§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Garel-Jones.]
10.12 pm§ Mr. Laurie Pavitt (Brent, South)First, I should like to make it abundantly clear that I am not opposed to the hearing aid industry. Indeed, in April 1968 I helped to put a measure on to the statute book to help and enhance the best elements within that industry. My purpose now is to oppose the unscrupulous operations, which the best elements of the industry deplore as much as I do. I plead for some protection for the most vulnerable sector of our society—those who have a hearing disability and who are also elderly.
My main concern is the failure to put an end to the advertisements which are a con-trick of the worst kind, exploiting those in need for the purpose of making a profit. Many of those advertisements are diabolical. They raise the hopes of those who are looking for a miracle. All those who suffer from deafness and loneliness must hope that there is some way in which their problem can be solved. An advertisement which promises to transform them into normal hearing members of society again raises hopes which cannot be realised. That is morally wrong.
I have worked on this matter for some years in close association with organisations 'which want to help the hard of hearing and the deaf, especially the Royal National Institute for the Deaf. The institute's director, Mr. Roger Sydenham, has sent me a letter containing a stack of advertisements which worry those who are concerned with the hard of hearing. He quotes the following phrases:
I know of no other disability to help which people would suggest giving a Christmas present. The letter also mentions "Crystal Clarifier".
- "Don't worry about your Hearing …
- It's almost like having new ears
- A miniature high technology hearing implant …
- … hearing capsule
- … Golden ear
- … Christmas hearing".
The letter continues:
We have stated many times that gimmickry must not be linked with deafness: in my view all of the above references smack of gimmickry. Hearing-impaired people continue to be a highly vulnerable group, receptive to misleading and exaggerated claims of what an aid will be able to do.Another issue which concerns us is the way that many advertisements are directed towards pensioners. We do know of many instances where elderly people have been persuaded to buy expensive aids which they could riot afford.I know of many people from my advice bureau who have parted with life savings only to find that the aid has been useless. One of the worst advertisements runs:
Don't buy a hearing aid until you have seen this tiny nonfunctioning model … We have 1250 models to give away free".If one fills up the form on the advertisement, one receives a small piece of wood showing the aid's size. That is not the impression given by the advertisement.My second condemnation of these hearing aid advertisements arises from the fact that they perpetuate the idea that a hearing aid is a badge of shame. Nobody likes to wear one. The advertisements reinforce the idea that it is socially unacceptable to be seen wearing a hearing aid. The result is that advertisements tend to say that nobody will notice, that it will be hidden, that nobody will be aware of the disability. That means that people who could be helped are not helped because they are ashamed.
469 People with hearing loss can be aided. Two generations ago we had the same problem with spectacles. We remember the adage, "Nobody makes passes at girls who wear glasses." Now people with sight loss have no hesitation in wearing glasses. Hearing loss is an equally important disability, but there is a continued reluctance to use the available benefit of a hearing aid.
I blame the unscrupulous side of the hearing aid industry for perpetuating the idea that hearing loss is something to be ashamed of. One of the worst offenders is a company called Hidden Hearing. The person in charge of that company was a member of the Hearing Aid Council when my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) was the relevant Minister. She had to dismiss him from the council for several good reasons.
It has been said that I am opposed to the private sector. That is not true. My efforts have had the support of small businesses—the little shop in the high street has been grateful to me for providing what protection I can from the unscrupulous hard-selling outfit. The Guild of Hearing Aid Specialists comprises a group of small business men who are always inclined to get in touch with me on occasions such as this and say "More strength to your elbow." However, I am constantly opposed by the seven large firms which employ 60 per cent. of all dispensers of hearing aids. They are Scrivens, Ultratone, Amplivox, Ingrams, Hidden Hearing, Ardente and Seatons/Moss.
The third thing that is wrong about these advertisements is that they lead to coupon selling. One of the main problems now, as it was when I brought in my Bill in 1968, is to prevent the doorstep salesman with his foot in the door. These advertisements invariably carry a coupon which, if one fills it in, because of the way in which the Hearing Aid Council code of practice is drawn up, means that within 24 hours there is a person on the doorstep selling. It is not possible to diagnose correctly from a suitcase with a small bit of appartus such as that which produces a simple audiograph and to secure a correct fitting of the hearing aid. However, in 99 cases out of 100 the advertisements have a coupon arrangement. At the moment there is an arrangement whereby the hearing aid trainer should at least sign a form before the aid is sold by a trainee, but in my experience — and I have some experience of this—that is easily got round. All that is needed is a signature on a piece of paper.
Another claim made by the advertisements is that they are superior and that if one buys a private aid it will be superior to the 1 million dispensed free of charge by the NHS. In my left ear I have the NHS BE30 and in my right ear the NHS BE50. Both these aids are made by two well-known international firms, and if I bought them privately, as I could do, the same aids, with brand names on them, would leave me with no change out of £500. Yet they are available free through the NHS. It is wrong to pretend that one gets a superior service by paying, when the NHS hearing centre has all the modern technology and diagnostic aids which a first-class otologist consultant and audiologists command to provide all the arrangements that can be made to give the best possible help to the person whose hearing is impaired.
There are three possible answers to the problem. The first is that the Advertising Standards Authority should intervene to prevent these bad advertisements. The RNID 470 sent me one advertisement which it commended. It is possible to advertise responsibly, and if all the advertisements were like the one shown to me by the RNID I should not be making this speech tonight.
Since 19 January 1983 I have been in contact with the ASA to try to take in a deputation from the RNID, with myself and some of my colleagues, but with no result. The previous chairman, Lord Thomson of Monifieth, gave me every assistance, and when I had a Bill before the House was ready to pilot it through the other place. However, the present chairman, Lord McGregor of Durris, is not so helpful. I have a stack of correspondence here going back 19 January 1983, but I still cannot get any action from the ASA. I shall continue to try, because that is an avenue that is important, especially with the latest development.
Often, if one reads The Sunday Times, one will see on page 2 a thing that looks like an article and talks about hearing aids, but then says turn to page 28. On page 28 there is the advertisement for the coupon, and that contravenes the code of conduct for good advertising.
The second way to solve the problem lies with the Minister. He has the power to alter both the constitution and the code of practice of the Hearing Aid Council to enable it to deal with these problems. When this issue was raised, the council was prepared to move on it, but then there was a counter attack from the industry and two years later the original decision was rescinded. The Minister at that time, who is no longer a Member, came to a compromise. We have still had no action.
There is a third possibility. The Government could again support my private Member's Bill which seeks to amend my own Act. The history is interesting, because it shows how we in this place get caught up with timetables and events. I introduced the Bill and I got it through to the Report stage. I pay tribute to the hon. Member for Pudsey (Mr. Shaw), who was leading for the then Opposition. Together, we finished the Committee stage, and we thought that the Bill would go through, only to find that a counter-attack on Report put it down.
The following Session, the right hon. Member for Wanstead and Woodford (Mr. Jenkin) was leading for the then Opposition, and on Second Reading he gave his full support to the Bill. He accepted that there was no way in which the hearing aid industry's code of practice had any sanctions that bite. The right hon. Gentleman was kind enough to tell me that he and the Opposition—we in the Labour party were in government at the time—would help me to get my Bill on the statute book at the earliest opportunity. However, a general election intervened and the opportunity did not arise. In spite of a two-hour session with the right hon. Gentleman, who had then become the Secretary of State for Social Services, I was still unable to get it through, because the pressure of the amount of legislation made the right hon. Gentleman withdraw his support.
That Bill will come before the House again for a Second Reading. It is an innocuous Bill. All that it seeks to do is to give the Hearing Aid Council the power to vet and examine the unscrupulous advertisements. The Hearing Aid Council consists of six people from the industry, and only five representing the users of hearing aids. In other words, the industry has an in-built majority. It is not a draconian measure to propose that these ladies and gentlemen, with their knowledge of the industry and the 471 problems, should have the power to examine these unscrupulous advertisements and put in their code of practice the means whereby they can stop them.
That would be an easier way than for the Secretary of State for Trade and Industry to try to persuade his colleagues to find the time in a heavy legislative programme to introduce a Governmemt Bill. I shall introduce my Bill in the hope that the Whips will not be instructed to block it on a Friday, and in the hope that it will pass through a Committee stage. It has already had a Committee stage, because the Bill is identical to the one that I lost. I commend that as a possible solution.
Unless something is done, old people and people who have hearing problems tend to drop out of society. The side effect of deafness is loneliness. It means that elderly people are taken out of society although science and technology could help them to remain active. I hope, therefore, that the Minister will look sympathetically at my plea tonight and do something to protect this vulnerable section of our society.
§ The Under-Secretary of State for Health and Social Security (Mr. Tony Newton)In responding to the hon. Member for Brent, South (Mr. Pavitt), I shall begin by expressing my thanks, on behalf of my hon. Friend the Under-Secretary of State for Corporate and Consumer Affairs — which I understand is his full title at the Department of Trade and Industry—for the opportunity that I have— possibly to the hon. Gentleman's slight surprise—to discuss this important topic with him this evening. Unfortunately, my hon. Friend from that Department is unable to be here tonight, but I am happy to reflect, in the tangible form of being present and speaking in the debate, my own interest in this matter.
As the hon. Gentleman will know, part of my responsibility as Minister for the Disabled, although not the Minister for consumer protection in general, is to take an overview of the work of all Government Departments, in so far as they affect people with handicaps, including that of impaired hearing. Deafness is a handicap that can be easily overlooked, as the hon. Gentleman has cause to know better than many of us, because of its invisibility, and it can have serious and difficult effects on those who suffer from it. Not the least of my reasons for being pleased to be here tonight is that since I have been Minister with responsibilities for the disabled, the problems of the deaf have especially engaged my interest. Only this morning I was at a gathering with one of our well-known colleagues, the right hon. Member for Stoke-on-Trent, South (Mr. Ashley). We were with Mr. Roger Sydenham and others of the Royal National Institute for the Deaf.
I pay a warm tribute to the efforts over a long period of the hon. Member for Brent, South on behalf of those suffering from impaired hearing. The hon. Gentleman sponsored the Bill which became the Hearing Aid Council Act 1968, and without him there would, I suppose, have been no council for him to be discussing the amendment of this evening. He was one of those appointed to represent the interests of the deaf when the council was established under the Act, and I know that he played an important part in drafting and negotiating the original standards of competence for dispensers and the code of trade practice which formed the basis of the council's later work. Although he has been suggesting some changes this evening, the small number of changes which have proved 472 necessary, certainly until now, have demonstrated the soundness of the council's original work and the hon. Gentleman's original efforts. Since then, he has sponsored the Hearing Aid Council (Extension) Act 1975, which extended the benefits of the 1968 Act to Northern Ireland. It is a pretty formidable record of the passage of private Member's Bills, which are not always the easiest things to take through the House. That is his record, despite the difficulties that he has experienced more recently.
The council, which was established under the 1968 Act, has the general function of securing adequate standards of competence and conduct among people engaged in dispensing hearing aids in the private sector. It has undertaken a number of other tasks, including examinations for those wishing to register. It has powers to discipline those who are guilty of unprofessional conduct. There is no doubt that the council has enhanced standards of competence and conduct among those engaged in dispensing hearing aids. For that very reason, all those who need such aids, or have impaired hearing, undoubtedly owe a considerable debt to the hon. Gentleman.
Hearing aids are complex miniature electronic instruments on which research is constantly being carried out to improve and refine their effectiveness. They can be very expensive items, the cost of some running into several hundreds of pounds. In 1977, the former Price Commission investigated the price of private hearing aids and charges for related services. It found that the industry had an unusual structure with a small turnover, a very static market, a large number of models and high advertising expenditure by some firms. This meant that the cost to the consumer, covering fitting, purchasing and after-sales service, was unusually high in relation to manufacturing costs. Nevertheless, profits in the industry were found to be modest.
As I am a DHSS Minister and not a Minister in the Department of Trade and Industry, I wish to emphasise the role that the NHS plays for those with impaired hearing. It provides a comprehensive programme of diagnosis, treatment and rehabilitation. It does that irrespective of whether the patient wants also to use the services of the private sector. The Government —I think that I shall carry the hon. Gentleman with me—see the two systems not as separate but as complementary. Patients can choose to have their hearing aids provided by the NHS, and many do. The standard range of NHS hearing aids, which are centrally purchased, is now wider than it has ever been. It should meet the needs of all but a very few patients. In exceptional cases, consultants can prescribe a commercial model that can be purchased from local funds.
There has been a continuing improvement in this service. For example, measured simply and perhaps crudely in cash terms, expenditure on the hearing aid budget alone has increased from just a little over £10 million in 1981–82, to about £11.5 million in 1983–84. The intention of improving NHS provision has been to expand the total service provided rather than to displace the private sector by the NHS. I certainly could not accept, nor do I think the hon. Gentleman would claim, that people are being forced into buying commercial aids. Indeed, if anything, the movement has been in the opposite direction.
Although the total number of hearing aids supplied through the private sector has remained static over the past three years, the number of dispensers has fallen. But, 473 whatever the numbers and trends in this market, there is general agreement—certainly, I am sure, between the hon. Gentleman and me — about the importance of ensuring that people with impaired hearing, who include, as the hon. Gentleman said, many who are elderly or infirm, are protected from dubious selling methods.
High-pressure salesmanship was one of the abuses that the 1968 Act set out to control. Although the code of practice did not entirely outlaw unsolicited home visits, paragraph 10 of the code stated:
Dispensers shall not interview any potential client at his or her home with regard to the possible provision of a hearing aid unless requested to do so by the client or unless such client has already been in communication with the dispenser or his employer and, having been given reasonable opportunity, has not indicated objection to such a visit.In 1981, after extensive consultations with interested parties, a series of additional safeguards was added. The requirements are that an unsolicited visit cannot now be made unless the client has previously sought information or assistance from the dispenser, and has been given 10 days written notice of the intended interview, has not objected, and has been given a pre-paid card or envelope so that he can decline. When such a visit is made, the interview must be free of charge and, most important of all, the client must be allowed a seven-day free trial period and be given written notice of his right to cancel the order and obtain a refund of any money that he has paid.I would emphasise that all those conditions have to be met—not just one, two or three of them—before a dispenser can make an unsolicited call. In our view that should be sufficient to prevent abuse. But if anyone, including the hon. Gentleman, has evidence that those conditions are not being met, he should certainly put it to the registrar of the Hearing Aid Council, who will investigate the matter further.
The hon. Gentleman was mainly concerned about advertising. I would accept that it is obviously important to make sure that people are not misled about the characteristics or benefits of such instruments. The majority of advertising by hearing aid dispensers appears in national newspapers and magazines. As the hon. Gentleman is well aware, such advertising is subject to the British code of advertising practice, administered by the Advertising Standards Authority. Perhaps I should acknowledge that I was a member of that authority until I became a member of the Government in 1979.
The code includes a special section dealing with hearing aid advertisers. Those who quote prices are required to specify the upper and lower limits of their price 474 range. The names of hearing aids are not allowed to exaggerate the product's effectiveness. Advertisements for hearing aid exhibitions are accepted only if the organiser undertakes to display a comprehensive range of models, to have at least one dispenser present throughout the exhibition and to make certain testing equipment available. Those safeguards apply in addition to the general requirements of the code that all advertisements should be legal, decent, honest and truthful.
In the early months of 1979 the Advertising Standards Authority conducted a monitoring survey of hearing aid advertisements, which lasted until November of that year. It was ended partly because no breaches of the code had been brought to light and partly because the authority had embarked on short, sharp, monitoring exercises, to be repeated if they were found to be necessary. At the end of the survey, it was decided that there was at that time no need for changes in the code.
The Department of Trade and Industry, which has responsibility for the council, receives very few complaints about hearing aid advertisements. Clearly the number will rise substantially as a result of the hon. Gentleman's speech. I shall ensure that what he has said is brought to the attention of my hon. Friend the Under-Secretary of State for Trade and Industry who is responsible for corporate and consumer affairs. I have no doubt that he will wish to bring it to the attention of the authority. If he has not already done so, I hope the hon. Member for Brent, South will pass on the examples of advertisements which he thinks should be considered.
Our general view is that the safeguards in the hearing Aid Council's code of practice, the British code of advertising practice and the new provisions of the Companies Act 1981 make it unnecessary to impose further controls. The existing arrangements should be adequate to protect the consumer and at the same time allow him to choose for himself the type of treatment and instrument he prefers.
As I have already said, I shall draw to the attention of my hon. Friend as the Minister immediately responsible and reflect to myself as Minister for the disabled on the points which the hon. Gentleman has made. Whatever differences of detail may lie between us on the specific points he has raised, I hope that the hon. Gentleman will maintain his interest in the council which he did so much to create and continue his work in the cause of those with impaired hearing, for whom he has done so much.
§ Question put and agreed to.
§ Adjourned accordingly at nineteen minutes to Eleven o' clock.