He said: “These individuals are not health care practitioners and are not working in a health care setting.

“And they are not used to routinely providing an active level of intervention in response to the normal conditions required of first aid”.

Dr Bell said when staff from the private nursery were giving evidence they were visibly upset.

He said: “To expect these individuals to apply the level of first aid that is required in these circumstances I think is probably too much to expect”.

The inquest has already heard how the ambulance was delayed in getting to Adam because it first went to the wrong nursery.

It was dispatched to a nursery in Portland Street, Huddersfield, rather than the nursery at Lindley.

Coroner Roger Whittaker asked Dr Bell that if it had gone to the right address, and arrived four minutes earlier than it did, would Adam have survived? Dr Bell said the toddler might have survived but in any case he would have been severely brain damaged and would not have recovered any “meaningful” life.

The inquest’s verdict will be decided by a jury and continues today.