HC Deb 09 July 1973 vol 859 cc1035-42
The Secretary of State for Social Services (Sir Keith Joseph)

With your permission, Mr. Speaker, and that of the House, I wish to make a statement on behalf of myself and my right hon. Friends the Secretaries of State for Scotland and Wales about important steps which the Government are taking to improve services for the deaf.

As hon. Members will know, the hospital-based treatment of deafness has been an integral part of the National Health Service, and has included the provision of a range of hearing aids for those likely to benefit from their use. But as knowledge has grown, the body-worn Medresco aids which have served us so well are ceasing to be fully adequate. We propose, therefore, as part of the National Health Service to provide over the coming years a behind-the-ear aid free of charge for all adults for whom it is suitable, and for children who already receive this type of aid. This will offer an alternative to Medresco aid users, and help many who do not now use a Medresco aid and cannot afford a commercial behind-the-ear aid. These people will for the first time be able to benefit from the hospital-based clinical and allied services in obtaining an aid and in using it effectively.

The numbers involved are large—probably one million or more. The cost will be met from the resources available for the expanding health service programme, but it will necessarily take time to produce enough suitable aids, and to secure suitable staff. We therefore aim to begin issuing the new aids in the autumn of next year, and to complete the operation over five years. This programme will offer the opportunity to British industry to establish large-scale manufacturing facilities for head-worn hearing aids with potential benefits for overseas as well as home sales.

In the first year we propose to give priority to war pensioners who require aids for accepted disabilities; mothers with young children; children of any age and young people receiving full-time education; young people whose behind-the-ear aid has been replaced by a body-worn model on leaving school; people with an additional severe handicap, such as blindness; people with exceptional medical need not included in these groups.

There are many other people with impaired hearing, both of working age and elderly, outside these groups, and we shall therefore be consulting the bodies concerned to help us in determining priorities for the second and later years of the programme.

Even with this new aid not all needs will be met, and in particular some of those suffering from sensorineural deafness may not be helped. Further research is required, and the Medical Research Council is taking steps to encourage fundamental studies.

We recognise that other services for the deaf call for improvement. There are shortages of trained staff, which will take some years to remedy. I must emphasise that a great range of skills needs to be secured before we can apply our existing knowledge to those who might benefit, and that much new knowledge needs to be won before substantial groups of the deaf can be fully helped. We hope that the National Health Service and local authorities, in partnership with the voluntary organisations which have done so much pioneering work. will strengthen these services as quickly as practicable.

Mr. Alfred Morris

We welcome the Minister's statement, but is he aware that we also pay tribute to my hon. Friends the Members for Willesden, West (Mr. Pavitt) and Stoke-on-Trent, South (Mr. Ashley) for the sustained pressure they have exercised on this deeply important matter? Is the Minister also aware that there are many who feel that there has been unconscionable delay in effecting this improvement? How many new aids does the right hon. Gentleman envisage will be available each year after next autumn? Is there any chance of speeding up the proposed timetable for distribution? Is the Minister aware that other services for the deaf call for urgent improvement, not least those available to deaf children? The right hon. Gentleman's statement referred to hearing research. Is he able to make any comment on the likely effect of the recent Rawson Report on hearing research arising from Section 24 of the Chronically Sick and Disabled Persons Act? Finally, what is the cost of the proposals announced today?

Sir K. Joseph

I think that the whole House respects the services of the hon. Members for Willesden, West (Mr. Pavia) and Stoke-on-Trent, South (Mr. Ashley), but I do not think that the hon. Member for Manchester, Wythenshawe (Mr. Alfred Morris) has any right to bring party politics into his question. The Labour Government did precisely nothing to help the deaf.

The decisions on the Rawson Report are primarily for the Medical Research Council whose first batch of decisions has already been announced. Two specialist committees are being set up to carry the work further.

I expect the cost of the provision of the hearing aid to rise to a peak of £5 million in 1978–79, and there will be an additional cost of about £1 million per annum when we have recruited sufficient staff.

Sir John Hall

In welcoming my right hon. Friend's statement, may I ask what discussions he has had with the industry about the possible effect of this decision upon the industry as a whole and in particular on its export trade?

Sir K. Joseph

My hon. Friend the Under-Secretary of State has had at least two discussions with the industry at my request, and we are well aware of its views. In the interests of the deaf people who look to the industry, it is most important that it should continue in a flourishing condition. My hon. Friend and I are willing to see representatives of the industry as necessary. I do not believe that any damage will be done either to the industry's overseas trade or to its home trade.

Mr. Ashley

There will be other occasions on which to ask the Minister questions about other aspects of deafness. I have been campaigning for years for these improvements to be made and there can be no qualification, no half praise and no prevarication. The Minister, deserves the full credit of the House for making this great advance in helping deaf people. Thousands of deaf people will be deeply indebted to him for his generous statement.

Sir K. Joseph

The hon. Gentleman is as generous as he is robust.

Mr. Hugh Fraser

I, too, congratulate my right hon. Friend on this generous and imaginative proposal. Am I right in saying that those who cannot obtain these machines through the National Health Service will have to pay VAT on the instrument bought?

Hon. Members

No.

Mr. Pavitt

I join my hon. Friend the Member for Stoke on-Trent, South (Mr. Ashley) in saying that this is a sunny day for those of us who have been interested in this subject for a number of years. Will the mercury cell batteries also be free? They cost about 14p per cell, which is a heavy charge. Will the right hon. Gentleman take action to reduce the price of the cells when the additional demand arises?

The right hon. Gentleman knows the complications that will ensue from the additional provisions which he has announced today. Will he take immediate action to solve the personnel problems which will arise, possibly by bringing in as part of the task force registered dispensers under the Hearing Aid Council and by discussing with the Department rehabilitation and the training needs for the otological services? Will the right hon. Gentleman immediately establish departmental working parties to give him quick results?

Sir K. Joseph

I am grateful to the hon. Gentleman. Batteries will be free. We are well aware of the need for a whole range of skills, and I am slightly daunted by the list on pages 5 and 6 of the Rawson Report of all the skills that need to be multiplied. It is our intention to multiply those skills, but the time for the carrying out of this programme is largely related to the difficulty in recruiting and training the extra skills needed.

Mr. Burden

I congratulate my right hon. Friend on this further intimation of his compassionate feelings for the disabled and on the help that he is giving to deaf children. Will he consider the position of severely disabled children, of whom there are many in schools. who are equally deserving of his compassion and imagination?

Sir K. Joseph

The House is being so kind that I must repeat the warning that it will take some time to reach all the people who can benefit from this proposal. We need a great increase in knowledge before we can help the deaf. I hope that the multiplication of combined services in hospitals will improve the diagnosis, assessment, treatment, aftercare and social help for deaf children and their families.

Mr. Robert Hughes

Will the Secretary of State look particularly at his priorities and bear in mind that there are some deaf people who in their ordinary jobs have to deal with the public and find it impossible to carry out their work because of the unsuitability of present hearing aids? Will he be flexible in his policy and allow such people to obtain priority for the new aids?

Sir K. Joseph

It is because we want to understand the implications that we shall consult voluntary and other interested bodies concerned about the priorities after year one.

Mrs. Kellett-Bowman

I thank my right hon. Friend warmly for this news today and for his care for the deaf. Will he ask his right hon. Friend the Secretary of State for Education and Science always to bear in mind that, as deaf children will have to earn their living and live their lives in the hearing world, it is tremendously important that they should not be incarcerated as weekly boarders in schools for the deaf? I ask that, wherever possible, they should be daily travellers, for example, from Arkholme and Lancaster to Preston, rather than staying in Preston during the whole week.

Sir K. Joseph

I must leave that question to my right hon. Friend, but I will draw her attention to it.

Mr. Mayhew

At the end of his very welcome statement the Secretary of State referred to other groups of deaf whom it was difficult to help. Will he bear in mind the particular hardship of those who are both deaf and mentally sick or handicapped? Will he look at the excellent work being done at Whittingham, which is an improving hospital, and see whether somehow the very highly qualified staff cannot be found for other mental hospitals of that kind?

Sir K. Joseph

The Government are well aware of the outstanding work of Dr. Denmark and his team at Whittingham. We are trying to repeat that unit in the South.

Dr. Stuttaford

Will my right hon. Friend accept my congratulations not only on behalf of myself but also on behalf of doctors who treat the deaf and, above all, deaf children? Will he look at the problem of the multi-disciplinary assessement centre for the early diagnosis of deafness in children, because this must be the answer? Taken purely and early, they may miss out on some of the other handicaps later.

Does my right lion. Friend agree that it might be a good idea always to refer to "deaf people" and to "deaf children" rather than to "the deaf" or "the handicapped", thus trying to personalise the problem slightly more?

Sir K. Joseph

We are convinced that we need multi-disciplinary assessment centres for all disabilities, including deafness. We have authorised the building of 50, which are now being either designed or built at present, and that will suffice to cover about one-third of the country. We shall hope to continue that programme later.

Mr. Carter-Jones

While I warmly congratulate the right hon. Gentleman on his step forward, may I ask him if now he will move forward one stage further to deal with those who are totally deaf, such as my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), and can we move forward rapidly on the use of new technologies, such as print-out, line writer, television screens and the talking brooch, which would enable the totally deaf to communicate with us in this place and at schools?

Sir K. Joseph

The hearing aid will primarily help those suffering from conductive deafness but will also benefit many suffering from perceptive deafness, but by no means all. We shall certainly bear in mind the hon. Gentleman's suggestion.

Mrs. Knight

Will my right lion. Friend permit me to join in the all-party chorus of approval for his statement, which surely must have set in train a long-ranging improvement for a group of people who have been neglected for far too long? Will he also bear in mind the need to cut the hospital waiting lists for children who have ear problems, and particularly those who may lose their hearing or whose hearing may become impaired unless they reach hospital fairly coon?

Sir K. Joseph

Yes, we shall do our best to cut waiting time. I am glad that my hon. Friend emphasised the long-term nature of what we have to do. The Scandinavians, who are very far ahead of us in their services to the deaf, started what we are announcing today 15 years ago, and they still reckon that they have a great deal to do before they can help all the deaf.

Mr. Bruce-Gardyne

I do not wish to act the ghost at the wedding, but will my right hon. Friend recognise that there are, perhaps, some serious implications in the statement for the commercial hearing aid industry? Will he confirm that there is a significant minority of the deaf who cannot and will not be able to benefit from the Medresco aid, whether head worn or body worn, and that if the announcement today were to have the effect of doing serious damage to the commercial dispensers, people will be deprived of a choice? This is against the background of a statement which will surely arouse more expectation than it will be able to fulfil and should be a source of preoccupation to us all.

Mr. Pavitt

Nonsense.

Sir K. Joseph

If the result were to be as my hon. Friend suggests, it would be very sad indeed. I agree with him that there are and will always be many people who, for one reason or another, will prefer to go to the commercial hearing aid industry. I hope that in my statement today I have not aroused expecta- tions unduly. I have twice gone out of my way to emphasise that it will take some years before we reach even those who will be helped by this ear-worn hearing aid. I have emphasised that there will be many, particularly with sensorineural deafness, who will not necessarily be helped by this aid.