from the Heart Foundation, Imelda Lynch, the CEO for South Australia and the Northern Territory. She starts her letter with:

The Heart Foundation supports the bill to make Automatic External Defibrillators (AED) mandatory in South Australia introduced by Hon. Frank Pangallo MLC.

I will not read the whole letter but it points out that in Australia less than one in 10 people who have a sudden cardiac arrest outside of a hospital survive. That is a very poor survival rate. Anything we can do to increase that survival rate has to be a good thing.

The Hon. Frank Pangallo's bill is certainly ambitious but that ambition is absolutely necessary. He is right, I think, to start with public buildings, public transport and other places where lots of people gather, because that is where these devices are most likely to be needed. I am very happy to be supporting the bill.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (16:03): I rise to speak on the Automated External Defibrillators (Public Access) Bill 2020 and indicate that I will be the lead speaker for the government. The bill proposes to require the mandatory installation of automated external defibrillators (AEDs) in a range of buildings and vehicles. This includes requiring external defibrillators in public buildings, schools, tertiary institutions, prescribed sporting facilities, retirement villages, caravan parks, casinos, theatres and correctional facilities, as well as emergency service vehicles.

I thank the Hon. Frank Pangallo for his passion and advocacy to increase the prevalence of AEDS in our community, and his commitment to save the lives of South Australians. I also thank the honourable member for organising yesterday's briefing and demonstration of AEDs and cardiopulmonary resuscitation.

Unfortunately, I was unable to attend due to another engagement, but I am advised it was an excellent demonstration by Shauna from St John. There were contributions from Greg Page, better known as the 'Yellow Wiggle', and Guy Leech, a former Australian Ironman surf lifesaving champion, both of whom shared their personal testimonies, which were both informative and insightful.

I note the information that the honourable member has circulated on the importance of AEDs in saving lives, which includes the story of Rod Hutchinson, who rowed at the 1962 Commonwealth Games and has remained a keen rower his entire life. Rod had a heart attack out of the water while training in an eight-seater. His crew were able to get to shore and perform CPR, but it was a quick-thinking motorist who raced to the local IGA, knowing it had an AED available. The AED saved Rod's life.

I acknowledge the many stakeholders and campaigns dedicated to raising community awareness of and access to life-saving defibrillators, from Guy Leech's Heart180 campaign that aims to have a defib within 180 seconds for any Australian suffering a sudden cardiac arrest to the annual Restart a Heart Day on 16 October, which of course is tomorrow. I also thank the Heart Foundation for their representations in relation to the bill.

Sudden cardiac arrests affect more than 1,800 people each year in South Australia, with only one in 10 surviving. The most recent information about cardiac arrest in South Australia is published in the South Australian Ambulance Service Cardiac Arrest Registry Summary Report 2016-17. The report highlights that in a 12-month period 863 patients required resuscitation by SAAS, and 18 per cent of patients were in a public place. Of the 863 patients, 63 had received bystander resuscitation before SAAS arrived, including 18 patients who had an AED used as part of the bystander resuscitation response. Of these 18 patients, 72 per cent survived.

AEDs are installed on a voluntary basis in many public locations. The cost to purchase, install and maintain AEDs is the responsibility of the organisation or business. By installing AEDs in publicly accessible locations, such as a foyer or a building, members of the public are able to access an AED when attempting bystander resuscitation. SA Ambulance Service is already conducting an awareness campaign to increase the voluntary installation and registration of publicly accessible AEDs on its AED register. I understand there are currently around 1,000 devices on the register.

When members of the public call 000 to request emergency medical assistance, the SA Ambulance dispatch officers use the register to direct members of the public to the closest AED. The government is active in increasing awareness of and access to AEDs. However, we will not be supporting the bill today due to a number of significant limitations. For example, we believe that the locations are not well defined. Many would already have AEDs installed, and the bill lacks clarity in managing the costs imposed on private businesses.

The bill does not currently assign responsibility for the maintenance of an installed AED. The focus of the bill is also on the purchase and installation and lacks a focus on the installed AED being accessible to the public. Clarity is required on how such an extensive system would be monitored for compliance to ensure that all additional AEDs are accessible and operational for the public.

As an example of the complexities of public policy in this area, Eldercare has written to me to voice their opposition to the compulsory installation of AEDs in residential aged-care facilities. They highlight the complexities around an AED possibly being used by visitors, contractors, volunteers and other people who are not well informed of the risk of trying to resuscitate somebody who may have a 'do not resuscitate' order in place or clear end-of-life plans that do not involve active resuscitation.

Again, I reiterate that the government strongly supports broad community use of both CPR and AEDs. I commend the honourable member for his passion and work in this area, and I look forward to ongoing discussions on how we can continue efforts to educate and inspire South Australians to act so that many Australians dying from cardiac arrests may have their lives saved. However, we respectfully consider that this bill is not the best next step.

The Hon. F. PANGALLO (16:09): I would like to thank all the members for their contribution to this bill and also thank the members of parliament and staff who yesterday attended the demonstration of an AED and CPR by St John and heard those compelling life-and-death experiences of my guests who came over from Sydney to show their support, the original yellow Wiggle, Greg Page, and the original ironman, Guy Leech, who explained his passion to try to get AEDs installed for use within three minutes of somebody suffering a cardiac arrest.

Survival rates decrease by about 7 to 10 per cent with every minute that defibrillation is delayed. SA Ambulance figures show that 95 per cent of all cardiac arrests will die before they get to hospital, so every second counts. Just in the 13 or so minutes that we have been in the chamber discussing this bill, one person has died of cardiac arrest somewhere in Australia. Just think about that. There are about 48 a day, and 8,000 die a year as a result of cardiac arrests. We now have the ability, using this cost-effective technology, to reduce those figures significantly.

Tomorrow is Restart a Heart Day. Just this week, the health and wellbeing minister stood up to speak about the lifesaving importance of using defibrillators and CPR and also having them in our community. I am greatly disappointed and totally dismayed that today the government refuses to support this bill and particularly because of what the minister has said. That can only make me think that some of those words he used the other day were perhaps empty ones.

It has been clearly shown that these devices save lives. For example, an AED applied soon after an incident—within that three to eight minute window; if that person is revived and conscious when they are taken to hospital, they might not even required to be ventilated in an ICU. Their recovery will be quicker and they can return to work sooner. That is a win-win for our bursting-at-the-seams health system and for employers.

It also kills the malarkey I read in The Advertiser this morning that if my bill was passed it would impose costs on business. The LGA gave me the same lame line. But I will commend the City of Adelaide, which has around 28 dotted around the city, including on the Torrens Riverbank; and Norwood and St Peters council, which have put two in their streets. I have seen them inside council offices that I have visited. They appreciate the value of having them, just like having mandatory fire extinguishers that may also rarely be used.

They cost under $2,000, and I am certain there are plenty of innovative businesses in this state that could easily find ways to raise the money to buy one. There are good corporate citizens out there who are willingly installing them: Coles, Woolworths, Bunnings, Officeworks and the AHA, one group we do not normally see eye to eye with because of their gaming machines, but I will commend them and their CEO, Ian Horne, for their program to roll out more than 300 defibrillators.

They are not whingeing about the cost. They can see the intrinsic value in them. You cannot put a price on lives, but that is what this government is doing right now. Imagine not putting seatbelts or airbags in cars and not making helmets mandatory for motorcyclists and cyclists because they would be an additional financial cost. Sorry, but that argument of not wanting to burden businesses with extra costs is totally nonsensical, and it would go against overwhelming community support I know exists. I have not received one complaint or objection, save from the government, about what I am proposing.

Just to paraphrase the Premier this morning, when he accused the opposition of being whingers, knockers and blockers, well, you could not get any more hypocritical than that remark. Whinging, knocking and blocking is exactly what they did in the House of Assembly with my colleague the Hon. Connie Bonaros's life-saving initiative on having warning labels affixed to LPG bottles. They blocked debate. They used every excuse they could find to gag something designed to avoid further loss of life, and they are doing it here today with this bill—whinging, knocking and blocking—probably, as with Connie's bill, because it is not their bill, but that is politics for you.

I would also like to note that the always forward-thinking member for Florey, Frances Bedford, attempted similar legislation to mine about three years ago, without much success, but we are still knocking on the door. I do not particularly care who puts up this bill, and if the minister tells me that he intends to do it in a reformed way I would gladly support him to the hilt, just as we did with CCTV cameras in aged care.

Talking about aged care, I will certainly reject Eldercare's concerns about having AEDs in aged-care facilities because it may contravene any existing advance care directives that could be there for any of the residents. Residents are not the only ones in aged-care facilities and they all do not have advance care directives, so it is ludicrous that Eldercare would even put up such a suggestion that it may impact on these aged-care directives. Quite simply, they have numerous staff in there, they have people who come and go in nursing homes who could fall victim to a cardiac arrest, so it is important that they have one there.

As my colleagues have pointed out, they are quite harmless. They are such sophisticated technology that they will only stimulate a heart back to life if they detect the need for it. I must say that I have also heard some dopey remarks come from some government members while we have been attempting to garner support for this. One was that they could not trust a stranger to apply one of these things on them—and they used the term 'things'.

As I have pointed out, they are harmless. In South Australia there is no legal barrier to using an AED and the Civil Liability Act of 1936, the good Samaritan clause, safeguards individuals who aid in a life-threatening emergency. This law ensures that a good Samaritan cannot be sued while aiding someone in an emergency unless their ability to exercise due care was affected by either alcohol or a recreational drug.

The provisions are clear and unambiguous. Another ignorant and misinformed comment from the government today was a fear that it could result in fewer people being trained in CPR. Honestly, I had to read it twice to make sure my eyes were not playing tricks. I will exonerate the minister for being responsible for this flippant dismissal, because I am sure that he of all people would be aware (or should be aware) of the facts, unlike the person who gave that sloppy and unresearched quote to The Advertiser's Liz Henson.

Had they been to the demonstration yesterday, they would have seen that CPR and defibrillators work together. The devices speak through the steps to the user, including applying CPR, particularly if the first shock did not restart the heart. This bill requires and encourages training in CPR. Therefore, it goes without saying that the more AEDs you have in the community the more people will be able to apply CPR than can now.

I will use the perfect example—and I have used it in my second reading explanation—of Kangaroo Island, where one of the resident doctors, Dr Tim Leeuwenburg, has overseen the rollout of almost 50 AEDs, and in doing so they have achieved a stunning 25 per cent of the island's population being able to perform the CPR procedure.

The bill will also see AEDs in schools, enabling students from year 6 upwards to learn CPR. So, minister, we are encouraging and promoting training in CPR, not the opposite. If the government wanted more people to learn CPR, they could follow the innovative lead of countries like Switzerland, Germany, Norway and Denmark, which require first-aid training before driver's licences are issued.

Another feature of this bill is the register of where these devices are located, either on a website, an app or, as the minister has pointed out, when someone calls 000. Adopting an app called GoodSAM not only provides this information but can alert passers-by with the app who have been trained in the use of CPR and AEDs. It works very successfully in Victoria and Europe, yet I am told that this government is opposed to its introduction here. Why on earth would you do something like that?

Thank you for the opportunity to sum up. I do hope the government gives this bill further consideration in the other place, should it reach there.

Bill read a second time.

Committee Stage

In committee.

Clause 1 passed.

Clause 2.

The Hon. J.E. HANSON: I move:

Amendment No 1 [Hanson–1]—

Page 2, lines 6 to 8—Delete clause 2 and substitute:

2—Commencement

(1) Subject to subsection (2), this Act comes into operation 12 months after the day on which it is assented to by the Governor.

(2) Sections 1, 2 and 16A come into operation on assent.

The purpose of the clause, as I outlined in my original speech, is essentially going to how we are seeking further governance over what the bill is seeking to do. You will see that my next amendment comes in at 16A, where the minister must provide a report. Essentially, the operation date is somewhat reflective of exactly what we are also doing in regard to 16A, so these two effectively tie in together.

The Hon. F. PANGALLO: I rise to say that SA-Best supports the amendment from the Hon. Mr Hanson and the opposition.

Amendment carried; clause as amended passed.

Clause 3 passed.

Clause 4.

The Hon. F. PANGALLO: I move:

Amendment No 1 [Pangallo–1]—

Page 4, line 28 [clause 4(i)]—After 'authorised' insert', other than a venue where the only gambling authorised is the selling and buying of lottery tickets'

In the definitions of 'buildings', the designated buildings or facilities listed are public, sporting, school and education facilities, correctional institutions, a retirement village, an aged-care facility, caravan park, residential park with more than 12 residents, a casino or gambling facility, a theatre, and I have just added there, under 'authorised', 'where the only gambling authorised is the selling and buying of lottery tickets'.

The Hon. M.C. PARNELL: I rise to support the amendment. I think the member's list of designated buildings or facilities makes sense. They are places where large numbers of people gather. That includes casinos or other venues where gambling is authorised. As I understand the honourable member's amendment, there are places where gambling is authorised that might not attract a lot of people. It might be a very tiny country store that has four customers a day but they happen to sell lottery tickets, so they would technically be caught up in that definition which is why the honourable member's amendment to exclude such venues from the definition of designated buildings makes a lot of sense.

Amendment carried; clause as amended passed.

Clauses 5 to 16 passed.

New clause 16A.

The Hon. J.E. HANSON: I move:

Amendment No 2 [Hanson–1]—

Page 10, after line 2—Insert:

16A—Report

(1) The Minister must prepare a report on how the Government will provide support to persons who are required by this Act to install an Automated External Defibrillator.

(2) The Minister must, within 6 months of the commencement of this section, have copies of the report laid before both Houses of Parliament.

(3) In this section—

Minister means the Minister responsible for the administration of the Health Care Act 2008.

This amendment is not going to shock anyone, but it is close to Frank's heart. The reason for this amendment is that, essentially, there is a recognition that there is a cost in this legislation for community groups and other organisations in the community, so we have some concerns about support. There is essentially going to be a cost that some may not be able to bear.

We believe the government should be providing some assistance with the implementation of this legislation and not relying solely on community groups; therefore, this amendment tied to the previous one we have already moved requires the Minister for Health and Wellbeing to report back to both houses of parliament. The report should be on how the government plans to support the affected organisations with the installation of AEDs as required by the legislation, and that is foreshadowed in the amendment.

The Hon. F. PANGALLO: I rise to say that SA-Best will support the amendment of the Hon. Justin Hanson.

New clause inserted.

Title passed.

Bill reported with amendment.

Third Reading

The Hon. F. PANGALLO (16:31): I move:

That this bill be now read a third time.

Bill read a third time and passed.

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