§ 4 pm
§ Mr. Tony Favell (Stockport)I beg to move,
That leave be given to bring in a Bill to require health authorities, in certain circumstances, to contract-out the provision of hearing aids and services ancillary to such provision.Many right hon. and hon. Members will have received complaints from constituents—
§ Mr. SpeakerOrder. It is very difficult to hear at this end of the Chamber. Will the hon. Gentleman speak up a little?
§ Mr. FavellI shall indeed, Mr. Speaker.
Many right hon. and hon. Members will have received complaints from constituents about the length of time that they are required to wait for a hearing aid. In its excellent publication "Hearing Aids: The Case for Change" the Royal National Institute for the Deaf pointed out that, in some parts of the country, a consumer may wait up to two years—I have come across even longer waiting periods —for a hearing aid. That is not good enough. People often wait until their hearing difficulty is far advanced before they go to see their general practitioner about the problem. To have to wait for up to two years for a hearing aid when one is elderly is a ridiculously long period. If a man needs a hearing aid, his wife complains bitterly that he has the television up too loud. If a woman needs a hearing aid, her husband complains that his wife does not hear what he says to her.
The Bill will help to reduce the waiting period. My proposal is that, unless a district health authority can within three months test and fit with a hearing aid a patient who is referred to it, the testing and fitting must be contracted out to the private sector. For the time being, the hearing aid would continue to be supplied by the national health service. My proposal is by no means a complete answer to a very complex problem. However, I believe that it is a start.
According to the RNID, 3.9 million adults in the United Kingdom with a hearing loss are likely to benefit from a hearing aid. It is important to explain how a hearing aid is obtained. The consumer has two choices. He can go to a private hearing aid dispenser. Unless the patient is in need of medical advice, the dispenser will sell him an aid that costs between £350 and £1,000. Alternatively, the consumer can go to his general practitioner with a view to obtaining a free national health service hearing aid on permanent loan. Not surprisingly, in view of the cost of the private hearing aid, four out of five people choose to go to the national health service.
If the general practitioner judges his patients suitable for a hearing aid, the patient is usually referred to an ear, nose and throat consultant. Surprisingly, that occurs whether or not the general practitioner believes that the consultant can do anything for the patient. In some parts of the country, general practitioners can refer patients not requiring medical or surgical treatment directly to hospital audiology departments. Clearly, that is preferable, because it is estimated that half the cost of fitting a hearing aid is taken up with seeing a consultant whose advice is not needed, and it takes them away from more important work and adds to the waiting list.
861 The RNID and my hon. Friend the Member for Torridge and Devon, West (Miss Nicholson), who has done a great deal of work in this sector and highlighted the problems of the existing system, have both been critical of unnecessary referrals. They often lead to long delays, In my constituency, there have been direct referrals for almost 15 years now, and Mr. Gerry Dunster, the chief technician there, tells me that there have been no problems during the 13 years that he has been chief technician. When my hon. Friend the Member for Kettering (Mr. Freeman) was at the Department of Health, he responded to the criticisms. He published a consultative paper in July 1989 and set up a working group and a pilot project to encourage direct referrals by general practitioners to hospital-based audiology departments. Furthermore, he encouraged health authorities to enter into contracts with the private sector for the provision of hearing tests and the fitting of hearing aids.
My Bill goes one step further than that. It obliges health authorities to employ the private sector whenever they are unable or unwilling to provide a speedy service. I believe that it is an important measure to reduce waiting lists. Even when general practitioners were permitted to refer directly to hospital audiology departments in my constituency, where, as I have said, there is a direct referral system, there was still a 12-month waiting list for testing and fitting hearing aids. It was only after I kicked up a rumpus that the management responded and contracted out work to the private sector. The waiting list has now been reduced substantially, to the delight of my constituents.
Similar results have been achieved at the Royal Liverpool hospital, where I have been, thanks to the work of Mr. Anthony McIver of Merseyside regional health authority, Mrs. Julie Pritchard of Dee Hearing Services, which is a private organisation, and the excellent co-operation of the national health service. There the waiting list was reduced from 15 weeks to three weeks. At St. Mary's hospital in Paddington, which I visited yesterday, there is no audiology department because of staffing difficulties. The service is now run by a private sector organisation—Siemens—which has reduced the waiting list from 14 months to four weeks. Only a few health authorities with long waiting lists are volunteering to involve the private sector. The laggards, in the interests of their patients, should be obliged to do so.
§ 4.8 pm
§ Mr. Harry Ewing (Falkirk, East)rose—
§ Mr. SpeakerDoes the hon. Gentleman seek to oppose the Bill?
§ Mr. EwingYes. I promise not to detain the House for long. I have had a request from my hon. Friend the Member for Livingston (Mr. Cook) to be brief, and I shall do a deal with him if he is prepared to speak as briefly as me.
§ Mr. David Winnick (Walsall, North)And the Minister.
§ Mr. EwingYes.
This is a serious issue. It is yet one more attempt by Conservative Members to break up the co-ordinated service that has been offered by the national health service under successive Labour Governments. The national health service was introduced by the late Nye Bevan on the 862 basis that it should be an integrated service, free at the point of use. Throughout the past 11 years, Conservative Members have sought to attack the national health service and this Bill is yet a further attack on that integrated service that has been such a jewel in the crown of health care in the United Kingdom. It is in the best interests of those who have hearing problems and who must attend clinics to obtain hearing aids and appliances to enable them to hear more easily, that this service remains with the national health service.
I shall make only those few brief comments, because the arguments against privatising other aspects of the national health service have been rehearsed. The hon. Member for Stockport (Mr. Favell) said that the Bill is not the complete answer to the problems of those who use deaf aids and hearing aids. I must tell him that it is no answer at all. It is compounding difficulty with further difficulty and I oppose it.
§ Question put, pursuant to Standing Order No. 19 (Motions for leave to bring in Bills and nomination of Select Committees at commencement of public business):—
§ The House divided: Ayes 80, Noes 182.
864| Division No.37] | [4.10 pm |
| AYES | |
| Aitken, Jonathan | Macfarlane, Sir Neil |
| Alexander, Richard | Meyer, Sir Anthony |
| Arnold, Jacques (Gravesham) | Mills, Iain |
| Ashby, David | Mitchell, Sir David |
| Banks, Robert (Harrogate) | Montgomery, Sir Fergus |
| Beaumont-Dark, Anthony | Mudd, David |
| Bottomley, Peter | Nicholson, Emma (Devon West) |
| Bowden, A (Brighton K'pto'n) | Onslow, Rt Hon Cranley |
| Bowden, Gerald (Dulwich) | Page, Richard |
| Braine, Rt Hon Sir Bernard | Pawsey, James |
| Browne, John (Winchester) | Porter, David (Waveney) |
| Bruce, Ian (Dorset South) | Rhodes James, Robert |
| Buck, Sir Antony | Rost, Peter |
| Cash, William | Shaw, David (Dover) |
| Churchill, Mr | Shaw, Sir Michael (Scarb') |
| Clark, Rt Hon Sir W. (Crydn S) | Shelton, Sir William |
| Coombs, Simon (Swindon) | Shepherd, Colin (Hereford) |
| Critchley, Julian | Shepherd, Richard (Aldridge) |
| Day, Stephen | Shersby, Michael |
| Dicks, Terry | Stanbrook, Ivor |
| Dunn, Bob | Thompson, Patrick (Norwich N) |
| Durant, Sir Tony | Thornton, Malcolm |
| Favell, Tony | Thurnham, Peter |
| Franks, Cecil | Vaughan, Sir Gerard |
| French, Douglas | Viggers, Peter |
| Gale, Roger | Walker, Bill (T'side North) |
| Gardiner, Sir George | Waller, Gary |
| Gill, Christopher | Ward, John |
| Goodhart, Sir Philip | Warren, Kenneth |
| Greenway, Harry (Eating N) | Watts, John |
| Griffiths, Sir Eldon (Bury St E') | Wheeler, Sir John |
| Grylls, Michael | Wiggin, Jerry |
| Hayward, Robert | Wilkinson, John |
| Howell, Ralph (North Norfolk) | Wilshire, David |
| Janman, Tim | Winterton, Nicholas |
| Jessel, Toby | Wolfson, Mark |
| Jones, Gwilym (Cardiff N) | Woodcock, Dr. Mike |
| Jones, Robert B (Herts W) | |
| Kellett-Bowman, Dame Elaine | Tellers for the Ayes: |
| Kilfedder, James | Mr. Richard Holt and |
| Knight, Dame Jill (Edgbaston) | Mr. David Harris. |
| Latham, Michael | |
| Lawrence, Ivan | |
| NOES | |
| Adams, Mrs. Irene (Paisley, N.) | Ashton, Joe |
| Allen, Graham | Barnes, Harry (Derbyshire NE) |
| Armstrong, Hilary | Barron, Kevin |
| Ashdown, Rt Hon Paddy | Battle, John |
| Ashley, Rt Hon Jack | Beggs, Roy |
| Beith, A. J. | Ewing, Mrs Margaret (Moray) |
| Bell, Stuart | Fatchett, Derek |
| Benn, Rt Hon Tony | Field, Frank (Birkenhead) |
| Bennett, A. F. (D'nt'n & R'dish) | Fisher, Mark |
| Benton, Joseph | Flynn, Paul |
| Bermingham, Gerald | Foot, Rt Hon Michael |
| Blair, Tony | Forsythe, Clifford (Antrim S) |
| Boateng, Paul | Foster, Derek |
| Bradley, Keith | Foulkes, George |
| Brown, Gordon (D'mline E) | Fyfe, Maria |
| Brown, Nicholas (Newcastle E) | Galloway, George |
| Brown, Ron (Edinburgh Leith) | Garrett, John (Norwich South) |
| Bruce, Malcolm (Gordon) | Godman, Dr Norman A. |
| Buckley, George J. | Golding, Mrs Llin |
| Callaghan, Jim | Gordon, Mildred |
| Campbell, Ron (Blyth Valley) | Graham, Thomas |
| Campbell-Savours, D. N. | Grant, Bernie (Tottenham) |
| Canavan, Dennis | Griffiths, Win (Bridgend) |
| Cartwright, John | Grocott, Bruce |
| Clarke, Tom (Monklands W) | Hardy, Peter |
| Clay, Bob | Harman, Ms Harriet |
| Clelland, David | Hattersley, Rt Hon Roy |
| Clwyd, Mrs Ann | Haynes, Frank |
| Cohen, Harry | Heal, Mrs Sylvia |
| Cook, Robin (Livingston) | Hinchliffe, David |
| Corbett, Robin | Home Robertson, John |
| Cousins, Jim | Hood, Jimmy |
| Crowther, Stan | Howarth, George (Knowsley N) |
| Cryer, Bob | Howells, Geraint |
| Cummings, John | Howells, Dr. Kim (Pontypridd) |
| Cunliffe, Lawrence | Hoyle, Doug |
| Cunningham, Dr John | Hughes, John (Coventry NE) |
| Dalyell, Tam | Hughes, Roy (Newport E) |
| Darling, Alistair | Hughes, Simon (Southwark) |
| Davies, Ron (Caerphilly) | Illsley, Eric |
| Davis, Terry (B'ham Hodge H'l) | Janner, Greville |
| Dewar, Donald | Johnston, Sir Russell |
| Dixon, Don | Jones, Barry (Alyn & Deeside) |
| Doran, Frank | Jones, leuan (Ynys Môn) |
| Douglas, Dick | Jones, Martyn (Clwyd S W) |
| Dunnachie, Jimmy | Kaufman, Rt Hon Gerald |
| Eadie, Alexander | Kennedy, Charles |
| Eastham, Ken | Kinnock, Rt Hon Neil |
| Evans, John (St Helens N) | Lamond, James |
| Ewing, Harry (Falkirk E) | Leadbitter, Ted |
| Leighton, Ron | Rogers, Allan |
| Lestor, Joan (Eccles) | Rooker, Jeff |
| Lewis, Terry | Rooney, Terence |
| Litherland, Robert | Ross, Ernie (Dundee W) |
| Livingstone, Ken | Ross, William (Londonderry E) |
| Lloyd, Tony (Stretford) | Rowlands, Ted |
| Lofthouse, Geoffrey | Ruddock, Joan |
| Loyden, Eddie | Salmond, Alex |
| McAllion, John | Sedgemore, Brian |
| McAvoy, Thomas | Sheerman, Barry |
| McCartney, Ian | Sheldon, Rt Hon Robert |
| Macdonald, Calum A. | Shore, Rt Hon Peter |
| McKay, Allen (Barnsley West) | Short, Clare |
| McKelvey, William | Skinner, Dennis |
| McMaster, Gordon | Smith, Andrew (Oxford E) |
| Madden, Max | Smith, C. (Isl'ton & F'bury) |
| Mahon, Mrs Alice | Smith, Rt Hon J. (Monk'ds E) |
| Marek, Dr John | Smith, J. P. (Vale of Glam) |
| Martin, Michael J. (Springburn) | Steel, Rt Hon Sir David |
| Martlew, Eric | Steinberg, Gerry |
| Maxton, John | Stott, Roger |
| Meacher, Michael | Strang, Gavin |
| Meale, Alan | Straw, Jack |
| Michael, Alun | Taylor, Mrs Ann (Dewsbury) |
| Michie, Mrs Ray (Arg'l & Bute) | Taylor, Rt Hon J. D. (S'ford) |
| Morris, Rt Hon A. (W'shawe) | Thompson, Jack (Wansbeck) |
| Mowlam, Marjorie | Turner, Dennis |
| Mullin, Chris | Vaz, Keith |
| Nellist, Dave | Wallace, James |
| Oakes, Rt Hon Gordon | Wareing, Robert N. |
| O'Brien, William | Welsh, Andrew (Angus E) |
| O'Hara, Edward | Welsh, Michael (Doncaster N) |
| Parry, Robert | Wigley, Dafydd |
| Patchett, Terry | Wilson, Brian |
| Pike, Peter L. | Winnick, David |
| Powell, Ray (Ogmore) | Wise, Mrs Audrey |
| Primarolo, Dawn | Worthington, Tony |
| Quin, Ms Joyce | Wray, Jimmy |
| Redmond, Martin | Young, David (Bolton SE) |
| Rees, Rt Hon Merlyn | |
| Reid, Dr John | Tellers for the Noes: |
| Richardson, Jo | Mr. David Lambie and |
| Robertson, George | Mr. Jeremy Corbyn. |
§ Question accordingly negatived.