Defibrillators should be as ordinary a fixture in New Zealand buildings as smoke alarms, a senior Hato Hone St John clinician has argued, after national figures showed only a small fraction of people who collapse in cardiac arrest are given a shock before an ambulance reaches them.
Jon Moores, deputy chief executive of clinical services at Hato Hone St John, set out the case in a viewpoint article published in the New Zealand Medical Journal on Friday. He told 1News the devices were “absolutely critical” to saving lives, and that survival rates had gone “static” while access to the machines stayed patchy.
A cardiac arrest is not a heart attack. It is the heart stopping outright, and without a shock and chest compressions the person dies within minutes. An automated external defibrillator, usually shortened to AED, is the portable box on the wall of sports clubs, supermarkets and school halls. It reads the heart rhythm on its own and talks the user through what to do, so a bystander with no training can operate one.
The numbers behind the argument come from the Out-of-Hospital Cardiac Arrest Registry, which St John and Wellington Free Ambulance publish each year. In 2024/25, ambulance crews attempted resuscitation on 2,192 adults who had arrested before help arrived. About 11 percent were still alive 30 days later.
The gap Moores points to sits between two of those numbers. Between 81 and 83 percent of witnessed arrests got CPR from a bystander, which is a good result by international standards and reflects decades of first aid training. But only 6 to 7 percent were defibrillated before the ambulance turned up. New Zealanders, in other words, are willing to push on someone’s chest but almost never reach for the machine that restarts the heart.
That matters because the clock is brutal. Moores writes that survival “decreases by approximately 10% for every minute defibrillation is delayed”. Early defibrillation more than doubles the odds of walking out of hospital.
Part of the problem is simply where people collapse. Around 72 percent of cardiac arrests happen at home, not at the netball courts or the shopping centre where the AEDs are. Rural communities and high deprivation areas carry both a higher rate of arrests and worse survival, a pattern that tracks ambulance travel times and how far away the nearest machine is.
The starkest disparity in the data is between men and women. Moores reports that females have “60% lower odds of receiving community defibrillation compared with males”. The registry has flagged this before. When the report was released in February, St John’s clinical evaluation, research and insights manager Dr Sarah Maessen said there was “a strong call to action for us all to consider how we can improve survival outcomes for women, MΔori and Pacific peoples”.
Moores drew a direct comparison with the way the building code treats fire risk. “When I renovated my bathroom, the council came round and said, ‘oh, you’ve renovated your bathroom, you need to put in some smoke alarms because that’s the code’,” he told 1News. “Should we be thinking about AED access and availability? And whether that’s something that we want to have more readily available and potentially a requirement for certain facilities and locations?”
Defibrillators are not compulsory in New Zealand workplaces. Health and safety law requires adequate first aid facilities, and AEDs are often treated as falling under that, but nothing forces a business to buy one. Cost is a real barrier. St John sells defibrillators through its online shop at prices between $2,760 and $4,981. A household smoke alarm costs somewhere between $10 and $50. Moores accepted the price gap, while noting the machines have got cheaper as more brands have come to market.
His second complaint is about habit rather than money. Plenty of defibrillators already bought and installed are locked inside buildings that shut at five o’clock, or sit in cabinets that need a key or a code. “Do we want that AED behind locked doors, locked cabinets, and unavailable to the people around the community where that building is?” he said. His preferred model is closer to the little free libraries bolted to front fences around the country. “I do wonder and do feel as though, as a community, we should be looking at it almost like the community library box that sits on the side of your fence. Having an unlocked AED cabinet that’s well marked and the device is readily accessible.”
Theft, he acknowledged, was “always going to be an issue”, and suggested GPS tracking as one answer. Owners can also register a defibrillator with St John, which lets 111 call takers direct a caller to the nearest one. A machine nobody has registered is invisible to the person who needs it.
The viewpoint sets out five changes. Moores wants mandatory CPR and AED training in schools, defibrillators deployed where the data says arrests actually happen and logged in a national registry, stronger community responder schemes such as the GoodSAM app that pings trained volunteers nearby, fairer access to hospital care after an arrest, and ambulance performance measured on quality rather than raw response times. He calls school training “one of the most scalable long-term interventions”, pointing to Denmark, where national CPR programmes lifted bystander rates and survival together.
“We feel there’s a really good opportunity to teach people basic life-saving skills, much as you would other skills for life, whether it’s opening a bank account or you’re learning to drive a car,” he told 1News. “Why not include it in education? Maybe it’s a requirement when you get your driver’s licence.”
None of this is government policy. There is no bill before Parliament to make defibrillators compulsory anywhere. What has changed is that the argument has moved from a St John media release into the country’s medical journal, with a specific list of things that would have to happen.
The case St John keeps returning to is a Canterbury one. Casie Blakelock, a 37-year-old mother of six, went into cardiac arrest at home in July last year after her daughter rang 111. Paramedics arrived within five minutes and started compressions. Her heart had stopped for six minutes. She survived, after weeks in hospital and a spell in an induced coma. St John’s account of it credits the speed of the response, saying the force of the CPR is believed to have shifted the clot that stopped her heart.
Do you know where the nearest defibrillator to your house is, and have you ever done a CPR course? Tell us in the comments below.
This article was written by AI, briefed to report the facts, hopefully without some of the bias people bring to the job π
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