Hearing Aids: NHS Service (Hansard, 15 January 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the National Health Service has provided and continues to provide a very good hearing aid service to large numbers of hearing-impaired people. A variety of proposals for hearing aid services announced last year included the setting up and evaluation of pilot projects which will involve the direct referral of patients from their general practitioners to the hospital audiology department without the need for a prior examination by a consultant. However, there are some patients with a hearing loss caused by an underlying medical condition who may need to be examined by a consultant before being referred for a hearing test and fitted with a hearing aid.

§ Lord Hunter of Newington
My Lords, I thank the Minister for that reply. Does she believe, as I do, that every senior citizen should be offered an audiogram at suitable intervals? There is a growing practice for the machines to be available in general practice, and one hopes that in future large general practices will have that facility. Does the Minister agree that the ideal person to operate the machine would be the practice nurse? Does she further agree that the overcrowding of ear, nose and throat departments with so many additional patients is burdensome?

§ Baroness Hooper
My Lords, the screening of elderly patients in particular, which is proposed in the new GP contracts, will go some way to meet the noble Lord's anxiety. We encourage testing and dispensing services in community centres in order to cope with geographical problems, but under the control of the hospital unit. If GPs have the necessary expertise and equipment, there is no reason why that service should not be carried out by them.

§ Lord Molloy
My Lords, is the noble Baroness aware that the old-fashioned National Health Service 414 hearing aid has brought millions of people immense happiness and relief? Is she further aware that there now exist on the British market exceptionally super hearing aids which could be a further blessing to those who are very hard of hearing? Is it not possible for the Government to make them available on the NHS? If a doctor believes that a patient's problem is caused primarily by a hearing aid deficiency, is it not possible for the patient to go direct to the hearing aid department, and for the patient to be referred to the other departments only if that department believes that there is an additional problem? Could at least that prospect be examined?

§ Baroness Hooper
My Lords, as I said, we believe that the National Health Service hearing aid service has provided and continues to provide a very good service. As a result of the proposals announced last year by my right honourable friend we shall be looking to increased co-ordination. As regards choice of hearing aids, there is a wide range of National Health Service hearing aids available to meet a variety of needs. In a few cases however a patient's clinical need may only be met by a commercial hearing aid which may be purchased and supplied free of charge to the patient by the National Health Service hearing aid centre.

§ Baroness Fisher of Rednal
My Lords, can the Minister tell the House whether it is understood that the general practitioner who supplies a hearing aid through his own clinical diagnosis without sending the patient to the hospital will have that charge come out of his practice money? If for one reason or another that is not possible because the general practitioner does not supply that service, and the patient has to be referred to the hospital, will that come out of the practice budget and will he have to pay a hospital charge for that patient?

§ Baroness Hooper
My Lords, as said, testing outside hospitals will continue to take place whether in community centres or via GPs under the control of the hospital unit. Therefore we have no plans at present to make the kind of arrangements that the noble Baroness suggested.

§ Lord Peston
My Lords, clearly hearing problems and remedial work are subjects which noble Lords take very seriously. Did I understand the Minister to say that the NHS would provide whatever state of the art hearing appliance that was required by the patient and that there is no restriction on the ability of the medical profession to provide under the National Health Service the exactly correct hearing aid? In other words, is the noble Baroness saying that the stories that one hears to the effect that the very best hearing aids are not available on the NHS are not true?

§ Baroness Hooper
My Lords, what said was that there is a wide range of hearing aids available under the National Health Service. In fact the Mersey Regional Health Authority which is responsible for the procurement and distribution of all National Health Service hearing aids has recently negotiated with the hearing aid industry for a reduction in the 415 cost of commercial hearing aids supplied free of charge to NHS patients. That means that in future National Health Service hearing aid centres should be able to supply even more commercial hearing aids and that is certainly the intention.

§ Lord Peston
My Lords, may I ask the Minister to clarify her answer? I agree that I used the cliché "state of the art". Nonetheless I asked in the case of a person going for a hearing aid under the NHS and who required the very best available technologically advanced hearing aid, whether that would be prescribable under the NHS? Is she able to say categorically "yes" in answer to that question?

§ Baroness Hooper
My Lords, our firm intention—and I wish to emphasise it—is that National Health Service hearing aids should remain free at the point of issue. The vast majority of hearing aids come within that definition, which is being expanded as a result of the procurement and distribution arrangements being made by the Mersey Regional Health Authority. We certainly hope to have the widest possible choice available for patients.