§ Motion made, and Question propdsed, "That this House do now adjourn."—[Captain Michael Stewart.]
§ 10.2 p.m.
§ Mr. Edward Evans (Lowestoft)
I am grateful for this opportunity of bringing to the attention of the House the needs of those born deaf. the deafened, and those suffering from impairment of hearing known as the partially deaf, or hard of hearing. I do so not only because of my long professional association with this group of disabled persons, but because I feel that no section of the community suffers more from a lack of understanding, of sympathy, and of administrative assistance, nor are so completely isolated from the rest of the community as those unfortunate people who suffer from impairment of hearing. Yet their potentiality in the economic life of the community is considerable. It has been calculated that about 16 per cent., or roughly one-sixth, of the population of this country suffer from some defect or diminution in hearing capacity. Unfortunately, the time at my disposal will not allow me to elaborate very broadly on their needs, but I should like to bring to the attention of the House the requirements of these afflicted people and suggest some of the means by which their disabilities may be alleviated. These concern many Departments—the Ministry of Education, the Ministry of Labour, the Ministry of Health, and if time permitted I could bring in the Ministry of Pensions also and, of course, finance.
Deafness imposes a greater educational and social handicap than any form of disability in otherwise healthy persons. A 983 child born deaf has to learn, by highly specialised instruction, not only how to speak, which is but a means of expressing language, but how to acquire language itself by a laborious and lengthy process, and seldom, except in a relatively small number of cases, does he attain the fluency of a normally hearing person. The basis of deaf education is to secure linguistic ability. It is, therefore, of the greatest importance that the deaf child should receive, as early as possible, the benefits of special education, but there is at the moment a tragic dearth of nursery accommodation, and places for infants, and 1 urge as forcibly as I can the need for this provision. Nearly all deaf schools are woefully understaffed with trained teachers, and I recommend to the attention of the Minister of Education the need for encouraging ex-Service personnel taking up the Emergency Training Scheme to enter for the course on deaf education at Manchester University, and that the Minister should recognise the one year course there as absolving from the additional year at a training college. This. of course, I recommend only as a temporary expedient in view of the highly technical character of deaf education. There is also a very grave shortage in the residential schools of domestic workers and children's nurses and attendants.
There is only one secondary grammar school available, quite incapable of dealing with the demand for places, inadequately financed, and lacking representative control. There is also an urgent need for a first-class technical school where a considerable development from the traditional trades could be undertaken. For generations past they have been confined to these traditional trades, boot making, tailoring, baking, dressmaking and so on, but their capacity is much beyond that and provision should be made for them to develop into the widest fields of industry, art, and commerce. I am convinced that there are in the normal schools a large number of children classed as dull, backward, and mentally retarded, who suffer from deafness in some form and who, if given appropriate training, would develop educationally. This suggests that these children should be ascertained as early as possible by the use in every school of the gramophone audiometer for preliminary group testing. May I call the attention of hon. Members to 984 the film which will be exhibited tomorrow night in the cinema and which will give a very good account of the technical training of the deaf?
I would like to emphasise at this point the anxiety of all of us associated with deaf welfare in regard to the certification as mental defectives of deaf persons. Most, indeed all, pyschological tests depend upon linguistic response utterly beyond the capacity of the totally deaf. We feel strongly that no deaf person should be certified unless a trained teacher of the deaf or welfare worker is present at the examination and taken into full consultation. I can assure the House that my own experiences over a great many years of deaf education have been most disquieting and have left me very anxious on this subject.
I want to refer now to an aspect of deaf welfare which will require the most careful consideration, and that is their placement in industry. I feel that to leave the placement of the deaf to the Minister of Labour without specialist assistance is to invite disaster. Placement for the deaf is not merely finding jobs, but requires constant supervision in order that recurrent difficulties should be resolved, not only vis-à-vis the employer but, alas, too often between the deaf workman and his fellow workers. Most of those difficulties have been misunderstandings, due to the problem of communication by language. This work should be delegated to the deaf welfare societies, and generous grants provided for the purpose. This would more than repay the cost in the long run. On local committees, under the Disabled Persons (Employment) Act, a specialist in deaf welfare should be appointed or co-opted. The Minister of Health has powers to pay for placement services under the Employment Exchanges Act, 1909, and I trust that he will exercise his powers generously and sympathetically.
With regard to deaf welfare generally, Circular 1337 of the Ministry of Health empowers local authorities to make grants for this purpose, but the exercise of these powers has been niggardly and sporadic. I can recall in my experience when we established the Eastern Counties Association for the Deaf. It died in a few years for lack of support by the local authorities. The deaf welfare societies do an enormous amount of good in providing, through their missions, for the spiritual 985 and social welfare of the deaf, but there is a grave lack of suitably trained officers, and a tragic dearth of funds. The Government have powers to help. I trust that the Minister, with his well-known sympathy for the afflicted people, will do all in his power, and that if his powers are insufficient he will seek new ones, in order to effect an extension in this field. In this connection, I wonder whether the Minister would consider the setting up of an advisory committee on the welfare of the deaf, analagous to the body set up for the blind. Such a gesture would be warmly welcomed by those who work among the deaf, and by the deaf themselves.
I turn now to the hard of hearing, who form the larger section of those whom we are now considering. Unfortunately, the position in regard to them has been put entirely out of focus by the emphasis placed on hearing aids as a means of alleviation. It cannot be too strongly stressed that the provision of hearing aids touches but the fringe of the problem. A very large percentage of those suffering from deafness cannot possibly benefit from electrical aids, although quite a large number can. Indeed, good results can be obtained -from the use of other mechanical means such as trumpets, and so on. Nor can the operation for otosclerosis, known as fenestration, benefit very many of those suffering from deafness. It is wrong to suggest, because of success in a few cases, that there is going to be universal benefit. The deaf are deluded and disappointed by such an attitude.
Above all, while I am discussing aural aids, may I say that it is important to get the right type? This can only be done by consultation with qualified otologists and by purchase from a reliable firm whose ethical standards of sale have been approved by the National Institute for the Deaf. Many of the firms supplying these instruments in the past have done valuable work. Their standards are high, their research investigations worthy of the highest praise and they do not exploit their customers. It is highly unfair that they should receive the odium merited by the more disreputable elements in the business.
It is all nonsense to suggest that the Americans produce a better instrument than our own best. I have compared 986 many samples and I can assert that the British product is quite as good, and is better in most cases, as well as being cheaper, than the American instrument in the same category. The Americans are doing their best to capture the Dominion markets. I hope that our people will be given every encouragement to continue developments and to maintain and increase their overseas connections.
I am glad to see that the Government propose to put a machine on the market which, I hope, will be provided free, or at a nominal cost. I urge very strongly that they will set up, under the National Health Service Act, a number of easily accessible testing clinics and maintenance centres. To issue the machines without controlling their distribution would be worthless, and would be rather like going into a store, buying a bundle of spectacles and issuing them out to shortsighted people. The cost of batteries deters many who could benefit from the use of aids, and the free provision of them in necessitous cases should be considered; but, as I have said, provision of aural aids is but part of the problem.
Probably the greatest help the deaf and hard of hearing can derive is from competent lip reading. Both the Minister of Health and the Minister of Education should give the greatest encouragement and assistance to deaf and hard of hearing societies to maintain clubs not only for social intercourse but for the teaching and practice of lip reading. These societies are increasing in number, especially those for the hard of hearing. They have a heavy up-hill struggle to get going, their power for good is tremendous, and they require the good will of authority in high places. The difficulty of lip reading is little understood by the general public. If it were better understood, they would make much greater efforts to speak slowly and clearly when trying to converse with deaf people, would not speak with a cigarette in their mouth or behind their hands or stand in the shadow, and expect deaf people to follow their lips.
I must mention one special class of deaf person, those who are deaf and blind, a class in which I have had a very special interest for a very long time. We have all heard of the wonderful attainments of that remarkable lady, Dr. Helen Keller. It is not generally known that 987 there are in this country many people who suffer from this terrible dual affliction. Some are gainfully and happily employed, others take part in social activities, and most of them are intelligent decent people. It was particularly disquieting to hear of a judge at Southend not long ago suggesting that all that could be done for them is to see that their material needs are met—bread and butter and a bed. Their spiritual, intellectual and social needs must be met and their human relationships fostered. The last place for this is in a large institution where they would be put in a corner and left to sleep and where no one would be able to converse with them by the special deaf manual alphabet which is available. There are a number of excellent special homes run by the National Institute for the Blind but they do not meet anything like the need, and the need for more is urgent.
I would like to say a word about prevention and research. One of the most disturbing elements in the incidence of juvenile deafness is that following meningitis and diseases such as measles and diphtheria. I would like to see the Minister of Health set up in his own Department a virile programme of otological research not only into the causes of deafness in children but into those more associated with the stress of modem life industrial conditions and the onset of old age, There is need, too, for the Minister to encourage by financial assistance research into certain technical developments; the evaluation of hearing aid instruments; and the standardisation of testing equipment, particularly audiometers. He should be able to make grants to bodies conducting research. In this way only can administrative effort march step by step with acquired knowledge through research in all its forms. I could continue on this theme for much longer but I trust that not only will the matters I have raised interest the Minister present tonight, but that by some means other Departments concerned with the welfare of this afflicted section of our community will have their attention directed to this problem and take the necessary action.
§ 10.19 p.m.
§ Mr. Gilzean (Edinburgh, Central)
I am glad to have had the opportunity of listening to that clarifying speech by the 988 hon. Member for Lowestoft (Mr. E. Evans) on a question which, I am afraid, is of little interest to the majority of people. I am more concerned about the hard of hearing, because I recognise that there is a general sympathy (for the deaf person throughout the community, but the problem of the person who is hard of hearing has never yet been appreciated and understood. It is more than 17 years since the Education Act was first passed, and during that time tens of thousands of children who are hard of hearing must have passed through our schools and been written down as of a low mental quotient simply because of this disability. Consequently, anything that is likely to help cure that position is to be welcomed by everyone in this House.
In the City of Edinburgh, to which I belong and about which I know most, there is under the aegis of the Education Committee a school specially established for the hard of hearing, and I am glad to say that it has been of inestimable benefit. The point to remember is that you can only get at the child through his hearing, and if there is any hearing at all you can immensely improve the knowledge and the understanding of that child. I would like to stress the fact that all over the country there are education committees, many of them of great importance—that is, judged by the number of children they have to handle—which have not yet made any provision of any kind for the hard of hearing. Consequently I think the Minister ought to direct his attention to the need for the establishment of schools specifically brought into being for the purpose of dealing with this particular class of the community. As I have already said, they are put down as being of low mental quality for no other reason than that although they cannot be described as being absolutely deaf, nevertheless they go from class to class always being looked upon as of low mentality, when actually the position is altogether different. Therefore, I hope that the Minister will seek to do something to alter this position.
§ 10.22 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Key)
This House always listens with pleasure to an expert on a subject, and I am sure that we listened with great interest to what was said by my hon. Friend the Member for Lowestoft (Mr. E. Evans), who introduced 989 this subject, for he has had many years' experience in the matter, and his original work has had an effect upon the treatment of the deaf-blind throughout the country. As he mentioned in his speech, a number of Departments are concerned with this problem, and I can only now assure him that the points he raised which affect other Departments will be brought definitely to their attention. So far as the educational side is concerned, there are a goodly number of schools—some 44 already in existence—in the country for the purpose of dealing with deaf children. In recent years there has been a growing appreciation of the problem, and changes have been made with regard to the minimum age at which children shall be sent compulsorily to school who suffer from deafness. We all recognise that during the period of the war there has grown up a scarcity of the necessary qualified teachers for doing this work, but I can assure him that my right hon. Friend the Minister of Education is pressing upon local authorities the need for making special provision for these children, and that conferences are being held in many areas to consider the provision of additional schools and the extension of existing schools for that purpose.
With regard to the point in relation to the Ministry of Labour on the placement of the deaf in employment, the suggestion he made of the appointment of specialists in deaf welfare to local committees appointed under the Disabled Persons (Employment) Act, will be brought to the notice of the Minister of Labour, whose Department is already attempting to extend the cooperation with the Employment Exchanges of local deaf societies, and the appointment also of specialist officers is under consideration in that connection.
At the Ministry of Health we fully recognise that in the past this problem of deafness has been what one might call the Cinderella of the health services. Among other things, provision for the proper testing of hearing and for the supply and maintenance of hearing aids has been greatly neglected. In the Debates we had on the National Health Service Act, it was pointed out that that Act will provide the opportunity for rectifying the many omissions that have been made. It must not be assumed from the fact that so much publicity has been given to the question of hearing aids, and to the 990 Government's intention to provide and maintain them free of cost under the National Health Service scheme, that the Government believe that the hearing aid is the beginning and end of this problem. The aid of which mention has been made results from researches which have been made by the Electro-Acoustics Committee of the Medical Research Council. That Committee, I want to emphasise, is only one of three committees of the Medical Research Council which were set up in 1944 at the request of the Departments concerned in this problem. Two other committees are at work, one on the medical and surgical considerations for diagnosis and treatment of deafness, and the other considering the problem of education of deaf children and adults.
The Government fully recognise that, important as hearing aids are, far more important are such matters as the treatment of infectious diseases in childhood, and prompt attention to particular diseases in connection with the prevention, as far as possible, of this complaint. Therefore, in the framing of the comprehensive measures for the prevention, diagnosis, and treatment of deafness as part of the National Health Service, which we are now in course of preparing,' the Minister will be armed with the authoritative recommendations of these three expert committees. There is not likely to be any difficulty, I think, in persuading the Medical Research Council to undertake further research. At the same time, I would point out that by Section 16 of the National Health Service Act, the Minister himself has power to conduct or to assist by grantsresearch into any matters relating to the causation, prevention, diagnosis, or treatment of illness or mental defectiveness.And the question of deafness will be included in that provision. I can assure the House that we shall take full advantage of those new powers to see that such investigation is made.
I am not trying to suggest that it will be possible to build up the necessarily complex organisation for the effective care of the deafened, and to have it operating everywhere, by the date that the National Health Service Act comes into operation. But deafness clinics, under the charge of specialists and equipped for the exact—and, it is to be hoped, for the early—diagnosis of deafness, as well as for the effective 991 treatment of the deafening diseases, will be developed as part of the hospital and specialist services as quickly as the resources available will allow us. Up to date and effective means of testing deafness, and of fitting the individual patient with the kind of aid which will benefit him, will not be overlooked, nor will the value of lip reading, vocational guidance, and other welfare work be forgotten. Arrangements for the large-scale production of the hearing aid, of which mention has been made, and which are now being worked out with the Ministry of Supply, will take into account all the requirements of audiometers, including gramophone audiometers for schools, and group hearing aids for schools, and of other equipment that is necessary.
The Government's plans, of course, are still in the formative stage, and it would be very premature for me to attempt to be more precise in these matters than I have been able to be tonight. My hon. Friend's suggestion that an advisory committee on the welfare of the deaf, analogous to the one which at present exists for the consideration of the welfare of the blind, should be set up, will certainly be given very careful consideration when the time seems ripe for it to be put into operation. Of his other points, I think 992 it may be fairly said that they are being kept fully in mind. The kind of service which he desires will, when the Government's comprehensive social security scheme has been fully implemented, be built up. Though it cannot be built up in a day, there will be no avoidable delay. 'We shall use every opportunity there is to bring this into existence as one of the important services in connection with our hospital and specialist services, because, as I said, we have regarded it as one of the services which so far have been very sadly neglected indeed. I am certain that in bringing this matter before us, today, my hon. Friend has continued that great social service to which he has given a great part of his life, and I can assure him that we appreciate what he has said. The points he has made I will make it my business to bring to the attention not only of my right hon. Friend the Minister of Health, but also to the attention of other. Ministers concerned, and my hon. Friend will have added to the other services he has given by making more certain the development of this service in our new scheme.
§ Question put, and agreed to.
§ Adjourned accordingly at Twenty-nine minutes to Eleven o'Clock.