§ Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Wilkins.]
§ 12.38 a.m.
§ Mr. Frederic Harris (Croydon, North)
The time is too late, I feel, to raise the very serious matter of hearing aids. I feel that deafness is one of the most dreadful of all ailments, and the provision of hearing aids is quite a worthy part of the National Health Service. I would further say that it is a part of that service which should not be as subject as it is to exploitation. Nevertheless, thousands of people are still in need of hearing aids. It is equally serious that the existing organisation cannot cope quickly enough with minor repairs to hearing aids that have already been issued. May I ask the 418 Minister to listen to the serious matter I am trying to put, or does he want one of the hearing aids to which I have been referring?
The history of the Medresco hearing aid is not a happy one. In this country there are at least 10 reputable firms which specialise in making hearing aids, and yet contracts given by the Government for Medresco manufacture or assembly have been given only to the radio industry. If the criterion was the price at which the tenders were originally accepted, I suggest that the money spent in correcting faults which arose in such numbers during the early stages far exceeds the extra expenditure the Government would have had to incur for the proper manufacture of these aids by the industry which knows about it. In the early stages, at least half the aids provided were faulty, and most of these faults were those which the hearing aid manufacturers, from their own experience, would have been able to avoid.
In the Mark 2 models of Medresco, there have been a large number of cord breakages which required a complete dismantling of the aids. In the Mark 3 model the cords will be attached to a plug for easy replacement. The hearing aid industry has been using these plugs for years. The industry would have saved the Exchequer many thousands of pounds in the repairs that have had to be paid for if these had been used in the first place. The original contract was given to one firm in the radio industry—there is no need for me to quote it—but the Minister may be able to confirm that there are now three radio firms doing this work. This is the only example of a surgical instrument under the National Health Scheme being manufactured outside its own industry, and in which manufacture is strictly controlled by the Ministry.
The industry has been practically ignored. They were not consulted on research work. I ask the Parliamentary Secretary what justification there has been for putting research work in the hands of Post Office engineers. Most of the research could have been eliminated by giving the work to experienced firms who knew the answers in the first place. I find, as the result of investigation, that over 60 per cent. of Medresco hearing aids already issued are hardly used; that is brought about by lack of training in 419 the use of them when they are originally issued. The bone conduction hearing aid with which the Post Office has been experimenting for two years has been on sale for some years in the industry. One firm in my own constituency manufactures an efficient bone conduction hearing aid. I know it is efficient because I have had it tested by a well-known Harley Street specialist.
The control of hearing aids is so rigid that only one stereotyped instrument is manufactured. Even a layman like myself appreciates that different individuals require different instruments. I am told that the two ears of each of us are not alike. The hearing aid industry has always produced a range of different instruments designed to take account of individual difficulties in hearing. The production of these aids should be in the hands of an industry which manufactures them, and has done so for many years, and which is only sustaining itself by trying to obtain private sales and export business. It should not be left to one or two firms. What would happen if there were a strike in those firms?
Is it not a fact that the weekly output of hearing aids at the present time is restricted to some 1,500 a week, which cannot possibly meet the needs of the urgent cases that exist? I am not sure of the Minister's figure of the number of cases existing at the moment, but I understand it is in the region of 40,000. In addition, the number of repairs that have to be done is appallingly high, and leads to a heavy loss of working hours. There is a solution to the bottleneck in the carrying out of voluntary repairs to hearing aids. Many people are restricted to private firms because they cannot wait for the work to be done at the Ministry's own workshops.
As the Parliamentary Secretary knows, there is an organisation with branches up and down the country called the Hard of Hearing League. While they try to do a lot for the welfare of the deaf, they are not recognised by the Ministry in the distribution and repair of these aids. In the ranks of the League there are capable electrical engineers with wireless experience who could be relied upon to give adequate service and to do minor repairs. The Minister could keep simply an efficient financial and stock control and 420 arrange for the deaf to enjoy the convenience of these additional services. I believe the Hard of Hearing League are actually prepared to play this rôle for the good of the deaf people if the Minister should call upon them to do so.
One cannot under-estimate the psychological effect of deafness on men and women. Therefore, any help given is a great social service. As the Minister said in the House on 6th July, it is true that many people who could not afford hearing aids previously may now look forward to a Medresco. I heard him make that comment, and personally I was disturbed at the way he made it and the tone he used when he said it. If these aids are being provided from taxpayers' money, it is surely the Minister's own responsibility to ensure that the most efficient service is given at the minimum cost.
Do not let us forget that before June, 1948, hundreds of deaf people who could not afford these aids to hearing were supplied free of charge through the media of philanthropic bodies. Since that time our whole outlook has changed under this service and these philanthropic bodies are not so easily able to come forward and grant such additional help. Therefore, we are falling back on the service given under the National Health Service and relying on it. I would say to the Parliamentary Secretary that it needs much more consideration and attention than, unfortunately, it has been given at the present time.
§ 12.48 a.m.
Major Hicks-Beach (Cheltenham)
I am sure we are all grateful to my hon. Friend for raising this important question. I want to speak only of one particular hearing aid—namely, the bone conduction aid—and to ask the Parliamentary Secretary when the bone conduction aid will be available to the public. I appreciate that this is an aid wanted by only a small proportion of those unfortunate people who are deaf. In an answer in December, 1949, the Minister of Health said that only 5 per cent. of those who suffer from deafness require this particular aid. The fact remains that as long ago as December, 1949, these people were promised that investigation was going on to see when the bone conduction aid would be available to the public. In recent correspondence with the Minister 421 of Health, I received the reply that this investigation continued.
As I understand it—and I know I speak in the presence of greater experts than myself—the position is that these aids are being produced commercially at the moment. I hope that the Parliamentary Secretary will make it clear whether they are to be issued under the National Health Service, because I have had a great number of complaints from people in my constituency that they do not know where they are. If these aids are going to be issued, these people should be told so, and also be told when they are going to receive them.
§ 12.50 a.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr Blenkinsop)
I am glad that this subject has been raised, even though it is at a fairly late, or early, time of the day. I am very glad to have this opportunity of saying a word about this particular service. It will be realised, I think, on both sides of the House, that this is a new service which has been in operation for only a comparatively short time. Naturally, it takes some time to get the maximum production force available. It also takes some time to get a number of distribution centres and testing centres organised. It must be realised that it is not merely a matter of production of the hearing aids themselves, but of having sufficient technically equipped personnel to test and fit them, which is a matter of great importance.
We cannot accept the implication that whatever manufacturing capacity exists can all be harnessed to the production of free Government aids. That is obviously economically impossible. Yet that was almost implied when the hon. Member for Croydon, North (Mr. Frederic Harris) suggested that there are many other firms which we know are producing hearing aids of various types. He seemed to be almost suggesting that their capacity ought to be used for the production of these aids for free distribution.
§ Mr. F. Harris
The point I am trying to make is that the Ministry did not use one single firm in the industry. They cannot give me the name of one firm. They use radio firms but not these expert firms.
§ Mr. Blenkinsop
The decision was taken when the service was started that we would produce the aids ourselves. This statement has been reinforced on many occasions. For that reason the Electrico-Accoustics Committee of the Medical Research Council drew up a specification on which the hearing aids were put into production. This specification is complied with in the instrument now available for distribution. Inevitably we started on a small scale. We have been steadily developing the distribution service so that today we have more than 80 technicians distributing hearing aids in some 47 distribution centres, to whom patients are referred after being tested in 137 diagnostic centres. The latest figure I have shows that more than 80,000 patients have had free hearing aids provided. That is a very big step in the direction of providing for all those who need hearing aids.
§ Mr. Blenkinsop
I cannot give that figure offhand. It is perfectly true that we have not the total figure of those who might be relieved by the use of a hearing aid. Therefore, we are still in the stage of having no complete evidence of the total number who need to have a hearing aid provided. Even so, I would say that the estimate of 400,000 which I understood the hon. Member to give tonight is an exaggeration. The best estimates which we have are lower than that.
The hon. Member for Croydon, North, also suggested that some 50 per cent. of those to whom hearing aids have been issued are not using them. There is no sort of justification for that statement. It is obviously true that there are many who (have received these hearing aids who used them a great deal more in the first week or two after receiving them than they have done later. It may be true that they have put them by for a little while for use on special occasions, and are using them a great deal Jess. As I think is known—I believe it has been mentioned in the House—we are making 423 an investigation into this matter. First, there has been a pilot investigation; then there will be a more thorough investigation to find out how many of those to whom hearing aids have been issued have given up using them altogether.
§ Mr. Harris
I do not make statements unless I am pretty sure of what I am saying. If the Parliamentary Secretary takes 100 cases, he will find that approximately 60 per cent. are not using them. The position can be judged by the number of refill batteries.
§ Mr. Blenkinsop
The hon. Member is merely taking a very limited number of cases which have been brought to his notice. Over the country as a whole, such estimates as we can make suggest that his statement is a gross exaggeration.
I have mentioned that the question of distribution is not just a matter of handing out these instruments over the counter, but that the hearing-aid service is part of a larger service, which involves a patient-hospital relationship, diagnosis, technical fitting, repairs and maintenance. We cannot, therefore, decide to take whatever aids the industry produces, and at whatever price they charge. We decide, from time to time, the quantities to order, and contracts are then placed on our behalf by the Post Office. All firms have an opportunity of quoting. Whether the number of firms is more than one or not, we take up the number we can adequately distribute through our service.
We must not merely look at the production side. The current contracts are with three firms well known in the manufacture of electrical equipment, firms of the highest reputation. The hon. Member also referred to the frequency of repairs. It is true that the Mark 1 design was subject to a great deal of repair, but experience shows that less than 17 per cent. of the Mark 2 sets require repairs. Continued improvement is being made, and the scale of repairs is being steadily reduced. It is true that we have faced this problem of the leads—minor repairs usually consist of replacing leads. An improved type of lead is in production.
§ Mr. Blenkinsop
I cannot say offhand. It is pointed out that commercial aids are expensive, and are purchased very often by those who can afford to take rather greater care of them. I would point out that the free aids are being issued to people in all types of occupations, which means there is a greater chance of repairs being needed.
On the question of bone conduction aids, it is true that to a certain extent we have been disappointed in not being able to issue a bone conduction set earlier, but we did not make any promise of being able to do so by any particular date. We are certainly anxious that one should be made available, and I can assure those people who want these sets that, although they are a small proportion, we have their needs in mind, and that we are a good way forward in our production efforts. It is not possible yet to give a date for their issue. As has already been said, investigations have been going on for some time with the intention of adjusting the Medresco aid for use with the bone conduction receiver.
Surely, when the hon. Gentleman says that he cannot get a date for the distribution of these sets, he knows that bone conduction sets are already on the market?
§ Mr. Blenkinsop
I am perfectly aware of that, but I hope that hon. Members will appreciate that we are certainly not going to accept for free issue to the public whatever may happen to be available for purchase on the market today. As a matter of fact, we are making arrangements for the production of a limited number of pilot sets for testing purposes, and it will depend on the results of this testing how far forward we can get with making available equipment for the general public; but we cannot accept any set on the market for sale.
One further point was that raised by the hon. Member for Croydon, North, who mentioned that valuable work is being done by the Hard of Hearing League. We are, in fact, considering the offers of various kinds of help, but there are some difficulties in the arrangements. We are anxious to do everything we can as a result of offers made to us.
I can assure hon. Members that we are anxious steadily to develop this service; there is no intention of causing 425 difficulty to the hard of hearing, and we are very glad that so many sets—over 80,000 so far—have been distributed, and the rate of distribution has been increased with the large number of centres we are setting up, and with the addition of trained personnel. It is the limited number of trained personnel, rather than anything else, which holds us back, and I hope that hon. Members who have rather suggested that these aids are of an inferior quality will realise that the aids are very good instruments indeed. They bear as close examination as most 426 sets on the market. They have limitations; they are not, we are aware, luxury sets, but they give very good service, and we have had in the Department many tributes from those who have had the joy of hearing for the first time for, perhaps, many years, as a result of the sets having been distributed.
§ Question put, and agreed to.
§ Adjourned accordingly at Three Minutes past One o'clock a.m.