HL Deb 24 May 1968 vol 292 cc926-39

1.13 p.m.

LORD SORENSEN

My Lords, I beg to move that this Bill be now read a second time. We have been discussing the significance of the seal population around our coasts, and now we are turning to humans. I am sure that those who remain in your Lordships' House are as concerned about human beings as about the animal world, as indeed I am myself. It is a significant moment for me, because this is the first speech that I have made since I ascended from the disciplined, restricted level of the Front Bench to the higher reaches of the Back Benches, apart from, I believe, a transient facetious intervention a fortnight ago.

I suppose I should declare an interest. It is not that I have any shares it in commercial companies providing hearing aids, or that I am deaf myself, but my wife occasionally uses a commercial hearing aid, as well as having possession of a Medresco aid, the device provided so spendidly by the National Health Service. This is not altogether an advantage, because it sometimes enables her to hear remarks by her husband that she would do better not to hear. Be that as it may, she is one of a large number of people who find, whatever the value is of Medresco, the National Health Service hearing aid, that their other device is in some respects superior.

As I say, I am not myself involved by being deaf, though sometimes, with others, I find it rather difficult to catch some of the things said by noble Lords who are speaking, and these flimsy stalactites that descend on us from the roof, as well as the little grills just behind us, remind us that many noble Lords are in great need of hearing aids in this particular place. I dare say that we have all had to explain to visitors occasionally that when noble Lords are seen in a slightly recumbent position, with their heads bowed, it is not that they are somnolent, but merely that they are trying to hear the speeches simplified by the grill behind them. It is also a useful pretence for those who are temporarily unconscious to pretend that they are not so.

This is a small Bill, but not a trivial one. I understand that there are something like 2½ million people in this country who are affected by deafness, either absolute or slight, and some 800,000 to one million who have taken advantage of the National Health Service to secure hearing aids of the type I have described. But, as I have said, there are a certain number, including people like my wife, who go beyond that. The Bill has been passed unanimously in another place; all Parties support it, and therefore I do not anticipate any difficulty in this House.

In a moment or two I will go briefly through the various clauses, but before doing so I should say that the manufacturers, and the suppliers in some respects, of commercial hearing aids, apart from a small minority support the Bill. A number of well-known hearing aids are now being used that have been made and supplied by firms who have behaved honourably and honestly, and about which no complaint has been made. There is, however, a minority who behave otherwise, and perhaps unscrupulously. It can be said, roughly speaking, that the complaints are three. First, there is at present from this minority of manufacturers, sellers or dispensers of hearing aids no guarantee that the fixing of the device is by qualified persons. Secondly, they sell devices without ensuring an available and reliable repair or adjustment service. I will illustrate that more fully in a moment. Thirdly, they encourage purchasers to pay more than is necessary for alleged superior types of device.

Perhaps I can give two illustrations of how this operates. I am informed, for instance, that one method employed by a minority (and I emphasise "minority") of salesmen is to advertise that free advice on hearing difficulties will be given at a certain place, maybe a local hall, on a certain date. The advertisement attracts a large number of people, and particularly the elderly. Thereafter, after a good deal of mumbo jumbo and inspection, they are told that a certain device is the one that would help them. The device is then purchased. Later on it proves defective, and the poor owner of the device finds that he or she cannot get any kind of repair or adjustment, and it therefore becomes quite useless. Another method, I understand, is to sell them the device at, say £24 or £25, and after a while the salesman, hearing of a complaint on the part of the purchaser that it is not working properly, looks at it gravely and solemnly says: "I see what it is. Your complaint is so serious that you now require a better type. It will cost you more, possibly twice as much, but obviously a cheaper one is not suitable for you." So the poor person parts with another £24 or £25, only to find sometimes that this, too, is ineffective or not altogether adequate. This may mean that he may part with as much as £100 to £125 for a device. These are but two illustrations, and that being so it is hoped that the proposals in this Bill will go some way towards ensuring for those who want this particular kind of hearing aid adequate service, and honest service at that.

May I turn, therefore, very briefly, to the actual clauses of the Bill? It proposes first of all to set up a Hearing Aid Council appointed by the Board of Trade. This may seem rather remarkable but, after all, it is dealing with the sale of appliances and in that respect it is not quite similar to superficially similar bodies governing the supply of other devices to assist those with infirmities. Dentists and opticians for a long time had no kind of supervision. They are now under supervision. They have to comply with certain regulations and councils that govern them, and now most dentists and opticians are glad that this is so. It places the whole of their service on a sound foundation. We hope that this Bill, by proposing that there shall be a Hearing Aid Council, will perform the same service for persons with this type of infirmity as the other councils or bodies have performed in regard to those with other infirmities.

May I just read for your Lordships' information the actual words in the first part of the Bill? Clause 1 says that the Council shall have the general function of securing adequate standards of competence and conduct among persons engaged in the retail selling of hearing aids, together with the specific functions assigned to it by or under the following provisions of this Act… …the Council shall study the facilities available for training persons to act as dispensers of hearing aids, and shall keep these facilities under review, and shall advise on methods for improving these facilities and shall publicise details of training and courses available". My last quotation is this: The Council shall draw up standards of competence for dispensers of hearing aids and codes of trade practice for adoption by such dispensers and by suppliers and shall from time to time review those standards and codes and may vary them as they consider appropriate". Clause 2 therefore proposes that there shall be a registrar who will maintain two registers, one for salesmen and dispensers—these are apparently synonymous terms—and one for suppliers. Anyone who has been practising for six months before the passing of the Act can go on the register on payment of a small fee, but subsequently examinations and other inspections and guarantees of that kind will be established and all applicants will be expected to conform to them before they then are placed on the register. In other words, they will have to satisfy certain qualifying tests. I will emphasise again, as I did just now, that this is no partisan proposal, and, equally, that the majority of commercial suppliers of these inconspicuous hearing aids want this Bill passed.

Clause 3 deals with offences by unregistered persons, dealing with fines and so forth. Clause 4 deals with rules being laid down by the Council and the payment of various fees. Clauses 5 to 11 provide for necessary disciplinary measures and also the means by which appeals can he made against what are thought to be unfair judgments. Clause 12 deals with accountancy; Clause 13 with a series of definitions, and Clause 14 with the Short Title and the appointed day for the operation of the Act. The Schedule describes the composition of the Council. That really covers the whole of the Bill.

I would refer to the fact that it is necessary here in this House to have some kind of assistance for those who are even partially deaf. I remember when I was in the other House Sir Winston Churchill, who was unfortunately increasingly afflicted by deafness, resented and resisted very strongly any kind of hearing aid until at last he was persuaded to have one. And so delighted was he that he had two, which was of great advantage to him, because after speaking and then listening to a few preliminary criticisms, he would blandly remove both hearing aids and sit there so that he heard nothing more. It might have some advantage in this House as well, but I will not pursue the subject. I will merely say, in conclusion, that I trust that this particular Bill, as I say, small but by no means trivial, will pass through this Chamber. I congratulate the honourable gentleman in another place for taking up this Bill and seeing it through. During the whole length of the time I was in the other House I myself introduced a Bill only on one occasion, and that Bill had to be withdrawn. I congratulate him on being more successful, and I am sure the Bill commends itself to everyone in this House. Therefore, I beg to move.

Moved, That the Bill be now read 2a.—(Lord Sorensen.)

1.25 p.m.

VISCOUNT SIMON

My Lords, I want to add only a very few words to what the noble Lord, Lord Sorensen, has said in introducing the Bill, and to thank him indeed on your Lordships' behalf for having expressed the intention of tile Bill so clearly and having given it such good support. I, like the noble Lord, have not the interest that I am hard of hearing—I am one of the lucky ones whose hearing is unimpaired—but I know something about the troubles and tribulations that afflict those who are deaf or hard of hearing, because I have been for some years the President of the Royal National Institution for the Deaf, and that is my interest in this matter.

I would say, first of all, that the Institution warmly welcome this Bill which seeks to give effect to a policy which the Institution have been recommending for some thirty years. We are delighted that the Bill comes forward not only, as the noble Lord has said, obviously with the approval of all Parties, but also with the approval of those concerned: the suppliers and dispensers of hearing aids and the organisations who represent, as best they can, the interests of the deaf People of this country. It is in my view high time that there was some proper qualification for those selling hearing aids to the public. I agree with the noble Lord that it is only a minority who have been exploiting the position, but that exploitation ought to be stopped, because the amount of grief as well as monetary loss that this leads to really does not bear contemplation.

One of the Council's principal aims is the setting up of adequate standards of competence and conduct in salesmen, who are very happily, I think, called dispensers—which calls attention to the fact that they are primarily, or they should be, engaged not in selling a commercial object, although that is what they are doing, but in trying to alleviate the sufferings of deaf people and helping them to overcome those sufferings. I am very glad that the Council will be able to undertake the investigation of complaints. I may say that the R.N.I.D. (if I may call it that for short) has undertaken this task for many years. We have a very efficient department and I think they have given great satisfaction to many complainers who have brought their troubles to the Institution; and because the Institution has a very happy relationship also with the commercial interests involved, it has been found possible again and again to iron over these complaints and get some adequate redress.

There are only two points on the Bill which I should like to ask the noble Lord, but as I did not give him notice I shall fully understand if he says he cannot deal with them now. They are, I think, a little more than Committee points. One of them arises on Clause 3(1)(b). I have not been able to understand why it is an offence for an unregistered supplier to employ an unregistered dispenser, and not an offence for a registered supplier to employ an unregistered dispenser. I can see that the registered supplier would be in danger of losing his registration and becoming a disqualified person, but if in the case of the unregistered supplier it is to be a criminal offence to employ an unregistered dispenser I am not quite clear why the same should not apply to a registered supplier.

My other point arises out of Clauses 5 and 6, which, as the noble Lord has mentioned, set up the Investigating Committee and the Disciplinary Committee. When I first read these clauses, I thought that these committees would be standing committees. In my view there is a great advantage in that, because it enables the members of those committees to become well acquainted with the tasks they are undertaking; and particularly in the case of the Disciplinary Committee it helps to ensure that decisions are taken on a consistent basis. I thought they were standing committees until I read Clause 6(3), which says that the rules shall be such that a member of the Investigating Committee does not sit on the same case in the Disciplinary Committee. This seems to suggest that perhaps the committees are to be ad hoc dealing with particular inquiries, and possibly between now and the Committee stage the noble Lord will be able to tell us something about those two points. Apart from that, I warmly welcome this Bill and trust that your Lordships will give it a Second Reading.

1.32 p.m.

LORD DONALDSON OF KINGSBRIDGE

My Lords, it is rather bad luck that we cannot have a Division on the Second Reading of this Bill, because unusually my Party has a majority in the Chamber at the moment. This Bill has sailed freely through the other Chamber, and all we want to do here is to give it a fair wind. The Consumer Council have been complaining about abuses in this sphere from their very first meetings, and they were highly delighted when Mr. Laurie Pavitt was persuaded to introduce a Bill. We feel proud of him for having brought the Bill, through dogged persistence, to this present stage of near completion. It took him two years to interest the Board of Trade. He eventually got their agreement, but on the understanding that the Council he wished to set up was to cost nothing. It took another year to get the industry to shoulder these costs, which must be recorded to their lasting credit. The result is a Bill which will do the job it is intended to do.

I was at one time a member of the Management Committee of the Royal National Throat, Nose and Ear Hospital. I asked them their views on this Bill, and they were enthusiastic about it. They told me that before anyone is allowed to fit a hearing aid at their hospital he has to undergo twelve months' training, consisting of three months' theoretical training and nine months' practical work, and then pass a written examination. The Council will set up standards which will perhaps not be as high as those of the Royal National Throat, Nose and Ear Hospital, but we must all welcome the fact that the fitting of hearing aids will be a technician's job and not a salesman's job. I wish the Bill a speedy passage.

1.36 p.m.

LORD DRUMALBYN

My Lords, may I join in congratulating the noble Lord, Lord Sorensen, on having introduced this Bill? If I may say so, I am much more accustomed to listening to him from the Back Benches than from the Front Benches, and he seems to me to be so much more interesting than he was in the position he first occupied in this House. I would also congratulate Mr. Laurie Pavitt upon his persistence in this matter. He has had to jettison quite a number of his original intentions before arriving at this particular solution.

There are only two points with which I want to concern myself, both of which were referred to by Mr. Pavitt in the course of his remarks in another place. To use a pungent, if vulgar, expression, the "guts" of this Bill really lie in Clause 7(1)(b) and also Clause 7(4). These two provisions, taken together, enable a code of trading practice to be established and set up a Disciplinary Committee which can remove persons from the register for serious misconduct. I should like to ask a question or two about that. The noble Lord, Lord Sorensen, said that dispensers and salesmen were one and the same. It is not entirely clear to me whether the people who are to he registered will be the employers of, say, the dispensers or distributors of hearing aids, or whether they will be the salesmen as well. I should he grateful if he could make that point clear.

The second point I wish to raise is simply in regard to cost. In another place Mr. Pavitt said that the one snag he had run into was that of finance. Originally he estimated that the cost of running this service would be £5,000. Out of that must be paid the salary of the Registrar and, presumably, the cost of the premises. There is a Council of 12 members, each of whom is entitled to fees for attendance; there is an Investi- gation Committee, a Disciplinary Committee, assessors to be appointed under Clause 11 and contingent liability in regard to appeals. If the Council loses its appeal in the High Court or the Court of Session, then presumably there is a contingent liability for costs there also. When Mr. Pavitt was speaking about costs he envisaged that the fees likely to be forthcoming would be in the area of £2,000 to £2,500. I think we should be careful to ensure that such a body will be viable.

Speaking personally I would rather regard this as a pilot Bill, because I think that as time goes by the fitting of hearing aids will become more and more like the fitting of spectacles; indeed, I believe that to quite a large extent this Bill is based upon the Opticians Act, though I do not think it goes quite so far as that Act. The definition of standards of competence that will be required have still to be worked out, and of course a person cannot be registered unless he has been occupied either in selling or dispensing for six months when the Bill comes into force or, otherwise, later passes tests with regard to standards of competence. I envisage this as being only the first stage in the development of this particular control.

My last point is that we are dealing here with something that comes mainly into the health sphere. I suppose it can be said that a person is not ill it he is deaf, but he certainly has a disability. Yet the sponsoring Minister for this Bill is the President of the Board of Trade, and it comes within his competence to approve the code of conduct, and so on. I am not certain whether he will have anything to say about the standards of competence, as there is nothing in the Bill to that effect, but the standards of competence would seem to lie rather more in the sphere of the Minister of Health and of the Secretary of State for Scotland. I am not quite certain how these are to be worked out, but there is a duality here. I think it is probably quite right that there should be just one sponsoring Minister, but I have the, feeling in my mind that when one looks at the Medicines Bill the noble Lord and Mr. Pavitt may not have made the right decision as to which the sponsoring Department should he.

1.40 p.m.

LORD ROYLE

My Lords, I should like in a very few words to express support for the Bill, in the first place because of my very deep regard for the honourable Member and the noble Lord who have charge of it. I have very deep regard indeed for Mr. Laurie Pavitt, and I know the tremendous amount of thought and work he has put into it over quite an extended time. I am happy for him that the Bill has now reached this stage after going through all its stages in another place. I congratulate my noble friend Lord Sorensen on the fact that he has taken over what I am quite confident is going to be a very popular and useful Bill.

I suppose my second reason for wanting to say a few words is because I first came up against this problem as a constituency Member of Parliament, and people used to come to me at my advice bureau (and this happened on many occasions) to complain about their difficulty with regard to hearing aids outside the National Health Scheme. I found very many elderly people harassed and worried because they had been tempted to purchase, outside the National Health Scheme, hearing aids which had proved to be completely unsatisfactory, as my noble friend said, at great cost when it came to a question of replacement and when no service was available. Very often sums like £60 or £70 had been charged for this kind of instrument, and the worry and the harassment that faced some of my constituents in those days on this question aroused an interest in me; and I am sorry that I never took the matter up in the way in which Mr. Pavitt has done in the House of Commons. Therefore, I am quite sure that a great service is being rendered on this particular occasion to the people of this country who are hard of hearing.

The problem has always been that so many of these people have been tempted by advertisements, and have been supplied with a device without any examination at all by a doctor or by an ear consultant. This has been the snag. Obviously, we should all regard it as the first necessity that a doctor should be consulted before there is to be a prescription for any kind of hearing aid, and it is because people were outside that kind of examination that they "fell for" the advertisements that have been going around. I would use a strong word and say that in some cases—though I agree with my noble friend and the noble Viscount, Lord Simon, that it is only a very small proportion of people who are doing this—it became a racket. I do not think that is too strong a word to use.

On the question of registration as a whole, there is a tendency in these days in medical activities for even their organisations to be pressing for registration, so that they should be protected against things that they themselves would not do. I believe that the principle of registration for many professions and trades is very desirable. Having said that, I want to make just two small points, and your Lordships may be surprised that they should come from this side of the House. I notice that Clause 7, "Erasure from the registers for crime, misconduct, etc.", states that if any person is convicted in, any court of a criminal offence, except a very trivial offence, the Disciplinary Committee may, if they think fit, direct that his name shall be erased from the register". I am wondering whether this goes a little too far. I know that none of us is desirous that people engaged in criminal activities of any kind should have the opportunity of providing a medical device, but I wonder what the relationship between the two is. I wonder how far the Disciplinary Committee might go in deciding that a person was not a fit person, because of criminal proceedings, to sell this kind of device, and I am just wondering where this line might be drawn. I know that the clause says, "may if they think fit", but I look at where the line of definition is and what should stop a man from being able to sell these things. I have always been against the idea of double punishment; and if a man is punished for an offence he has committed it seems to me that there may be no relationship whatever between that criminal offence and the sale of hearing aids.

The other point is very similar. Subsection (3) of Clause 7 says that where (b) the Disciplinary Committee is satisfied that a person whose name has been erased from one or both of the registers maintained under section 2 of this Act…is a director of or taking part in the management of such a body corporate, the Disciplinary Committee may, if they think fit, direct that the name of the body corporate be erased from the register. It sometimes happens that many bodies corporate get a "bad lot" on the board of directors from time to time, and it occurs to me that perhaps it is not quite a fair approach to think that, because one man on the board of directors has been proved to be a "bad lot", the whole of the body corporate should be prohibited from engaging in this kind of business. This is something that has always worried me, and we discussed it a great deal during the passage of the Companies Bill, I think last year. It is the same point, the same principle, and I am always concerned about it. This is not something that would stop anybody from agreeing to the Second Reading, but it might be something that should be taken into consideration as the days go by. With that very small reservation, I enthusiastically support the Bill, and I hope that it may have a very speedy passage through your Lordships' House.

1.48 p.m.

BARONESS PHILLIPS

My Lords, it is a great delight to hear the noble Lord, Lord Sorensen, introducing this Bill in his own inimitable fashion, and I am sure he will he very happy with the reception it has received. The small points which have been raised can certainly he replied to and ironed out during the passing of the Bill through your Lordships' House. I should like to add my word to the tributes paid to the honourable Member for Willesden, West. Those of your Lordships who have served in another place will know only too well the great tenacity of purpose that he must have shown in discussions with Government Departments, with the industry and with all the numerous interests concerned, to have achieved this point.

The fact that I can say that happily the Bill appears to have all-Party support, as well as the support of the industry and the organisations concerned with dealing with the deaf, means that it is set for a fair passage. This will certainly make life a little easier for those who suffer this affliction and seek to get a hearing aid outside the National Health Service. I know, too, from my experi- ence of the Citizens Advice Bureau of the undesirable practices that have been carried out by a very small section of the industry. I hope the noble Lord Lord Sorensen, and the honourable Member for Willesden West will realise that we wish the Bill a speedy passage through your Lordships' House.

1.50 p.m.

LORD SORENSEN

My Lords, it would be quite impossible for me to do justice to all the points that have been raised, partly because I am becoming increasingly senile, and partly because the swiftness with which the references were made dazzled me. But I am sure that all the items that have been raised will be carefully considered on Committee, and in some cases possibly I may be able to get further information and forward it to noble Lords before the Committee stage is reached or while it is in progress. I will do my best in replying to one or two points, but if I leave any out it will be for the reasons which I have mentioned.

May I say that it is particularly apposite that my noble friend Lady Philips wound up this debate for the Government, because her daughter is the Parliamentary Secretary at the Board of Trade in another place, and her daughter's husband is, I believe, a sponsor of the Bill in another place. Therefore it is quite a family affair, and I congratulate the family on having facilitated the passage of this most beneficial Bill.

To turn briefly to one or two of the points raised, may I say that in regard to the cost it is now assumed that the original cost of £5,000 was an under estimate. This often happens (does it not?) with all Governments and private persons when they estimate. But it is now estimated that £8,000 will well cover the cost. The Registrar will be only part-time. He may require a permanent shorthand-typist, and it is estimated that the expenses will be covered by the registration fees. With regard to the other matters, I agree with the noble Lord opposite that the Ministry of Health comes into this at some point in regard to standards of conduct. No doubt this will be worked out by the new Council when it is appointed. But it is initially, at least, concerned with the Board of Trade for reasons which I have given; in other words, it deals with the actual sale of appliances. I am perfectly certain that on their appointment the Council will see to it that there is a proper liaison between the Board of Trade and the Ministry of Health.

There was some reference, I believe by my noble friend Lord Royle, to companies being struck off. He thought that this was too hard. But this was inserted to prevent companies whose names have been erased from the register starting up under a new name, a device often employed in other spheres. My noble friend also made some reference to erasure for misconduct in regard to this Bill. This has some parallel to the provisions governing infamous conduct on the part of doctors, although there is no actual parallel between the two.

In regard to the question whether both the employers and the salesmen would be on the registers—because there are two registers—I take it that they would be on one or the other. Again, this is a matter which can be gone into.

In reply to the noble Viscount, Lord Simon, I would say that an unregistered person, whether supplier or dispenser, commits an offence under Clause 3. An unregistered supplier would not be allowed to operate. The noble Viscount asked about the composition of the investigating committee. Here again, like the disciplinary committee itself its rules will be determined by the Council, once this is set up. This Council will determine whether these are standing or ad hoc committees.

I hope that I have done justice, albeit frail and slight, to the Bill. I should like warmly to congratulate Mr. Laurie Pavitt who initiated this Bill in another place, for creating this service for a considerable section of our community. I am grateful that I have been privileged to be the messenger who carries on his good work in this House. I have often been a messenger in other respects as well, but others are in that position to-day. I commend this Bill to your Lordships, and trust that the House will give it a Second Reading.

On Question, Bill read 2a, and committed to a Committee of the Whole House.