HL Deb 26 January 1999 vol 596 cc875-7

3 p.m.

Lord Ashley of Stoke asked Her Majesty's Government:

What plans they have to improve the National Health Service hearing aid by replacing it with a modern version.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman)

My Lords, the NHS range of hearing aids has been substantially updated over the past three years. "In the ear" models have been introduced, as have high frequency aids, mini aids and aids in different colours. Additionally, modern features have been incorporated into some of the range of hearing aids to make sounds clearer. The NHS Supplies Authority also introduced a hearing aid specifically for children.

Lord Ashley of Stoke

My Lords, is my noble friend aware that, despite what she says, most national health hearing aids are old-fashioned? I note that the Government have set up a working group to act on this, and that is welcome, but can my noble friend assure the House the review will not drag on for too many years? All the facts are now known and well established. The private sector raced ahead using modern technology and far superior hearing aids are available because of the use of that modern technology. The National Health Service could obtain the benefits of those aids by mass production and the cost-savings of large-scale economy, yet it is not doing so. Can we please get a move on and have a commitment from the Government that they will introduce digital aids on the health service? The cost will be minimal.

Baroness Hayman

My Lords, my noble friend makes a number of points. Perhaps I can reassure him on the first; that is, the review that is taking place of both hearing aid and audiology services will not be dragged out. I hope that it will report later this year. I recognise that great advances are on the horizon, particularly using digital technology. We must explore those. However, we must be certain that they are safe, effective and give value for money before including them in the NHS range. My noble friend is right to pinpoint the role of the NHS Supplies Authority as a bulk purchaser. In that regard there will be opportunities in the future for driving down the price of what is, at the moment, expensive new technology.

Lord Clement-Jones

My Lords, can the Minister confirm whether or not she believes that there is adequate price competition in the market for digital hearing aids? If not, is there a good case for referral of the manufacturer of digital hearing aids to the Office of Fair Trading?

Baroness Hayman

My Lords, this is a new technology. It is being introduced at the moment mainly in the private sector. We will have to see how that market and pricing within that market develop. The NHS Supplies Authority has started to look at future provision of hearing aids and one element of its investigations will cover analysis of digital hearing aid technology, including the cost considerations in that regard.

Lord Jenkins of Putney

My Lords, is my noble friend aware that a large number of people of modest means are obliged to pay £500 or more, which they can ill afford, in order to acquire a satisfactory hearing aid which meets their requirements? The old-fashioned type will not deal with many of the problems from which people suffer. Is it not more urgent than is generally appreciated for people to be enabled to acquire a hearing aid at a reasonable cost—or, indeed, without cost—on the National Health Service as soon as possible?

Baroness Hayman

My Lords, I certainly agree with my noble friend that this is a serious issue and one that affects a great number of people. But as I said in my earlier reply, we should not think that there is simply one old-fashioned, outdated hearing aid available. Over the past four years there has been substantial updating in the range of hearing aids available, including in-the-ear aids, high-frequency aids and mini aids. Also, the type of hearing aid provided by the NHS is a matter for the clinician concerned. If it is clinically necessary for the patient, it is possible for a hearing aid outside the normal NHS range to be prescribed.

Baroness Carnegy of Lour

My Lords, since the price of newly invented hearing aids inevitably reflects the cost of development, does it not stand to reason that to buy large quantities of newly invented digital hearing aids—provided their success is proven—would rapidly reduce their price? Should not the Government look at the matter in that way? There is no question but that digital hearing aids are infinitely more useful?

Baroness Hayman

My Lords, I alluded to the possibility of bulk purchase by the NHS Supplies Authority driving down the price of what is at the moment expensive new technology. We must recognise that there is a need to evaluate the technology and to conduct trials to see exactly what enhanced benefits there are—for example, against the existing advanced programmable analogue aids—when considering large numbers of users. That is not to say that digital technology does not offer great possibilities of advance. We need to look at how it will be cost-effective and of benefit to patients. Also, we need to look at how the price may be brought down.

Lord Annan

My Lords, does not the Minister agree that the noble Baroness, Lady Carnegy, is entirely right when she says that digital aids have been tested and tried time and again? There is therefore no need to have large exploration and a programme designed to delay any decision on this.

Baroness Hayman

My Lords, the review is not designed to delay a decision. We are looking carefully at what exists. As I understand it, there are needs for other technology in addition to the aid itself—the calibration mechanisms and so forth. It is important that we recognise this and look carefully when considering use by large numbers of patients at what are the additional and cost benefits. That is work we are now taking forward.

Baroness Pitkeathley

My Lords, is my noble friend aware that in the recent Royal National Institute for Deaf People survey 51 per cent. of those hard-of-hearing who were surveyed said that they would not take consultation about the matter for fear that they would be prescribed a hearing aid and did not want to wear one? A further 21 per cent. said that they did not believe anything could be done about their deafness. Does not my noble friend agree, therefore, that a campaign of public awareness as to what can be done to alleviate hearing problems would be beneficial?

Baroness Hayman

My Lords, my noble friend makes an important point. Large numbers of people see hearing loss as a normal part of the ageing process about which nothing can be done to help. Indeed, they have an idea that hearing aids are a cumbersome and old-fashioned mechanism with which they do not want to be involved. It was in order to raise public awareness that the Royal National Institute for Deaf People launched a campaign last year to encourage people experiencing hearing loss to speak to their GP. The Secretary of State was happy to launch that and 39,000 GPs were alerted to the importance of being aware of the problems of hearing and of referring patients for appropriate audiological tests and treatment.