Cardiac Risk in the Young (Screening) Bill
Official Parliamentary Report
House of Commons
10th March, 2004

Ms Dari Taylor (Stockton, South) (Lab): I feel privileged to have the opportunity to bring my Bill to the Floor of the House for the consideration of Members and Ministers from the Department of Health. I realise that I am lucky to have secured the fifth position on the private Members' Bills list. Many Members have congratulated me, wished my Bill good passage and told me how lucky I am. Many have been in the House for 20 years and more yet have never surfaced in the selection process, despite their reputation and considerable knowledge of specific policy areas. It is indeed a privilege to have the opportunity to put on the record the fact of sudden death in the young, and the medical knowledge and experience that could-and I believe should-inform medical practice through screening.

The short title of my Bill is Cardiac Risk in the Young (Screening). Its substance refers to the tragedy of sudden death in the young from a variety of cardiac problems. If diagnosis of the condition had taken place-the condition is clearly visible through screening and its symptoms are known-its potential to be fatal would have been recognised by a cardiac specialist. A different lifestyle, drug support, a small surgical operation known as an ablation, or the fitting of an implantable cardioverter defibrillator device could have been suggested and might have resulted in a life being saved.

Before I outline the detail of the Bill, I should say why its substance-the knowledge and experience of cardiac specialists and their research teams that in some cases inform the medical response to sudden death-is important to me. The inspiration for the Bill was a tragedy. Two years ago, just after new year, the son of a very close friend of mine died. Levon Morland was 22 years old-young, athletic, a keen sportsperson, in a demanding job, and showing no sign of a health problem that could be fatal. In fact, Levon and his family knew that he had a heart condition: Wolfe-Parkinson-White syndrome. He had been screened and had visited a cardiac specialist. An operation to correct his condition was available, but it was nasty, so as the specialist suggested that his condition was no more than a nuisance, Levon was more than keen to just get on with his life. He no longer has a life to get on with. Levon's parents, Jeff and Sandra Morland-a friend to many in the House-his twin brother and the rest of the family were and remain grief-stricken. They never stop feeling guilty, saying again and again, "What if? What if we'd done . . .?" The critical fact for me and for the Bill is that it was not up to them to do anything. The potentially fatal condition should have been clearly and factually explained. A lifestyle package of drug support, radiofrequency ablation or a pacemaker-various treatments could have been prescribed to control the problem or reduce the risk. Levon's first-degree relatives should have been given a clear understanding of the nature of his condition. As it was genetic in his case, they too were at risk. He should have been reassured that all that could be done medically was being done. He should have been led to understand that even without warning symptoms, Wolfe-Parkinson-White syndrome could be fatal.

David Wright (Telford) (Lab): One of the tragedies is that the treatment for the condition can be carried out quickly. Does my hon. Friend agree, therefore, that it is very sad that the problem was not identified and dealt with speedily?

Ms Taylor: My hon. Friend's intervention is timely. From the symptoms and the diagnosis, it is clear that treatment should have been undertaken. My young friend should never have been told, "It's a bit of a nuisance. Get on with your life." My hon. Friend is right-the treatment is quickly put in place, and should have been done.

Levon Morland should have been able to understand and to accept that, even with full medical support, his condition could be fatal-he should have been left under no illusion. Because I know the family, I know that no such advice was given. Levon was merely told, "Your condition is a bit of a nuisance. Get on with your life."

Mr. Eric Pickles (Brentwood and Ongar) (Con): As the hon. Member for Telford (David Wright) said, Wolfe-Parkinson-White syndrome is relatively easy to treat. However, in a case in my constituency the family of a toddler who was diagnosed with the condition were told that it was a relatively common condition, and that although it would be a bit of a nuisance everything would be okay. Everything was not okay. That demonstrates the importance of the hon. Lady's Bill in relation not only to screening, but to increasing understanding among the medical profession.

Ms Taylor: I thank the hon. Gentleman for that intervention. It is crucial to have an educative process. I do not want to find the established heart community disputing the clear evidence that too many hon. Members will present to the House today.

Mr. David Stewart (Inverness, East, Nairn and Lochaber) (Lab): Does my hon. Friend agree that although screening is a vital tool, it is not suitable for the whole population, but should be aimed at high-risk groups?

Ms Taylor: My hon. Friend is absolutely right. Repeated electrocardiogram screening can be an expensive procedure, and that has to be controlled. It is equally important, of course, that if an inherited condition exists, families-first-degree relations-should have the opportunity to be screened. The Bill does not ask for a national screening programme, but many countries have those for young people at different stages of their lives and for families with potentially fatal conditions.

Levon Morland received a diagnosis statement from a professional cardiac specialist. I want to ensure that such a casual and uninformed statement about a life-threatening-in Levon's case, life-taking-condition can never be made again. Levon's death has left a mark on our community in the north-east. We all want to support the Morland family because we know that the pain of his death will not go away. The best support that we could give-I press this on the Minister-is to ensure that full and effective medical treatment is provided. I hope that the Government will acknowledge that and deliver it.

If that untimely death was not bad enough, and it was, I was soon afterwards told of the death of another young man in my region-a 19-year-old from Redcar who died suddenly while out enjoying himself with friends after a day on the golf course. Ian Bowen, who lived with his parents Maralyn and Kenny, died from Wolfe-Parkinson-White syndrome that had been diagnosed but not treated. Ian suffered from an additional electrical connection between the atriums and ventricles of the heart. He had been diagnosed with the condition and had regularly consulted his cardiologist, but was repeatedly reassured that it was not serious, would not affect his life, and was nothing to worry about. He died suddenly just 10 months after visiting the doctor complaining of feeling his heart racing. One can imagine his family's complete shock and utter devastation.

My hon. and learned Friend the Member for Redcar (Vera Baird) is unable to be in the House today, but asked me to express her support for my Bill, to press the Government for a positive response, and to emphasise the belief that all people should receive the best medical service available and should never be left wondering, "Was there anything else that could have been done?" She sends her sympathy to the Bowen family, who live in her constituency.

My hon. Friend the Member for Monmouth (Mr. Edwards) is also unable to be here, but wrote to me about his constituents, Mr. and Mrs. Berzolla, whose case has persuaded him to support the Bill.

I have mentioned the concern, sympathy and support of two hon. Members. I had to stop other colleagues giving me additional comments to pass on because there were so many. I decided that that it would be sufficient to mention two and to assure the House that there are many more.

After that tragedy upon tragedy, I soon became aware of the number of deaths that have occurred. Such tragedies do not happen only in Britain, but in other parts of the world, including Europe; we constantly see them reported in the press. Cardiac Risk in the Young has produced a very able and academically organised booklet that outlines the scale of the problem. We are talking about four deaths a week.

Dr. Ashok Kumar (Middlesbrough, South and Cleveland, East) (Lab): How accurate are the assessments of how many people die from the disease per week? Are we sure that it is so many, or is it guesswork?

Ms Taylor: The figure of four is no more than a best guess that comes from pathologists' reports. Unfortunately, many sudden deaths that do not involve accident or suicide end up being recorded as death from cardiac failure or from natural causes. I press my hon. Friend the Minister to accept that better analysis of cause of death is required to provide an accurate picture.

Mr. Kevan Jones (North Durham) (Lab): Is it not also the case that many such deaths are put down to accidents? For example, many fit and healthy teenagers who die in swimming pools have their deaths put down to drowning, but the real cause is a heart condition.

Ms Taylor: That is absolutely correct. Many youngsters' conditions remain undiagnosed, although they have presented symptoms to general practitioners. They are sent away with the statement, "You are probably suffering from stress", "It could be depression", or "It may be asthma." That is a serious problem. Although the symptoms are well documented academically, they are not generally known to GPs.

Mr. David Stewart: On a similar subject, does my hon. Friend agree with the analysis in the magazine, "Heart", which suggested that 80 per cent. of deaths among athletes follow vigorous exercise?

Ms Taylor: Many hon. Friends are demonstrating their knowledge of the problems. That is right: the young people involved are often keen athletes who are putting a strain on their heart. They have shown symptoms that, sadly, were undiagnosed. They could still be competent athletes-some have Olympic potential. They require control mechanisms so that they live to enjoy their athleticism. Sadly, that does not happen.

I want to mention some people who died suddenly without necessarily receiving a diagnosis to explain the reason for their deaths. I shall begin with some of the stars of the world. The Hungarian footballer Miklos Feher played for Benfica in Portugal and died at the age of 24. A Georgian football player died in his sleep. He was 23 and had shown no sign of illness. Later, he was found to have suffered from a cardiomyopathy. The same condition killed the Cameroon international football player, Marc-Vivien Foe, and Terry Yorath's young son, Daniel. Those are high profile cases, which show that young, apparently fit people throughout Europe as well as Britain suffer from the tragic fate that we are discussing. All those cases presented comparable characteristics.

Tim Loughton (East Worthing and Shoreham) (Con): I hope that my intervention is not untimely. It is on a related subject. The hon. Lady is making a forceful speech, as she did when she addressed Cardiac Risk in the Young-CRY-earlier this week.

Constituents of mine lost a 17-year-old son from sudden arrhythmic death syndrome only a few weeks ago. A fit teenager suddenly died. My constituents were subject to a police investigation because of the sudden nature of the death. It is bad enough to lose a child out of the blue, but it is doubly distressing to be subject to investigation, albeit for understandable reasons. Will the hon. Lady take on board that other aspects need to be considered and that parents who have suffered a terrible tragedy and have the blow compounded need to be treated more sensitively?

Hon. Members: Hear, hear.

Ms Taylor: The House has responded to the hon. Gentleman. Unfortunately, the circumstances that he mentioned are replicated time and again. When a young person dies, the immediate thought is, "Was there drug abuse? Were the parents involved?" That is an outrage. Sadly, that occurs even when symptoms that suggested a condition were left undiagnosed. I shall stress that continually. Again, the hon. Gentleman made a timely intervention.

We are considering young, athletic people who die suddenly, sometimes with little or no medical warning. There is often no prescribed medical treatment and no acknowledgement that the disease that killed a young person is genetically inherited. According to the coroner, the majority die of cardiac failure-natural causes. That is unacceptable.

Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op): Later, I hope to have the opportunity to talk about a constituent who has a specific heart condition. There appears to be a range of heart conditions that can lead to sudden death. Will my hon. Friend cover that point? The issue is especially complex because not only one heart condition is involved, and the affected families could suffer from a range of conditions that could be difficult to detect.

Ms Taylor: My hon. Friend has anticipated a part of my speech. Of course, I shall respond to that point in detail as I progress.

To emphasise the importance of the issue, I point out that The Independent, The Mail on Sunday, the Daily Mail, The Daily Telegraph and the Daily Mirror often produce reports that outline the problem of heart defects that strike the young and the fit. It is a common theme of many of the articles that I have read. I suggest to my hon. Friend the Minister that if such cases are reported again and again, one would like to believe that the medical fraternity recognises the problem and begins to accept that there must be better and different solutions. The Bill would introduce screening procedures that would help to prevent sudden death.

I have mentioned some of the stars who suffered sudden death and I should now like to refer to some cases of the stars in our homes who have been affected. Ewan Bellamy was 31. He was returning from New Zealand with his pregnant wife when he suffered sudden death. His family requested that its members should be referred to a specialist for screening. The local national health service trust denied the request.

Ellis Curran, a fit and healthy 28-year-old, had shown symptoms. He died in his wife's arms after playing with his children. Tests showed that he suffered from a hypertrophic cardiomyopathy-an inherited condition that is well known and well documented throughout the medical profession. He showed symptoms but received no treatment. Earlier, I mentioned Marc-Vivien Foe, who had shown clear symptoms, including chest pains that were more severe than would ordinarily be expected. The condition was undiagnosed, and the post mortem showed that he died from hypertrophic cardiomyopathy.

Joanne Fotheringham was 24 and lived in the Western Isles. She went to bed and never woke up. A statement said that she died from an undetected heart condition. With all our medical competence, do we seriously accept that an academically well-documented medical condition should go undetected?

Alison Linforth was a bright and sparky 16-year-old from Birmingham. On the first day of her A-level course, she sat down and died at her desk. The pathologist told her family that she had died of Long QT syndrome. The coroner's verdict was natural causes. That is unacceptable. She had complained of chest pains but they were not investigated.

Lisa Harley was a 27-year-old nurse. She had complained of tiredness and fainting, which is closely associated with a potentially fatal condition. She was diagnosed with depression and died of a heart condition. We all know from medical evidence that an implantable cardio defibrillator could have saved her life. After her death, the family insisted on screening for the rest of its members. Her sister was diagnosed with Long QT syndrome. She was fitted with an ICD. Her heart stopped last October but the device kicked it back into action.

Several doctors dismissed Alex Edwards's symptoms. He was a 12-year-old promising young cricketer. His problem was undiagnosed. Laura Moss was 13 and a national swimmer, who was tipped as a future Olympic champion. She died at the poolside, watched by 200 school friends. Her parents watched the young female from Weymouth die. Youngsters are showing symptoms of potentially killer diseases. Again and again, the medical profession does not diagnose or respond to them.

Miss Anne Begg (Aberdeen, South) (Lab): Obviously, in many cases the symptoms were not picked up. As general practitioners are in the front line of the medical profession, does the Bill contain anything that will help them to pick up the symptoms to do the necessary screening and ensure that the proper treatment is provided?

Ms Taylor: I can respond positively to my hon. Friend. Clause 1 clearly identifies how crucial GPs are in the train of diagnosis to preventing or defining a potential problem. In relation to that, the proposal in the Bill is that the conditions that we know to be tied into potentially fatal diseases should be clearly chronicled so that general practitioners are able to understand what a young person might be suffering from. So, yes, the Bill responds to the problem that my hon. Friend has just outlined.

Dr. Brian Iddon (Bolton, South-East) (Lab): I congratulate my hon. Friend on highlighting the fact that there are many preventable deaths among young and older people. It has been well known for a long time that approximately one in five Down's syndrome babies are born with a heart defect, but until just a few years ago there was no routing screening of such babies, either at birth or shortly afterwards. As a result, many of them died in the early years of their life. Will my hon. Friend join me in congratulating the Down's Syndrome Association for highlighting these problems? I, in turn, would like to congratulate the charity Cardiac Risk in the Young-CRY-on stimulating the introduction of this Bill through my hon. Friend. Does this not illustrate the important role that charities play in bringing relatively unknown problems to the Floor of the House, which can result in the saving of quite a few lives?

Ms Taylor: Yes, those charities make an excellent contribution. I am only too pleased to be associated with all the work that the Down's Syndrome Association has done. I hope that my charity, Cardiac Risk in the Young, will be equally successful. We are here to try to persuade the Minister that we should be recognised.

I shall return to the examples that I was giving to the House. David Staff, aged 17, who lived in Blackburn, the constituency of my right hon. Friend the Foreign Secretary, was found to have suffered from hypertrophic cardiomyopathy. He was a runner and his father was the marshal of the race that he was taking part in when he died. These are cruel details, but hon. Members must try to get their head around them. Christiaan Smith, aged 24, from the Gower constituency, was told that he was suffering from flu symptoms. A few days later, he was found slumped at the bottom of the stairs. His mum, Pauline, said:

"Our buoyant, effervescent son, so full of life, had died from a condition called myocarditis."

The question must be asked: why was that condition not diagnosed earlier, and if treatment was feasible, why was none put in place?

David Elliot, aged 24, lived in the constituency of my right hon. Friend the Prime Minister. This young man was an international triathlete. He died from an undiagnosed heart condition. His sons are now receiving periodic testing from a special paediatric cardiologist, and they will continue to do so until they are 20 years old, so I am delighted to be able to say that something positive has come from the tragedy in the Elliot family. Jim Lorrimer watched his sister's daughter die from hypertrophic cardiomyopathy, an inherited condition that nobody thought could impact on other members of the family. He then watched his 25-year-old son die from the same condition.

I could go on to list many more young people who have died. They were usually athletic, and many died from a hypertrophic cardiomyopathy, which is clearly detectable by screening. Their symptoms were regularly ignored, and neither they nor their first-degree relatives were tested.

Mr. Alan Campbell (Tynemouth) (Lab): My hon. Friend has listed a number of cases, each one a tragedy in its own right. If I understood her correctly, the age range of the people involved was between 12 and 31. Can she tell us how she defines a "young person"?

Ms Taylor: I am not in line to define what a young person is. I think that I am pretty young at 60, frankly. [Hon. Members: " Hear, hear!"] Thank you very much. I appreciate that warm and welcome-and, of course, accurate-response. The medical profession defines people under 35 as young. Because they are young, and especially if they are in their teens or early 20s, it is assumed to be improbable that they could have a serious heart condition. That is the message that I hope to transmit to the House today.

I could outline many cases to the House; all of them are tragedies. They often involve people who were athletic, and whose condition was either undiagnosed or misdiagnosed. In many cases, no treatment was given. The condition is often inherited, but many first-degree relatives do not receive an invitation to be screened and therefore remain unaware that they might have a fatal condition.

Each death sends shock waves round a community. The positive response to the Bill has been widespread. Relatives and friends are desperate to make sure that no one else has to suffer the sudden death of a loved one. I pay tribute to the dozens of relatives and friends who have campaigned for action. Many, if not all, are active in the charity Cardiac Risk in the Young, a body that has focused attention on this issue, organised research, lobbied Members of Parliament and provided central support to the achievement of the Bill. It has been, in part, the inspiration for today's debate. Many of the people involved have written to their Members of Parliament, to the Secretary of State for Health, to the Minister herself, and to the Prime Minister, to say how desperate they are for the Government to support the provisions in the Bill.

The all-party group on cardiac risk in the young has been outstanding. It has publicised the Bill to families through newsletters and through its website. Even the YMCA, which I managed to contact through my close friend, Councillor Louise Farthing, has taken up the initiative through its parliamentary officer, Rob Smith. It has sent out updates in its newsletter, "In Touch", and many of its members have written in. The response to the requests from the YMCA has been very positive. As I have said, newspapers cover the problem in ways that are distinct to their readership, and there are many examples of newspapers stating-perhaps implicitly, rather than explicitly-that a young person's death from an undiagnosed cardiac condition is an indictment of the medical profession. The campaigning has been widespread, because the impact of sudden death in the young is so widespread.

I am pleased that the Bill has received the support of nearly 100 Members of Parliament, all of whom were prepared to say their piece today. I am absolutely delighted that so many colleagues from both sides of the House are here. I have also received positive comments from the Chairman of the Health Committee, my hon. Friend the Member for Wakefield (Mr. Hinchliffe), who has wished the Bill every success. He has supported its passage and kindly given his advice. He has also promised me that if the Government respond positively to the Bill, he will persuade the Health Committee to carry out an investigation into cardiac risk in the young. He will also carry out an investigation into how the medical community responds to the problem. I would like to thank him for that incredibly positive offer.

Last Wednesday, a parliamentary reception filled the Terrace dining room. More than 200 people attended, including more than 50 Members of Parliament. There were positive speeches from the Minister of State, Department of Health, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), the shadow Minister for Health, the hon. Member for East Worthing and Shoreham (Tim Loughton), the ITV sports presenter, Jim Rosenthal, the chair of CRY, Greg Whyte, and the founder and chief executive of CRY, Alison Cox. They all made powerful and interesting speeches. Of course, I was persuaded to speak for two minutes, which I did, as I never want to take a liberty.

Tim Loughton: It was a long two minutes.

Ms Taylor: We should not be picky over time.

I want to reassure the House that the Bill references two factors: the typical medical response to symptoms that suggest a potentially fatal condition, and the known and proven value of screening that prevents conditions resulting in fatality. From the research and experience of a small number of highly qualified specialist cardiologists, knowledge of the diseases that can cause sudden death is available and has been published in reputable journals. That provokes me to ask the question: if this knowledge is available, why is it not used to inform medical diagnosis and prescribe medical responses?

A desired procedure exists that can respond to problems that can cause sudden death. First, when an individual presents early symptoms to a GP, which could include fainting, disproportionate breathlessness or palpitations, he or she should be referred for screening to a relevant cardiac specialist. Secondly, the specialist, who would have detailed knowledge of cardiomyopathies, ion channelopathies and other conditions listed in the Bill, would perform the screening and pick up those conditions. He would be able to see an extended QT interval for Long QT syndrome, or an enlarged myocardial wall for hypertrophic cardiomyopathy. With careful and expert involvement in diagnosis, such definable problems will be seen using a straightforward screening procedure. Thirdly, a patient's first-degree relatives would be involved, so that they understand that the disease has a genetic relationship to the rest of the family. Clearly, these diseases are life-threatening, and such an inherited condition should be understood by family members.

Tim Loughton: On the last point about inherited disorders, will the hon. Lady acknowledge that a particular problem exists in relation to looked-after and adopted children, in which both she and I have a particular interest? It is incumbent on those involved to pass on medical records for children placed in care, and to make available to the relevant authorities the records of the birth parents of adopted children.

Ms Taylor: Again, that is an excellent contribution. The hon. Gentleman speaks to my heart, as I am sure that he realises that my daughter is adopted. We have a full medical record of her family, and we understand exactly what conditions could have impacted on her. Of course, my daughter also knows her natural family, which makes that relationship so much easier. It was a worthwhile intervention.

The conditions outlined in the Bill are rare-I have no problem in admitting that. I also have no problem in stating that invariably cardiac specialists are used to examining a different generation of people with different heart problems. That is one of the problem areas-because their surgeries are chock-a-block with the over-40s and over-50s, sadly, they are missing telltale signs. While screening is simple and cheap, it also requires a relevant specialist who has an understanding of cardiomyopathies and ion channelopathies, and such specialists, who know what they are looking for, must be given the opportunity to look for those conditions when symptoms suggest that they exist.

David Wright: My hon. Friend mentioned earlier what was happening across the rest of Europe, and it would be helpful if she could say whether more comprehensive screening is available in other countries. I understand that that is the case in Italy, and we may be falling behind some of our European partners.

Ms Taylor: My hon. Friend is again correct. I do not have complete knowledge of the availability of universal and national screening programmes throughout the world. I shall refer to that later in my speech, however, with regard to New Zealand.

To illustrate this point about using a specialist who has expert knowledge, who has researched this area and who is aware of the often small and incredibly detailed tell-tale signs, I ask the House to think of the emotional shockwaves when a young person dies after having been told that their echocardiogram was clear, when in fact it was not. Echocardiograms are kept-they can be looked at again-and in such cases, when the echocardiogram has been looked at again, it has been clear that there was a problem. I ask the House: how on earth can a family live with the knowledge that the echocardiogram screening process took place, and the medic missed the problem? I am sure that everyone will understand that that is a living hell for the family, but I suggest to the House that the cardiologist who looked at that echocardiogram would also have found it incredibly difficult to live with himself afterwards.

With the best screening practice, the cardiologist would spot the problem, as they know what they must look out for. I spoke earlier about my good friend who was told, "Get on with your life, this heart problem is no more than a nuisance." We now know that the nuisance killed him-he has no life to get on with. The Bill requests that specialist cardiologists are involved in this screening process, and that they must inform patients of the seriousness of their conditions. Patients must then have the opportunity to make decisions that reflect how and in what way they accept or reject that advice.

With best practice, the relatives would also be invited for screening. I want to illustrate that statement. Not only do we know that the condition is inherited, we also know what is the probability of risk: a child has a 50:50 chance of inheriting a disease listed in this Bill if their parents have it. I have been told again and again, however-and it is documented-that in the specific case it was not until the fourth death occurred that anybody thought to screen the rest of the family. The fact that first-degree relatives have a 50 per cent. chance of inheriting the condition means that screening is vital, not only when someone is diagnosed but after a sudden death when there was no diagnosis. Families who have seen siblings or parents die need to be told of the actual cause of that death, and the potential risks to them and the rest of the family. Too often, they are not-the coroner's report records that the death was by natural causes. It is crucial that a knowledgeable pathologist with relevant training determines the cause of death. On many occasions, families have had to fight to get that information, which is totally unacceptable.

I want to talk about each of those problems in more detail. Before doing so, however, let me say that in many cases the cause of most distress is also the cause of greatest hope. If we understand and know where the gap in service is, and we understand that by filling that gap we have a chance to prevent deaths in future, we must surely see this debate as a moment for optimism. We can do something about it. We can find the individuals at risk, treat them and enable them to manage a significantly lower level of risk. Perhaps we can even eliminate the risk altogether.

There are problems to which there are no solutions. I shall be analysing the problems and, where they exist, the solutions, and explaining how the Bill could plug some of the most important gaps.

I see the first hurdle as the point of diagnosis-diagnosis by a GP who must not shy away from the knowledge that certain symptoms can constitute a warning of a potentially fatal condition, no matter how young and otherwise healthy someone is. Diagnosis is not difficult if the doctor knows what he is looking for. There are often obvious warning signs: palpitations, shortness of breath, fainting or chest pains. All too frequently, however, they are dismissed.

Let me quote from research by Alison Cox, founder and chief executive of Cardiac Risk in the Young. She writes

"From the personal evidence given to CRY, when a person of 16 years of age presents themselves to a GP surgery or an A and E department, the medics think there can't be anything wrong and they are dismissed. If you have the same symptoms at 60 you are put straight into cardiology. It's ageism in reverse".

Once the GP has realised the potential seriousness that can normally be picked up by an electrocardiogram or an echocardiogram, that should be his concern. He should explain what treatment opportunity there is, and ensure that it is available to a young person.

An electrocardiogram, or ECG, is commonly used. It is a non-invasive procedure to examine electrical conduction pathways. It can determine the rate and regularity of the heartbeat, the size and position of the chambers, and whether there is any damage. An echocardiogram, or echo, shows muscle thickness and the size of the chambers by means of ultrasound. As well as providing one-dimensional images known as M-mode echo, allowing accurate measurement of the heart chambers, the echocardiogram offers far more sophisticated and advanced imaging. That is known as two-dimensional echo, and is capable of displaying a cross-sectional slice of the beating heart, including the chambers, the valves and the major blood vessels that emerge from the left and the right ventricle.

There are cases in which people have died apparently without cause, having been cleared by ECG and echo. Because both procedures are recorded, it is possible to take a look-and there, perfectly clear to those who know what they are looking for, are the tell-tale signs of the condition that killed those people. The problem lies not just with GPs but with cardiologists. I acknowledge that cardiologists are highly specialised and very capable, but it appears that in some cases they simply lack knowledge of this particular set of conditions, and do not see problems when presented with the results of an ECG.

I stress again that I am making no personal criticism of doctors. I do not want the medical establishment to take me on. I want the medical establishment to understand that what I am saying is academically detailed and uses practical evidence. I ask it to accept that a systematic problem exists: it is not any individual's fault. I realise that hardworking medics prioritise, and that their main clinics consist of people over 50. In such circumstances it is easy to underestimate the potential problem involved in a 20-year-old's heart condition. The Bill, which emphasises the connection between symptoms and screening by relevant cardiologists, should significantly reduce both the lack of screening and inadequate screening, as well as inadequate interpretation of the results. All those things are central to the cause of death.

Dr. Kumar: I listened carefully to what my hon. Friend said about doctors and the medical establishment. She is making a powerful case. People studying to become consultants and cardiologists may ignore the important factors that she has mentioned, or may be unaware of them. Could they not be included in the curriculum?

Ms Taylor: While I think my hon. Friend's intention is honourable, I think that politicians should be very cautious about telling professionals how to draw up their curricula. I can suggest and persuade, but it is up to those organisations to define appropriate training, and to ensure that medical practitioners in all spheres understand what they are doing.

We are talking about relevant cardiologists who have clear and specific knowledge of the problem, but are overwhelmed by the work that they are asked to do. That invariably means that they will underestimate the condition of a 20-year-old. I hope that there will be more understanding of the problem as a result of the Bill, and the education process that all of us, not just medics, are undergoing.

The second hurdle involves treatment. The belief that it is not just a question of the symptoms of confirmed conditions but of treatments that do not exist is nonsensical. People have complained that screening cannot be effective because the condition is unidentifiable. As I have tried to prove today, certain highly specialised cardiologists would not agree with that. It simply is not true. While I acknowledge that there is no cure for some conditions, there are treatments that can alleviate or control them, and possibly reduce the risk of death.

There are drugs such as beta blockers, which block the effects of adrenaline on the body's beta receptors. They slow the nerve impulse and travel to the heart. As a result the heart does not have to work so hard, because it needs less blood and oxygen. Beta blockers are also the impulses that can cause arrhythmia. They are used in cases of hypertrophic cardiomyopathy, arrhythogenic right ventricular cardiomyopathy, Long QT syndrome and Marfan syndrome.

Diuretics-water tablets-can be used for dilated cardiomyopathy. It is believed that the young Irish footballer Cormac McAnallen died from dilated cardiomyopathy, but that was induced by a virus. That is very different from inheriting the condition. Diuretics rid the body of excessive fluid, and can be very effective in improving the performance of the heart.

There are the simple steps involved in surgery-normal ablations or excisions of the heart, or a catheter ablation, which involves the delivery of electrical energy via a catheter inserted in the groin and travelling to the right side of the heart where the arrhythmia originates. That creates a small scar which is incapable of transmitting any arrhythmia, and is used for arrhythogenic right ventricular cardiomyopathy.

Radio frequency ablation is carried out by passing a wire into the heart via the large artery in the leg-the femoral artery. The abnormal pathway is located by the electrical stimulation, and destroyed by passing a high current through it. That treatment can be, and is, used for Wolfe-Parkinson-White syndrome. Pacemakers and implantable cardioverter defibrillators-ICDs-are also used. In some patients with hypertrophic cardiomyopathy, pacemakers achieve a normal signal. Such a signal may fail, and a pacemaker is there to kick the heart back into action. In cases of rapid heartbeat that cannot be controlled by drugs, an ICD can be fitted, which is similar to pacemaker. A box is implanted under the skin in the upper chest. The box has fine wires that are attached to the heart to record and deliver electrical impulses, in the absence of normal electrical impulses. It is important that I make it clear that treatment is possible. It is crucially important for us all that the need for treatment be acknowledged, and that it be provided.

If the first problem is lack of diagnosis and the second the lack of treatment, the third is that there are no referrals for families in which such a disease can be inherited. Relatives are not invited for screening, yet three or more people in a single family can die because such conditions are inherited. How can relatives not be at risk when it is known that the disease is genetic? I am afraid that no response or explanation can suggest anything other than a lack of knowledge. I defer to my hon. Friend the Member for Middlesbrough, South and Cleveland, East (Dr. Kumar), who suggested that we consider the role of training in this regard. The Bill does not provide for that, but the information that I have received suggests a lack of knowledge on the part of medical practitioners. These conditions are rare, but they have been well researched and well documented in medical journals. Their rarity only underlines the importance of establishing specialists throughout the country, and of using the solutions that the Bill offers.

There are so many examples illustrating the gap in service provision that I cannot give them all, but I shall briefly outline one that presents both a problem and a solution. A woman named Sandra Pearce asked her GP for screening following the death of her daughter, and was told, "I shouldn't worry if I were you. These things are very rare." I accept that that is so, but they are not rare when the condition is part of an inherited gene. There is a 50 per cent. chance of inheriting such a disease, as I have explained. Her primary care trust turned down her request for testing. Her cousin had come over from New Zealand for the funeral, and on returning, she explained to friends why she had been away. Within 48 hours, her GP was on the phone, advising her to make arrangements for genetic testing. All of us want this medical service to be available in Britain. My Bill asks that this service be recognised, and all will agree that it must be delivered. It is clear that it has great potential for saving lives.

Academic research, and research based on practical experience involving actual medical activity, has been published in serious medical journals. It outlined the conditions that can cause fatality, the accompanying symptoms and the treatments that can alleviate the conditions and cut the risk of sudden death. The Bill is primarily concerned with screening as a process for diagnosing conditions, thus helping to prescribe medical solutions where they exist. However, for the House to understand the Bill's relevance, I need to outline the conditions and relate them to the value of screening.

Let us first consider the group of conditions that come under the heading of cardiomyopathies. Hypertrophic cardiomyopathy is the most common cause of sudden death in those aged under 30, and its prevalence in the general population is one in 500. Today, more than 10,000 people in the UK suffer from this problem. In a healthy heart, every beat results from an electrical signal that starts at the top and passes down through the heart. Hypertrophic cardiomyopathy is caused by an abnormality of the proteins responsible for the contraction of the heart. For reasons that are not clear, the abnormal proteins result in a thickening of the heart muscle, and predispose the sufferer to arrhythmias that can cause sudden death.

Hypertrophic cardiomyopathy is incurable but the symptoms can be ameliorated and sudden death is preventable. In the majority of cases, the condition is inherited from a defective gene in one of the parents. As I have said, there is a 50 per cent. chance that each child will have the disease if the parent presents the symptoms. Those symptoms are well known: shortness of breath, chest pains brought on by physical exertion, rapid palpitations and an irregular heartbeat, light-headedness and black-outs.

Treatments do exist, and although there is no cure for hypertrophic cardiomyopathy, screening enables treatment to prevent complications, reduce symptoms and prevent premature death. Treatments include drugs such as beta blockers, the use of an ICD to record and deliver electrical shocks in the presence of fatal heart rhythm disturbances, and in some cases surgery. Through a surgical myectomy, a portion of the thickened heart muscle is removed, and the widening the outflow tract in the left ventricle relieves obstruction.

Arrhythmogenic right ventricular cardiomyopathy, involving a progressive replacement of normal right ventricular muscle cells by fibrous tissue and fat, is the second most common cause of unexpected sudden death in the young. The condition is inherited; indeed, there is a 50 per cent. chance of inheriting the abnormal gene. Diagnosis, involving the use of an ECG and 2-D echo, can be problematic and usually requires a specialist with expert knowledge. The features are often very subtle, underlining the crucial role of cardiologists with the relevant specialism. So it is clear that screening can outline the problem and offer solutions.

I offer some startling facts about arrhythmogenic right ventricular cardiomyopathy. Typical symptoms include rapid heartbeat, light-headedness and fainting episodes, occasionally leading to sudden death. Where drugs do not prove successful, the use of an implantable cardioverter defibrillator, a catheter ablation or a surgical ablation may be necessary. So treatments are available and the known symptoms can be detected through screening.

In instances of dilated cardiomyopathy, the main pumping chambers of the heart are dilated and contract poorly. This results in a low output of the blood from the heart. Occasionally, the right side of the heart is also involved, with fluid accumulating in the body tissues, particularly in the ankles and abdomen. Causes can include viral infection or an auto-immune disease. The immune system can be triggered to attack itself, and antibodies against the heart are found in approximately 30 per cent. of dilated cardiomyopathy patients, and in a similar proportion of asymptomatic relatives. In terms of genetics, dilated cardiomyopathy is familial in at least 20 per cent. of cases.

These conditions are well known. The symptoms are shortness of breath, lack of energy, swollen ankles, chest pains and arrhythmias. The treatment after effective screening is there: water tablets and angiotension, which converts enzyme inhibitors to reduce the amount of work that the heart has to do; there are receptor blockers and contractile performance enhancers such as digoxin, and beta blockers to improve the cardiac filling and reduce the work load on the heart.

I am not a medic, and I have taken the information from medical reports. I have been briefed by experts in the field, who have outlined the relationship between symptoms, screening and treatment. I hope that I am persuading the Minister.

Another group of problems are the ion channelopathies. They are genetic mutations that produce proteins that are found mainly on the outside of cells and regulate electrical activity. They are undetected in a post mortem, so it is crucial to understand what the symptoms are so that we can put in place a series of operational opportunities to diagnose.

Long QT syndrome is an ion channelopathy. It is the consequence of an irregular electrical pulse. Two of the potassium channels that regulate the behaviour of the potassium ions moving from the inside to the outside of cells are inefficient, or the sodium channel over-activates. This can be reflected in an ECG process as a lengthening of the period known as the QT interval-hence the name. There are no physical signs of the condition, which is why screening is so important. Diagnosis depends on observation of the ECG and may require repeated ECGs, exercise tests and a 24 to 48-hour tape monitoring. The symptoms are known: black-outs are the commonest, and there are palpitations and sudden death related to exercise or when startled, aroused suddenly or, sadly, when asleep.

The management of the disease is possible with beta blockers, pacemakers, cardiac defibrillators and lifestyle changes, which means avoiding strenuous exercise. There are many diseases, and I could go on in great detail. They include Brugada syndrome; Wolfe-Parkinson-White syndrome-which produces a very rapid heart rate but is usually completely silent and can be detected only with routine ECG screening; Lev-Lenègre syndrome, which is very rare, but well documented; and Marfan syndrome, an inherited disorder of connective tissue suffered by more than 5,000 people in Britain. The treatment suggested is regular ultrasonic scans to check the condition of the aorta wall and prevent a tear or ruptures. That can be done with beta blockers, or an operation may be required to strengthen the wall.

These conditions are well documented and presented academically in medical journals. The symptoms can be detected through screening, and there are clear and unequivocal corrective measures, including drugs such as beta blockers. The common factor in all the conditions is that screening can be seen to define diagnosis and support prescribed treatments. Nobody is under any illusion about the fact that some of these conditions will result in death, but surely not in the numbers that we have today-the best guess is four or eight a week. The conditions are inherited.

I have a little further to go. I promise the House that I will not be much longer-probably 15 minutes. [Laughter.] I wanted to give hon. Members a realistic hope and cheer them up.

What does the Bill suggest? Its aim is to achieve access to a screening process to confirm or identify a disease.

Mr. David Stewart: You mentioned screening. Were you disappointed that the National Screening Committee did not recommend a national high-risk screening programme, and do you take some hope-

Mr. Deputy Speaker (Sir Michael Lord): Order. I remind the hon. Gentleman that he must use the correct parliamentary language.

Mr. Stewart: Does my hon. Friend agree that it is important that the committee consider the issue again and introduce high-risk screening?

Ms Taylor: An excellent point. The committee is in fact not too unsympathetic to much that is suggested in the Bill. Although the use of language is loose and open-ended, it recommends a screening process, while I am keener to say that that should be tightened up and controlled. That will be my next port of call in lobbying.

The Bill is aimed at the recognition of certain symptoms, including palpitations, black-outs and breathlessness disproportionate to activity, that suggest the presence of a disease requiring screening to confirm or otherwise. It requests an acceptance that a "relevant cardiac specialist" is required to supervise the screening process, implying an acceptance that a specific and detailed research-based knowledge exists, so that an accurate diagnosis is possible. It requests an acceptance that a "relevant pathologist" is required when a sudden death has occurred, and thus an acceptance that in the case of inherited diseases such as hypertrophic cardiomyopathy, we need to know not only that the myocardium has become enlarged but that families will be told the details that the pathologist has determined. That is equally the case with dilated cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy.

When sudden death occurs without warning or diagnosis of illness or disease or an awareness that the cause of death was an inherited gene, it is crucial that we gain more understanding and can give advice to relatives. The Bill provides for an invitation to screen first-degree relatives, those who are genetically related to people diagnosed with an inherited disease. The research guidance says that children have a 50 per cent. chance of inheriting the disease from parents, so we need experts to determine whether it was present and communicate the facts to relatives.

Communication of the cause of death by the professional groups to first-degree relatives or next of kin should include a support mechanism, a statement of the cause, and a pro forma confirming that the disease causing death was genetically inherited. All first-degree relatives would then be invited to attend an immediate screening process, which means that we would be behaving proactively, in the hope of a high take-up, with the aim of preventing potential life-killing diseases and saving lives.

The Bill is minded to acknowledge the heavy work load of all medics and suggests that, at all defined points of communication, a pre-written letter explaining the cause of death be made available-requiring only a named identification of the person who has died and the signature of the medic. A pro forma should include the medic's name, the name of the person who died and a request for all first-degree relatives to attend an immediate screening. Crucially, I have referred to countries such as New Zealand, which offer that service, but I want to make it equally clear to the House that there can be no insistence. The decision whether to take up the offers made by the medics is a matter for individual family members.

Throughout the Bill, there is an implicit acknowledgement of the significant amount of research knowledge about the details of the diseases with a potential to kill, and on the vital links in the chain of diagnosis of condition, which can be used as a screening process. Use of the language "relevant specialist" explicitly draws attention to that point. Additionally, the aim of the Bill is not to seek a national screening process, but a screening programme that immediately kicks in at the time when concern is expressed about the symptoms or condition that someone is suffering from. As I have said, it applies to first-degree relatives when an inherited disease is confirmed in one of its members at a time when a pathologist establishes the cause of death as an inherited disease.

The Bill, as I said, implicitly acknowledges the research-based specialist knowledge that exists, in the belief that it should be easily and universally accessed by cardiac specialists and pathologists. That knowledge informs an understanding of the disease that can cause death. It significantly informs a medical process that defines screening as the potential means to save life. The system of communication is not perfect-families use different GPs and are geographically mobile-but the mode of communication and the structures outlined in the Bill are significantly better than the current ones.

The Bill could have placed a further responsibility on GPs to establish a "family history", similar to a family tree with the genetic conditions indicated. Such information, if available, would most certainly pinpoint accurately those individuals who are at risk of inheriting a disease that has the potential to cause death. Such a family tree could ensure that from a young age, appropriate lifestyle and drug support could be suggested and utilised to manage the disease, with significantly increased competence to prevent a fatality. The suggestion of a family tree is not included in the Bill, but its efficacy is without doubt, which I hope will be acknowledged and eventually accommodated by the NHS.

I have taken a long time to outline-

Dr. Kumar: Not really.

Ms Taylor: My hon. Friend is too kind. I am well aware that I have taken a long time to outline to the House a very complex set of conditions and to express a clear hope that screening can be used to define and support families with certain conditions. As I said, sudden death traumatises families. Many-certainly the majority-fail to come to terms with the loss of a young daughter, son, father, mother, brother or sister, especially when they believe that their symptoms were disregarded or undiagnosed and their conditions left medically untreated.

In the Cardiac Risk in the Young (Screening) Bill, I have attempted to outline and use the practical knowledge and research of a small number of highly qualified and respected cardiac specialists. That information has informed the content and structure of the Bill's clauses.

The work of the cardiac specialist, Dr. Sanjay Sharma, supported by the academic physiologist Dr. Greg Whyte, has centrally informed the content of this Bill. In their working lives at the University hospital, Lewisham and the English Institute of Sport, they have gathered information on symptoms that suggest the existence of conditions that have the potential to be fatal. Additionally and importantly to the Bill, they have produced research-based information that positively shows the value of screening by a relevant specialist to diagnose potentially fatal diseases as well as to prescribe a lifestyle or medical treatment that will control the condition and significantly reduce-in some cases eliminate-its potential to kill.

I am indebted to Dr. Sanjay Sharma. His advice has been indispensable, his medical knowledge central to achieving a Bill that, if adapted or accepted, could support the achievement of a universal national service for people who are at risk in order to diagnose a potentially killer disease. I hope that the Minister will acknowledge that that information has come from a specialist in this medical field.

My final word of thanks is to the charity Cardiac Risk in the Young. The support I have received from its chief executive, Alison Cox, has been persuasive, creative and very thoughtful, and the Bill would not have surfaced without her support. The members of that charity, mostly families who have suffered the loss of a loved one, have equally provided an abundance of support. I am very grateful to them all. They, along with my close friends the Morland and the Bowen families, have been the source of inspiration for the Bill. I will be eternally grateful to all.

I am grateful to the Minister for the time she and her officials have spent debating the issues and advising me about the content of the Bill. My only request to her as I end my speech is that she wholeheartedly supports the intention of this Bill and sees the veracity and efficacy of screening to define and explain conditions and symptoms in the hope that the definitions and diagnosis can establish treatments that will save lives.

Mr. Eric Pickles (Brentwood and Ongar) (Con): I am grateful for the opportunity to make a brief contribution to the debate on the Bill. It is a pleasure to follow the hon. Member for Stockton, South (Ms Taylor) and I hope that she will not mind my gentle teasing when I say that I was a little concerned that she might be about to enter parliamentary history by talking her own Bill out. However, she made a powerful and important speech, following an earlier equally powerful speech on Wednesday night at the CRY reception. She has gone in considerable detail into the various complexities of the problem, and the whole House is grateful to her.

I apologise to the hon. Lady, to the Minister and to my hon. Friend the Member for Westbury (Dr. Murrison) because, on account of a constituency engagement, I doubt whether I will be able to be in my place for the wind-up speeches. It is my intention, however, to stay for as long as I can.

I particularly welcome the commitment that the hon. Lady received from the Chairman of the Health Committee to hold hearings and an inquiry into the problem. If Select Committees are designed to achieve anything, it is to give the sort of precise forensic analysis and scrutiny that the hon. Lady displayed in her speech. I have the honour to be one of the sponsors of the Bill. I was going to say that two people persuaded me, but it was three because, as we have learned this morning, the hon. Lady can be very persuasive. It is an honour to lend my name to her important Bill. As my moment in the sun disappeared last Friday, it is appropriate for me to say that her Bill is the most important of the whole batch of private Members' Bills in this Session.

As I said, I wanted to speak in this debate because of two constituents, one whom I knew very well and one of whom I did not have the honour of meeting, although I have met his very brave mother and, this morning, his father. The first person about whom I wish to speak was my friend, Alan Gunnell. He was a young, serious man who was involved in the local party when I was first selected for Brentwood and Ongar in the early 1980s. We had an instant rapport. He was the kind of person most of us know from our local parties-serious and interested in politics. However, there was another side to Alan that I will long remember: he was a gifted mimic and he had a wicked sense of humour. He was one of those people to whom politics came easily. He had a natural rapport with the community and he was eventually selected to stand for a seat on the local council, which he won with enormous aplomb, such was his reputation.

A few short days after his second election, Alan sadly died. He did not turn up to an association event on a Sunday, which was unusual. We wanted to talk to him about various issues, so some of us left jokey messages on his answering machine. We did not know that Alan had passed away the previous evening. We did not find out until the Monday morning.

Alan was an only child and his parents were devastated. The effect of Alan's loss among his circle of friends was a deep sense of grief that continues to this day. A room in the local community centre was named after him, and life goes on. Only a few months ago, I held a surgery in the Alan Gunnell room at Tipp's Cross. I asked one particular constituent if there was anything else I could help her with. She said, "Yes, who was Alan Gunnell?" At that point, I felt a deep sense of anger, not at the constituent, because-as hon. Members will know-that way lies the route to madness, but because Alan should have been there. He should have been with me at that surgery. He was a man of great promise who did enormous things. He would probably have ended up in this place, and his loss is a loss not only to his friends, but to the wider community.

The second constituent, whom I did not have the opportunity to meet, was a young man called Ashley Jolly. Ashley was just 16 years old when he died in May 1998. He was a physically fit young man-as the hon. Member for Stockton, South said, that is often a characteristic in these cases. He played football from the age of six, he was a distance runner and he did the London to Brighton bike ride with his father. Ironically, he was awarded a prize for never having any time off school for illness. The day he died, he had a happy, peaceful day tinkering with a go-cart with his father. He went to bed, but he did not get up.

Ashley's parents were told that he had almost certainly died from asthma, and that was the verdict of the post-mortem. However, his mother is a remarkable woman and she realised that the verdict was not right. She looked on the web and made inquiries. She began to understand what had happened and informed herself about the electrical workings of the heart. She started a website and others wrote to it. She discovered an organisation called the Sudden Arrhythmia Death Syndromes Foundation-or SADS-in the US, and there are similar organisations in Australia and Canada. She took the brave step of forming the UK branch of SADS and organised a seminar to discuss the issues with other charities concerned with the problem of cardiac arrest. Another conference will be held in June at the Oxford genetics knowledge park.

Ashley's mother was later joined by Penny Hurrell, whose daughter Louise I mentioned in an intervention in the hon. Lady's speech. Louise was 12 years old when she died. She had had Wolfe-Parkinson-White syndrome since she was a toddler, but the family had been told that there was nothing wrong. However, a simple treatment could have ensured that she lived a long and happy life.

A common myth exists that if one is diagnosed with a condition that causes sudden arrhythmic death, one has no alternative but to wait to die. As the hon. Lady clearly demonstrated, that is not the case. The treatment is often simple and does not mean an invasive operation, but a course of drugs.

We meet at a time when our nation's attention is focused on the tragic deaths in a terrible terrorist attack in Spain. We have met on many occasions after accidents on our railways or on the roads. As my constituent Anne Jolly said to me yesterday, "If all our children had died on the same day, there would be a public outcry. Because they happen in isolation, we often feel abandoned by the system." The Bill offers a chance to end that feeling.

The hon. Lady said that the conditions that she was talking about are rare, and that is right, but they are not uncommon. I was very struck by discussions with fellow MPs in the Tea Room and at the reception on Wednesday, because it was clear that most of us know of such cases. Most of us have not just a constituency connection, but a personal connection to the issue. The hon. Member for North Durham (Mr. Jones) asked the hon. Lady for information about what is happening in other countries, but the truth that we have to come to terms with-and it is not easy-is that if we were Italian, French, Canadian or Australian we would have a better chance of surviving such conditions than as British citizens. That is a result not of policy, but of a combination of ignorance and neglect. These illnesses have been a hidden killer that we have not entirely understood. Families have been robbed by these illnesses, and so has society, of bright young people who should have lived full and happy lives.

The hon. Member for Tynemouth (Mr. Campbell) asked, "What is young?" That set me thinking about the commonality in all these deaths: shock. Such deaths should not happen to a young healthy person, an athlete, someone who receives awards for never taking time off. Doctors simply do not believe that anything could be wrong when such a person goes to see them. The Bill offers us a chance to address that reverse ageism, to ensure that young people and families, like all of us, have the right to enjoy a long, happy and productive life.

Mr. David Stewart (Inverness, East, Nairn and Lochaber) (Lab): My hon. Friend the Member for Stockton, South (Ms Taylor) deserves the highest possible praise for using her elevated position in the ballot for private Members' Bills to introduce this excellent Bill, which I fully support and endorse. My hon. Friend made a first-class speech, which was articulate and informative.

May I apologise to the House, as I shall be unable to stay for the wind-ups? I have a family engagement.

Few events in life can be more traumatic for parents than the death of a child, or the death an adolescent son or daughter. I speak with some personal experience, as 10 years ago, I tragically lost my nine-month-old son Liam, through cot death.

Over the years, I have met and worked with scores of bereaved parents. Support, understanding and counselling can, of course, help parents and children to come to terms with bereavement, but no one can answer the big question, "Why me?"

Ms Dari Taylor: My hon. Friend carefully and accurately says that the loss of a child would traumatise any family, but may I kindly ask him to extend that comment to include young husbands, young wives and young brothers and sisters, whose families are equally affected in such situations?

Mr. Stewart: My hon. Friend makes a very valid point; we sometimes forget the wider family network, which is incorporated in the Bill.

The effects on parents of the victims of sudden cardiac death are no different whatever the age, and, as we heard earlier, it is the main cause of death in those aged under 35. We also heard that the condition kills between four and eight young people in the UK each week. The Medical Journal of Australia reports that one in 200,000 school or college athletes will die suddenly, most without prior symptoms.

There is much concern about risk factors. On 18 February 2002, the Medical Journal of Australia identified a few of the factors to which my hon. Friend referred earlier; they included family history, previous cardiac arrest and links to genetic mutations. In July 2003, the journal Heart reported survey evidence showing that 80 per cent. of sudden cardiac deaths in athletes occurred following, or during, vigorous exercise.

May I refer to an example that my hon. Friend touched on earlier? In 2001, in the constituency of my hon. Friend the Member for Western Isles (Mr. MacDonald), a 24-year-old school teacher, Joanna Fotheringham, died suddenly in her sleep. The charity Cardiac Risk in the Young-about which we have heard so much today and which I fully support and congratulate on its work-led an excellent initiative with the Western Isles council and the Western Isles health board. They conducted ECG tests on 600 young people aged between 15 and 18. That was the first time in the UK that such a programme had been undertaken routinely for heart disease. The charity rightly wants British health authorities to back nationwide cardiac screening-albeit in a highly targeted way-such as that in Italy and America.

Alison Cox, the founder and chief executive of CRY said of the Western Isles scheme:

"Our programme in the Western Isles aroused considerable media interest . . . with moving interviews with Alex Fotheringham"-

the father of the young teacher-

"talking about the devastating impact on her family of Joanna's sudden death, and George Moodie, Joanna's headmaster on Lewis, explaining how the sudden cardiac death of a young and much loved teacher like Joanna affects the whole community".

I should like to touch on another semi-local issue. A few weeks ago, my local newspaper, the Highland News, launched a campaign to raise £3 million for a dedicated, cardiac rehabilitation and research unit. I congratulate the newspaper, as that project is very much in the spirit of my hon. Friend's Bill.

Screening is vital. As we all know, national screening programmes are usually carried out following advice from the UK National Screening Committee. In 1996, the previous Conservative Government said that no new programmes could take place until the committee had analysed their effectiveness. Although the NSC rejected screening for sudden cardiac death in the young, the evidence base is being reviewed this month and I am sure that the whole House looks forward to a more positive response from the committee.

Why do I support the Bill? I believe that high-risk, targeted screening, not general population screening, is vitally important. I believe that an automatic right to screening for all relatives of people who have died from sudden cardiac arrest is crucial. Relatives will have a high motivation to participate, so such screening will be highly effective and efficient. As the causes of sudden death in young people have a genetic link, family screening is imperative.

This is a first-class, well researched Bill. My hon. Friend deserves congratulations on her initiative in introducing it, and I strongly commend it to the House.

Mr. Nigel Jones (Cheltenham) (LD): It is a great pleasure to support this important Bill, and I congratulate the hon. Member for Stockton, South (Ms Taylor) on introducing it, and on the huge detail that she gave us about the various conditions and treatments for which she wants screening to be available. I also congratulate her on the passion that she showed in her speech.

I am a sponsor of the Bill, and I suspect that the main reason why the hon. Lady invited me to be a sponsor is that I am one of the few Members to have had a heart attack. I do not recommend the experience, and I would like to help colleagues to avoid it if possible, so I thought it might be useful to the House in considering the Bill if I explained some of my first-hand experience of the conditions that the hon. Lady was talking about.

First of all, finding out that one has a heart problem is a gigantic shock, not just for the patient but for their family and friends, too. On 7 November 2002, I was suffering from what I thought was just a heavy cold. I had just returned home from one of those weeks in this place when there had been a lot of votes and, in the Lobby, everyone was passing on germs from all over the country.

After hours of coughing and spluttering, I started to have real problems breathing. I eventually told my family, "Call an ambulance, I think I might be dying". Gloucestershire ambulance service arrived very quickly to give me oxygen and the paramedics walked me out to the ambulance. I want to put on record my enormous thanks to the paramedics for their promptness and professionalism.

In Cheltenham general hospital I lost consciousness for a time. A little later, my wife was taken into a corridor and told to prepare herself for the worst. My heart was not pumping properly, and my lungs were full of fluid. The doctors thought that they were going to lose me. I cannot find words of praise sufficient to thank the people who treated me. However, suffice it to say that they managed, eventually, to drain the fluid off my lungs and to stabilize me. An hour later my wife, son and daughters were allowed in to see me and the look of relief on their faces will live with me for ever.

The following day, the cardiologist, Dr. Challoner, whom I have tasked with keeping me alive, told me that I had suffered a heart attack. What he actually said was that I had had a myocardial infarction, or MI, which is what doctors like to call heart attacks. I had suffered no pain, so in that respect I was lucky, but the evidence from the blood tests was clear-it was a heart attack.

The doctor had been keeping an eye on me since 2001, when it was discovered that my heart had an irregular beat-a condition called atrial fibrillation. I underwent an electrical cardioversion, which the hon. Lady mentioned, when under general anaesthetic paddles were used to stop and restart my heart to try to restore a normal heartbeat. When I woke up, I asked the anaesthetist whether the procedure had been successful. "No," she said, "we had six goes, but they didn't work." She added, "And you snore." That was a year and a half before the heart attack, but a week after my heart attack, I underwent an angiogram, which the hon. Lady described. It is a process where a tube is inserted into the groin and fed along an artery into the heart and, using a dye, it is possible to see the function of the heart and detect any problem. Normally, an angiogram is a 20-minutes procedure, carried out under local anaesthetic-not in my case.

During the angiogram, the doctor was surprised to discover that my heart attack had caused only a tiny amount of damage in a single vessel of a side artery. He said that he could not understand why I had been so ill, with just a tiny bit of damage. I was able to watch what was happening on monitors in the room. It was fascinating-but frankly, it would have been even more fascinating if it had not been my own heart that I was looking at. The 20 minutes passed. My cardiologist left the operating theatre. A nurse kept giving me a spray under my tongue to stop the pain. I told her that I had no pain. She seemed surprised. A second cardiologist arrived. After a certain amount of prodding, he told me that they were thinking of transferring me to Oxford, where they have better facilities. He pointed out that there were advantages, including an opportunity for travel. At that stage, I wondered whether I ought to consider a spot of praying. Anyway, after a total of two and a half hours, what I had expected to be a 20-minute procedure was over.

Ms Dari Taylor: I am finding the way in which the hon. Gentleman is presenting his argument very engaging, but I want to ask a specific question. At that stage, he was invited to go to Oxford-probably to the Radcliffe hospital-and not asked to remain in his local NHS hospital. Is he suggesting-I would most definitely think this relevant if he were-that the some people's expertise is greater than others and that it is time that that was more acknowledged and more utilised in the NHS?

Mr. Jones: That is a really good point. There are certain centres of expertise, and, yes, we should make more use of them. In fact, I should like to see more centres of expertise in local communities. People in my constituency either have to go to Oxford or Bristol if they have a serious condition. What happened in my case was that, during the angiogram, I suffered another heart attack on the operating table. There was no pain. I did not know about it, and the doctors and nurses did not tell me. Frankly, I might have panicked if they had.

Ms Taylor: Does the hon. Gentleman agree that certain cardiac specialists have greater knowledge than others and that that should be clearly understood in the NHS?

Mr. Jones: Yes, and not only the knowledge, but the equipment varies. There is far more equipment at the Radcliffe hospital in Oxford and, indeed, at the Bristol royal infirmary, where I went later, than in Cheltenham. I should like to see more equipment in the local community, which is something that we can campaign for.

Where was I? I had just had my second heart attack. I had tubes in me, and the cardiologist told my wife, "We're having terrible trouble with him. He won't behave at all." To which she replied, "Nothing new there, then." The angiogram had turned into an emergency procedure-an angioplasty, where a balloon is inserted into the artery and inflated, and a piece of titanium mesh, called a stent, is inserted into the artery to keep it open. Astonishing though it may sound, the heart does not seem to object to titanium. In fact, I am told that, once it is in place, new cells grow on the inside of the stent. I was only the second person to have an angioplasty at Cheltenham general hospital, but it has since become a routine operation, so perhaps some good came of my experience.

It appears that one of my arteries had a problem that my cardiologist believes is a genetic fault, which is relevant to the Bill. It was something that I had inherited from my father, who died from a heart attack in 1985. It is possible that my children may also carry that genetic fault. In other words, there is a family history of cardiac problems. That is why the Bill is so important. We have already heard heart-rending stories about young people who have died suddenly. We all share the grief of their families. We were all struck particularly by the death of Marc-Vivien Foe, the talented Cameroon footballer. I know what it is like to lose someone close to me. Colleagues will know that, four years ago, I lost a close friend, Andrew Pennington, during an attack in my constituency office. That was a ghastly experience, both physically and emotionally, and the scars remain, but to lose a son or daughter, sister or brother, mother or father, wife or husband must be so much worse. I do not want to think about the anguish that I would feel if any of my children were to die before me, particularly knowing, as I do, that there is a family history of cardiac problems.

I could go on to tell the House about the further incidence of breathlessness that I suffered last April. There seems to be some appetite for me to do so. It was not a heart attack this time, but something called flash oedema, which presents similar symptoms. Again, an ambulance was called and arrived swiftly. Again, I walked to the vehicle and was taken to the hospital. Again, I lost consciousness, and my poor wife was told, by the same person as before, to prepare herself for the worst. I was unconscious for 12 hours, and I woke up with a horrible tube down my throat and a machine breathing for me. It was one of the most unpleasant experiences that I have ever had.

I was kept in hospital for two weeks, including being transferred to the BRI in Bristol, where I underwent a number of further tests. Those tests included another angiogram, which discovered that my stent is working well; several ECGs, which the hon. Lady has discussed; an echocardiogram; and, worst of all, a 40-minute MRI scan, where the patient lies in a tunnel and pictures are taken. In my case, the pictures were of my heart and kidneys. I do not normally get claustrophobic, but an MRI scan is just awful.

Ms Taylor: The hon. Gentleman is very generous in giving way; but, again, I need to ask this question, and I am looking forward to hearing the answer. He is explaining in some detail the care and responses of medics to his conditions, and we are all impressed. We are all delighted-it is such a pleasure to see him looking so well on the Floor of the House today-but does he accept that, if he were 22 and not over 40, the responses to his conditions might have been significantly less?

Mr. Jones: The hon. Lady is very generous to say that I am over 40-it is a bit more than that, actually-but she is right about inverted ageism, which might have affected me if I had been 22, rather than 50-something, at the time.

After all those tests, no reason could be found for the event last April, which is a bit worrying. It was definitely cardiac-related, but my cardiologist was unable to say what caused it or that it would not happen again. If I suddenly sit down, it may be happening again. He suggested that it might be "an occasional electrical fault", which made me sound like an old Vauxhall a friend of mine once owned. Regular checks are continuing, including daily blood pressure tests, which I carry out myself. I am currently taking five types of medication, some of which the hon. Lady mentioned. They including a medicine to control the atrial fibrillation; a mild diuretic to stop a build-up of fluid; a statin to control cholesterol; a calcium channel blocker-its role has been explained to me many times, but I still do not quite understand what it does-and an anti-coagulate to thin the blood. It is likely that I will have to take those tablets for the rest of my life.

I asked my doctor how ill I was on a scale of one to 10, where 10 was falling over completely. He told me that when I came in to the surgery, I scored nine and a half, but that I was now probably about two. One doctor who took my blood pressure said, "Oh, you've got blood pressure to die for", which I thought was an inappropriate description in the circumstances. Another doctor explained that the recovery time for a broken limb is six months, and that it is six months for a heart attack too. I had two heart attacks, and it took me a year to recover. Colleagues may have noticed, although it is more likely that they were too busy with their own work, that I was not around Westminster much during that year of recovery. Of course, I came here for the key debates and votes, especially on Iraq, but during my recovery, I followed to the letter the advice that I was given by my cardiologist and those in the splendid cardiac rehabilitation team in Cheltenham, who told me that if I continued working the same number of hours, I was going to kill myself. They are not too impressed by the lifestyle that Members of Parliament endure.

I must say that my colleagues, including my party leader and Chief Whip, were wonderfully understanding and supportive. That is unusual for a Chief Whip. My staff worked tremendously well, making sure that we dealt with all the constituency case work. I also received numerous "get well" wishes from my constituents, and it all helped with the recovery. I simply do not know how much my treatment has cost the NHS. It certainly cost many thousands of pounds. The titanium stent alone cost £5,000-my wife says that it more than doubles my value-and there was also the time that the wonderful NHS staff put in, including ambulance paramedics, the doctors and nurses who resuscitated me twice and looked after me in hospital, and two cardiologists; we had only two cardiologists in Cheltenham, and at one stage, they were both working on me at the same time. They spent a considerable amount of time with me. Those involved also included the technical staff who analysed all the tests and the anaesthetist who told me that I snored. I spent a total of four weeks in hospital. The process must have cost thousands and thousands of pounds.

The point that I want to make to the Minister-perhaps she could pass it on to the Treasury-is that screening those at risk, who we know are at risk because it is likely that they have a genetically inherited condition, can avoid much of the expenditure involved in the treatments. Accepting the Bill would not only prevent a person from dying but help the Treasury, as that person would become economically active and might remain so for decades. That would benefit not only the person concerned, in living a full life, but the economy and the Treasury.

I believe that it is in the Government's economic interests to pass the Bill into law, and I hope that we will see its modest proposals accepted. It is sensible and the proposed measures should be best practice. It will prevent many tragedies and much emotional turmoil. It will save not only precious lives, but scarce resources, and the Government will win a lot of credit and gain a lot of friends by grasping this opportunity.

Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op): My constituent, Jason Howell, is a lucky man. He is married to Michelle, known as Shelley, and he is the father of two children, Georgia aged nine and Tom aged seven. However, it is not the joys of family life that make him lucky. He is lucky because he is alive. Unlike many of the people whom we have heard about today and those who suffer unknowingly from the conditions that have been mentioned, Jason Howell has cardiomyopathy, but was diagnosed as having it. Now in his mid-30s, like many of the people whom we have heard about today, Jason had always played football several times a week. He worked, he never smoked and he had only the odd drink.

Six years ago, Jason had a cold. Somehow or other, he felt that there was something wrong; his situation was like that of the hon. Member for Cheltenham (Mr. Jones). He went along to his doctor's surgery, but his usual general practitioner was not there and he saw a locum. Thankfully, that doctor-from what I have heard today, this is unusual-took my constituent's concerns seriously. She told him that he needed a thorough examination, to which he agreed. To his surprise, within 24 hours, he found himself in hospital. This is a young man who must not yet have been 30 and found himself diagnosed with a heart condition-a condition that he tells me has caused his heart muscle to thicken, making it difficult to pump blood around the body efficiently.

Following that diagnosis, Jason was off work for some four or five months. During that time, he did not feel particularly lucky; he felt like saying, "Why me? Why has this happened to me and my family?" There was very little information around, and he did not know what the condition meant for him. As we have heard time and again in the debate, our health services are used to dealing with people with heart conditions who are somewhat older. There is advice around and there are support groups. Such people are told how to manage their condition and what to do. Jason Howell, who was not yet 30, did not quite know what the condition would mean for him and his family, and for the rest of his life. He did not know whether it was okay to exercise. We know that when people have heart attacks, they are often told that exercise is a good thing after a period, but he did not know about that. One doctor said that it would be okay, but his doctor said that he should not really do any strenuous exercise, as it was a problem.

Jason had worked for Black and Decker for a long time. He was a machine setter, and he had worked his way up to be a manager. The company experienced some problems, so he decided that, rather than wait to be made redundant, he would seek employment elsewhere. He got a job with a food manufacturer. Throughout this time, he generally felt well, but he had had the occasional dizzy spells, which, as we have heard, are a symptom of some heart conditions. However, he was having regular scans with nothing to worry about, and he was told that he could carry on his life as normal.

Working in a food factory meant that one day, Jason went into a fridge freezer at minus 16° C. That is the last thing that he remembers. He was later told by his work colleagues that he was missing for about an hour before somebody realised that he was missing, and he ended up in Rotherham hospital. Nobody told him that such conditions might be a problem, but he learned that extreme cold and heat were dangerous to him and could exacerbate his condition. I am not a medical expert-like my hon. Friend the Member for Stockton, South (Ms Taylor), I rely on what other people have told me-but I am aware that the temperature meant that the difficulty that Jason already had in pumping blood around his body was exacerbated.

At that point, Jason decided that it was no longer sensible for him to carry on working. He is now at home most of the time, and he experiences occasional blackouts and dizzy spells, but carries on as best he can in looking after his children and experiencing the joys of family life, which have perhaps become more precious to him than to most of us. He has had a pacemaker fitted to help in trying to find out more about what the dizzy spells and blackouts mean. As my hon. Friend said, there are ways of treating these conditions and finding out more about them. Jason explained to me that, when he experiences dizzy spells, he can switch on the pacemaker so that it records what is happening in his heart, after which the readings can be downloaded, so that the experts have some understanding of what has been happening to him.

Jason is not just worried about himself, because he has learned that first-degree relatives are likely to be at risk. As the hon. Member for Cheltenham explained, the sufferer's children may be affected, although at this stage, thankfully, there does not appear to be a problem. Jason's children have to be scanned regularly. Like many children, they are keen on sport. Nine-year-old Georgia is a keen runner involved in a local athletics club. Jason's seven-year-old son Tom supports Sheffield United-thankfully, he is not a Sheffield Wednesday supporter-and is a keen footballer. However, the condition may affect them, and their health has to be checked regularly. Jason's brother, incidentally, was a triathlete.

While Jason feels incredibly lucky to be here, he and his family feel isolated. Tragically, most people die before they are diagnosed, and Jason does not know anyone who is living with such a condition, so there is no one with whom he can share his experience. Many families who suffer traumatic events or people who are diagnosed with particular conditions turn to self-help groups or national bodies. Cardiac Risk in the Young-CRY-has provided Jason with help and information, but he does not know anyone else who is living with the problem. He has been told that 98 per cent. of people with the condition die before they are diagnosed. He is lucky to be here and fortunate that the locum GP had the skills to recognise the problem. However, although he has the support of his friends, family and CRY, he feels isolated. Who can he talk to about his experiences and situation? He is 35 and looking ahead, but there is no one else in his position, which is difficult and isolating for him.

CRY has been enormously important to Jason and his family in providing information so that they can understand his condition more. When someone is first diagnosed with a condition or something happens to a family member people want to know what services and support are available, how they can manage the condition, what their family should do and what is the best way forward. Organisations such as CRY help families to live as normal a life as possible.

Ms Dari Taylor: Once again, I am listening with great attention. Does my hon. Friend dispute the statement regularly made by people, including some medics, that families and young people do not want to know about those problems and resist screening? Does she agree that there is no evidence to support that statement?

Ms Munn: I completely agree with my hon. Friend. One has only to visit a family such as Jason's to see how important it is that people know about their condition. Having the opportunity to find out whether something is wrong and being able to manage it makes a huge difference. I do not know a great deal about my constituent's medical details, but if he had had the opportunity to be screened and had discovered his condition earlier, he might have done less damage to his heart. It is difficult to answer such questions retrospectively, but the use of screening to identify such conditions at an early stage is important.

I therefore congratulate my hon. Friend, who is also a good friend of mine, on choosing to tackle the issue in her Bill, which raises awareness and seeks to save lives. Those of us who have the honour of sponsoring it have learned more about certain heart conditions today and, because of the way she set out her aims and because of the case studies provided by CRY, we realise that it is even more important than we originally thought. Ultimately, it gives families who have suffered terrible losses or who, in a few cases, are living with such conditions hope that something can be done to prevent young people from dying suddenly.

The Bill also provides hope for the children and relatives of families who have suffered. We live in an age in which we generally expect to have a long life and do not expect children and young people to die, so we forget that many people have suffered the deaths of young children and relatives. We do not share such experiences enough and, as has been said, we do not bring the statistics together, so we think that they are isolated cases. Anyone who has lost a close friend, a child, a brother or a sister has experienced a tragic loss and knows that lives can be derailed. People become less able to work for a period, and may suffer from depression. The impact of someone's death on family and close friends can be huge, and we often deny that in our busy lives. We must get to grips with the problem by offering screening services, providing information and improving knowledge among clinicians at all levels, so that they know that the young person who has walked into their surgery with a seemingly innocuous problem may in fact, as in Jason Howell's case, have a life-threatening condition.

Counselling and support are important, and can sometimes be provided by close family and friends, but it is helpful at other times to provide professional services. People such as Jason Howell and his family do not just need information know about how they should live their daily lives, but a way of coming to terms with change. Jason is a young man who, like many of his friends, has a young family. Before his diagnosis, he expected to play football regularly, go to work and play with his kids, but he suddenly discovered that his life was restricted. How did he and his wife deal with that? How did they rearrange their lives, and how did their kids feel? How did they understand that daddy cannot do what he did before and how do they live with the possibility that he may have a shortened lifespan? Let us hope that that is not the case, but how do they come to terms with the problem? Support is therefore essential in helping people to continue functioning and live their daily lives.

It is good to know that it is not just in this House that elected representatives are campaigning on the issue. My local Member of the European Parliament, Linda McAvan, has campaigned with other MEPs. She first became aware of the problem when someone who worked for her son died from the condition at the tragic age of two. Last year, the World Health Organisation agreed to investigate these sudden deaths to try to gain some understanding of the wider situation, not just in the UK. Over 100 MEPs have signed a petition campaigning for a specific code to be added by coroners in such cases so that they can collate information about sudden death in young people, possibly from a number of different conditions, as my hon. Friend the Member for Stockton, South so ably outlined. Collecting and checking the information may lead to a better understanding of the problem.

The various conditions are difficult to diagnose. The Cardiac Risk in the Young booklet states that, in many cases, there are no symptoms. How can anybody be expected to diagnose such a condition? However, there are cases in which symptoms begin to show themselves, so collating that information, having some means of looking back over it, and establishing whether the outcome was, say, four deaths a week or eight deaths a week would help us to advance our understanding of the conditions.

In summary, the life of my constituent, Jason Howell, is not what he thought that it would be-a young dad who worked, played football and played with his kids. Instead, he is living with a life-threatening condition, but believes he is a lucky man to be still alive. He wants more people to be given that chance. To do that, we must find out what can be done through screening, raising awareness of the conditions and providing information to families who have suffered terrible deaths or who are living with those conditions.

Dr. Julian Lewis (New Forest, East) (Con): Sometimes there are visual images that stick in the mind from a film, a television programme, a documentary programme or a memorial programme. One of those occurred some years ago, around the time of Armistice day. I think that it was a film by Ken Russell. Towards the end, the camera zoomed in on one of the thousands of graves in an allied cemetery in Flanders. There was some music playing, and gradually the camera began to pan along the tombstones. The music speeded up, and the camera went on and speeded up. By the end of the programme, the camera was moving along a line of tombstones with no end in sight. One was left with the impression of a terrible roll call of bereaved families who had lost young people, in large part unnecessarily.

I was reminded of that image while listening to the hon. Member for Stockton, South (Ms Taylor) when she introduced her Bill. She should make no apology to the House for having taken some time to do so, because she was giving the equivalent of that camera image: she gave a roll-call of young lives that had been snuffed out, in many cases unnecessarily. I am proud to be a sponsor of her Bill, which endeavours to save as many young lives as medical science possibly can from such a cruel fate.

As well as paying tribute to the hon. Lady, I pay tribute to the hon. Member for North Durham (Mr. Jones), whose contribution I look forward to hearing if he is fortunate enough to catch Mr. Deputy Speaker's eye. He took up the mantle of forming the all-party parliamentary group on cardiac risk in the young, of which I have the privilege of being vice-chairman, while he has the burden of doing the work. I think that he would agree that it is significant that every speaker so far has come to the House motivated not by some general analytical interest in, or specialist knowledge of, the subject, but invariably by some personal experience of it.

In my case, as I explained on 21 June 2001 when I had an Adjournment debate on cardiac risk in the young, it was because a young constituent of mine, Adrian Woodhead, had come to my surgery and told me of the loss of his wife, Sarah, at the age of only 28. She was a young lady who had everything in front of her and who had the typical profile of not having any history of ill health, being immensely fit and strongly athletic. She died suddenly and without warning.

I said to the House then what Adrian said to me, and I repeat it now, with the indulgence of the House. He said:

"'I expected the house to be full of noise and life, as you get from children, not silent through death and loneliness . . . There is no structure to my life except for my work and my efforts to ensure that someone else might not have to go through this . . . I can do things for other people, but I can do nothing for myself.'"-[Official Report, 21 June 2001; Vol. 370, c. 273.]

One of the things that he did for other people was to interest and involve his local Member of Parliament in that cause.

One of the things that was explained to me by Alison Cox, who has justifiably been singled out for immense praise in the debate for her pioneering work in founding Cardiac Risk in the Young, was that the reason why it was difficult to create a groundswell of opinion about the problem was that, first, it was unexpected when sudden death syndrome struck; secondly, there were few survivors of it; and thirdly, therefore, anybody who might do anything about it would probably come from a family who had experienced a shocking bereavement. What a tribute it is to those families that so many of them have turned shocking loss into positive action. Once those groups sprang up, we found no end of examples of tragedy striking in that way, and because people were beginning to articulate it and organise around it, tremendous progress has been made. In response to the debate in June 2001, the Government pledged substantial funds to Cardiac Risk in the Young, which it received and put to good use in its pilot programmes for screening.