Lord Hunt of Kings Heath
To ask Her Majesty’s Government what action they will take to promote the needs of deaf people in the provision of public services.
Lord Hunt of Kings Heath (Lab)
My Lords, I am glad to institute this debate on public services for deaf people. I very much welcome the noble Baroness, Lady Jolly, who is going to respond for the Government. I am sure that I speak for the whole House in expressing our best wishes to the noble Earl, Lord Howe.
I am raising this matter because Parliament needs to put much greater focus on the issues facing deaf people and I hope that the debate will be the start of a much more considered engagement in thinking about what kind of services are most appropriate to support deaf people. I do not speak from any particular expertise but my father was a welfare officer for deaf people in Oxford. In fact, he worked for the late Baroness Faithfull when she was director of the first social services department created out of the merger of children’s and welfare services. We have now gone back to that split and I am not entirely convinced that that was a good thing.
My main concern is that the life outcomes for many deaf people are not as good as they ought to be. Public services are not sufficiently focused on deaf people and there is probably a lack of drive within government and an over-reliance on local government without it being given the means to deliver the kind of support that is required. Perhaps I may provide some statistics. It is reckoned that one in six people in the UK are affected by deafness and hearing difficulties; more than 45,000 deaf children live in the UK; and 25,000 deaf people in the UK use British Sign Language as their preferred language Deafness is of course not a learning disability but half of all deaf people have special needs compared to one quarter of non-deaf people; over 50% of deaf people have experienced some form of abuse as children; and one in four deaf people will experience a mental health problem at some point in their lives.
Of all the statistics that I could draw attention to, it is those on educational achievement that are the most important and worrying. In their GCSEs in 2012 just 37% of deaf children achieved five GCSEs at grades A* to C, including English and maths, compared to 69% of children with no identified special educational needs. The attainment of deaf children actually fell in 2012 from nearly 40% in 2011. That is not surprising because there is a direct connection between lack of educational achievement and lack of employment opportunities. Whereas 80% of the non-disabled population are in employment—it may be a bit less than that now—just over 50% of deaf people of working age are in work. An awful lot needs to be done to improve the support given to deaf people.
The National Deaf Children’s Society report Stolen Futures demonstrated the disproportionate effect of public spending cuts on the lives of deaf children. It identified reductions in services across education, health and social care, and said that inconsistent decisions by the Government are setting children up for failure. The society says that to achieve their potential deaf children are dependent on multiple smaller specialist public services such as teachers of the deaf. The children need consistent co-ordinated support from an early age through to adulthood across the public services. Yet in 2012-13 25% of councils said that they planned to reduce one or more of the education, social care and speech and language therapy services for deaf people. What do the Government intend to do about that and the squeeze on resources and support services for deaf people? Will the Minister consider asking Ofsted to inspect specialist educational services for deaf children? Unlike schools and early year providers, apparently these services are subject to no formal scrutiny, despite their vital importance. The Ofsted inspection of SEN services would surely help. What are the Government’s plans to improve the educational outcomes for deaf children?
There are similar issues when it comes to access to health services. This is a challenging problem. An Action on Hearing Loss survey in 2011 found that 35% of deaf and hard of hearing people experienced difficulty communicating with their GP or practice nurse and 24% said they missed appointments because of poor communication, such as not being able to hear staff calling their name. Have the Government thought of having national standards for access to healthcare for deaf and deafblind people? Are there any plans to provide all NHS staff and students with deaf and deafblind awareness training?
That brings me to the question of the British Sign Language and alternative communication methods. I am sure all noble Lords were delighted when, after many years, British Sign Language was officially recognised as a language in its own right. That was a very significant movement which received a lot of all-party support. However, there are only 800 registered sign interpreters in the UK and my understanding, coming back to the health service, is that 70% of British Sign Language users went without an interpreter during visits to A&E in 2010.
There are some solutions to the problems. We need to have more registered sign interpreters and support for family sign language classes. Clearly, if a child who is deaf is to communicate effectively with their parents and families, the whole family needs to have an understanding of sign language. Access to family sign language facilities becomes very much more important. I know that some organisations for the deaf think that having a named Minister responsible for driving a cross-government approach towards supporting British Sign Language would be a major advance. Will the Government consider how they could drive forward a number of initiatives to ensure that, following the decision to recognise British Sign Language, it will be put into practice in a very practical way? Will they make sure that it is used as much as possible, that public services recognise it and that there are enough people, both in family sign language facilities and among qualified interpreters, to provide the kind of support that people need when they come to embrace public services.
Deafness and partial hearing are issues that affect people throughout their lifespan. We need to recognise that many older people have hearing loss. We know that, if their hearing loss is managed effectively, there is a real chance of improving the quality of their lives. However, we know that diagnosis is currently opportunistic and ad hoc. If an adult hearing screening programme could be introduced for everyone over the age of 65, it would deliver long-term savings to the health and social care system. That would enable people to adjust to wearing and looking after hearing aids at a much earlier stage. Early identification and remediation would be much more effective than dealing with some of the issues that now arise from people who lack a diagnosis at the appropriate time.
Other noble Lords who will be speaking in this debate have far more expertise than I have in some of the issues that face deaf people. However, what unites us is an effort to raise in Parliament the question of services for deaf people and I hope that we will continue to do so in the future. I urge the Government to recognise that there is a need for a drive from the centre—from government—due to the diffuse nature of the services and the fact that people are spread around the country, which means that there may not be many people needing a particular service in a particular local authority area. I very much look forward to noble Lords’ contributions and to the noble Baroness’s response.
Baroness Eaton (Con)
My Lords, I thank the noble Lord, Lord Hunt, for bringing this important topic for debate to the House today. It is a matter that can too readily be defined as a health issue. However, as we have already heard, deafness has a profound effect on the life chances and well-being, and not just the health, of those suffering from the condition.
I speak from very limited experience but I now have a two year-old grand-daughter who has an as yet unknown level of impairment. As a family, we have seen some of the initial difficulties for her and are experiencing the challenges facing a family in understanding the issues and how we might learn to develop ways of helping her.
With almost one in six of our population living with such an impairment, I am pleased to see the Government taking action on the matter with the development of the national action plan on hearing loss. They are working with NHS England and Public Health England, and engaging with organisations that specialise in this to develop a pathway in this important and growing issue.
However, as a resident of Bradford and a member of the city council, it is deeply concerning to me that the rate of deafness among our children, at 2.3 per 1,000 children, is double the national average of one per 1,000 children. The number of active cases known to the service for deaf children in Bradford between 2012 and 2013 stands at 678, of whom 76 are classified as being profoundly deaf—that is, entirely deaf. Of the 678 children in Bradford who have a hearing impairment, 548 are in mainstream schools and an additional 89 are in schools with additionally resourced centres attached. A further 41 children are in specialist schools, not necessarily as a result of a hearing impairment.
Also of concern is the fact that this is a particular issue for our city’s Asian population. It is encouraging to see the steps being taken by our schools and authorities to allow our deaf children to benefit from a full and satisfying education.
Working with the University of Leeds, the teachers of the deaf service in Bradford are researching the development of language and literacy in multilingual and multicultural families. With a staff of more than 60 personnel, the service is able to provide specialist assistance to multilingual households with everything from full-time teaching to liaising with parents and providing speech and language therapy. It is worth noting that, of the families working with this service, 67 do not speak English but communicate with their children with hearing impairments by using sign language. Understanding the language barriers and working around them will be key to ensuring that these children have the best possible chance to advance just as other children do.
There is a protocol of transition from children’s social care to the sensory needs service in adults’ services. This will provide a specialist service to young people who are over 14 years old and are British Sign Language users. This service will routinely attend all the education reviews of these young people in order to provide advice and information. By doing so, it is hoped that the transition from children’s educational services to adult services will run more smoothly.
The noble Lord, Lord Hunt, has already mentioned the underachievement of deaf children. Certainly, the survey by the National Deaf Children’s Society showed that deaf children in Yorkshire suffered huge disadvantages in terms of GCSE grades. It is therefore concerning to note that among those qualified as specialist teachers for the deaf, the average age is now over 50, something that is sure to create a greater problem in years to come and to impact on the education of children with hearing impairment.
Responses to a DCMS seminar paper addressed the wishes of those within our society who are deaf, stating that it is far preferred that an inclusive manner in services and policies be adopted rather than an exception-based rule. This means that the mainstream should, indeed must, wherever possible, cater for the community as a whole and not simply the majority for whom hearing is not yet a problem.
An issue that frustrates those who are hearing-impaired is the general lack of knowledge, understanding and training around the issue. The Guardian newspaper published an article on 10 May highlighting the issues that deaf members of society face. In one case, a deaf patient at a hospital was unable to communicate with his doctors, nurses or those around him for 12 days because no sign language interpreter was provided.
Action on Hearing Loss published a policy statement entitled Access to Services for People with Hearing Loss in June 2012, directly addressing the issue of contacting services. They observed that people with hearing loss face very basic but fundamental hurdles when contacting organisations that only provide telephone numbers in their contact information and highlighted their awareness of the fact that staff simply hang up regularly on text relay telephone calls because the operator does not understand how to use the technology.
Further on the lack of the use of appropriate technology, the Lancet published an editorial in March 2012 highlighting the issue of deaf people physically having to go into GP surgeries in order to make an appointment, due to the lack of provision of e-mail and text software. This is something that may not be too much of a difficulty for a younger person, but for those who are ageing it becomes a real issue and something that could be solved very easily by implementation of basic technology and training of staff to understand what considerations or differences should be considered when assisting someone who does not have full hearing capacity. Aside from this, it is surely to be hoped, or rather expected, that those within our society who cannot communicate in the same ways as the majority of the population be afforded the same basic services. Access is one of the biggest barriers to deaf adults. This includes all areas of life where there is a need for communication.
In my own authority, Bradford, there has been a vast improvement in accessibility for deaf people. Deaf people now have representation on the Strategic Disability Partnership, providing a forum for full engagement, as representatives on this forum feed information from the deaf community into the partnership. There are BSL and subtitled theatre performances, opening up the world of entertainment to deaf people. Hearing loops are provided to give access to those who are hard of hearing. Representatives from the Deaf and Hard of Hearing Group sit on the Bradford theatres users’ group and have been influential in generating improvements to services. Our museums have BSL videos that provide detailed information about exhibits. Our libraries have full internet access, enabling deaf people to access online information. Excellent work has been done with the police service, which now provides much improved access to communication, particularly in areas such as hate crime. Adults’ services include statutory assessment and support services where staff work in inspirational ways to support service users. An example of this is an individual budget to purchase care where the worker can communicate in BSL and has an understanding of deaf culture and community. There is also a technical service, which provides flashing or loud doorbells so that older people are not put at risk by leaving the door open or not being able to hear when the home care worker calls.
While there have been great strides in improving access for the deaf to services in many areas, there is still much room for improvement. There is a high correlation between sight and hearing loss and learning disability, which needs much greater research and provision. Video-conferencing services enable deaf people to have BSL interpreting via a web link. Skype is being tested but the quality needs improving. Participation for deaf people in CCG user forums would greatly help the deaf.
Despite improved access to communication and information, social isolation and exclusion continue to be major factors for deaf and hard-of-hearing people. Work towards more integrated pathways, with transitions between education and children and adult services, is vital, and must be part of plans for service development. Local government, working with the local community and other appropriate organisations, often are best placed to develop services suited to the needs of service users who have special requirements. Legislation often can be too prescriptive and can prevent flexibility and creativity.
Baroness Brinton (LD)
My Lords, I congratulate the noble Lord, Lord Hunt, on securing this debate. I also have an interest in this topic. For 10 years, I was chair of governors of Mayfield primary school in Cambridge, which has the hearing impaired unit for the southern half of Cambridgeshire. My sister is a BSL interpreter at a university and I have deaf friends. I am proud to say that the Liberal Democrats passed some policy at a key debate at the recent conference in Glasgow. We are committed to the principle that deaf people are entitled to identify with their own language and to have this respected, regardless of minority or majority language status. We also want to see better awareness of information needs and services for BSL users, particularly in health, education and employment, as has been outlined by the two previous speakers.
In the time available, it is impossible to cover everything, so I shall focus specifically on education and family services. All children at Mayfield, whether they have hearing or are hearing impaired, learnt all songs for assembly both in sign language and singing. My adult daughter still remembers some of it. Children in the hearing-impaired unit were fully integrated into class with their hearing contemporaries, while also becoming fluent in British Sign Language and lip reading—but that is really for the second part of my speech, about the education of children with hearing impairment.
Research shows that early communication within the family is the strongest influence on language development at the age of two. However, if a deaf child needs to communicate in sign language, many hearing parents may struggle to communicate with their child because they have no knowledge of deafness or sign language. Many families who need to use sign language with their child are not getting the services that they need. Often, they are forced to pay hundreds of pounds just to learn to communicate with their own child. In several Scandinavian countries, that service is provided automatically and free of charge to all parents of deaf children.
It is good that the Department for Education is funding the I-Sign consortium to improve the availability of sign language courses to families. The work of the consortium has been recognised by even the Prime Minister as a success. One family commented:
“It is not always easy having a deaf child in the family and the opportunity like this course helps us to be positive about deafness and reflect on different ways of communication with a deaf child, this course has made a huge difference to the family”.
However, in 2011, a telephone survey by the National Deaf Children’s Society revealed that 56% of local authorities surveyed did not provide any support to families wanting to learn sign language, nor did they provide the society with any information. The support provided by other local authorities varied considerably and it is clear that not all families can rely on ready access to family-friendly sign language classes. What further steps will the Government take to ensure that families get the support that they need to promote early years communication for deaf children? Given how important that is, is there some scope for considering following the example of Scandinavia and placing a duty on local authorities to provide that support?
On education, many deaf children rely on support from their local education service. This support is often provided in the form of a teacher for the deaf who might support families in the home with early language and communication, visit deaf children in mainstream schools, support deaf children directly and/or advise mainstream teachers on how to adapt the curriculum and use technology effectively, or contribute to specialist assessments of deaf children and intervene to promote good outcomes. There is real concern that these services are being severely undermined by public spending cuts. The department repeatedly tells us that it has protected funding for the most vulnerable learners, but, as has already been mentioned, the NDCS’s Stolen Futures campaign has established, through a freedom of information request to all local authorities, that 29% of authorities plan to cut specialist education for deaf children this year. A further 28% are at risk of cutting services, or undertaking a review of them. These cuts are having a critical impact on deaf children.
The Government say that local communities should hold authorities to account and suggests that the Children and Families Bill will enable families to do this. Surely this is complacent. The NDCS has found that many local authorities do not disclose information nor involve parents in decisions about spending cuts. As currently drafted, the Bill will not directly improve accountability in this area, not least because it does not require local authorities to disclose expenditure on SEN support services as part of the local offer. How will the department ensure that its SEN reforms can be successfully implemented in the absence of any action to ensure SEN funding is adequate and not being squeezed out by other funding pressures?
I, too, am very concerned about a shortage of teachers for the deaf across the UK. Anecdotal evidence from services suggests that it is becoming increasingly difficult to recruit to vacant posts. Some of the detail has been outlined earlier, but I ask the Minister whether the department has carried out any assessment of the teacher for the deaf population. Is there a need for a national recruitment process? While I welcome the local offer outlined in the Children and Families Bill, I am concerned that it does not go far enough in recognising the importance of specialist education support for deaf children and other children with sensory impairments. The NDCS, RNIB and Sense are all calling on the department to make improvements to the Bill before Committee.
The key issues are also relevant to this debate. There is no explicit requirement to publish information about the local offer and neither is that offer published by type of need: local authorities only have to provide generic information about special educational needs. It is also not clear that the local offer will follow a set format. That can be difficult for parents trying to compare provision in different areas. The also local offer needs to be underpinned by a minimum provision. Too many children with a sensory impairment are being denied the support they need, at a considerable cost to families. The department argues that minimum standards would lead to a race to the bottom and stifle the development of local offers. Surely the opposite is true: in the absence of any expectation on minimum provision, local authorities with better provision will reduce it in line with poorer neighbouring provision. Can the Minister provide explicit reassurance that local authorities must include information about specialist support services for deaf children in their local offers? Will the department establish clear expectations for minimum provision to be included in the local offer, in line with a call for action on this from the Education Select Committee?
Finally, on an important note that I have not yet heard covered, outside the range of education, what are the Government doing to develop a vaccine against cytomegalovirus, one of the main causes of congenital deafness and blindness? Some 50% of the population are estimated to be carriers, but it is only dangerous if contracted in pregnancy and transferred to the foetus. The medical advice that a mother carrying the virus should not touch anything—including her other children—that might mean she contracts the virus is, frankly, ridiculous. If there were a vaccine for this virus, it would be targeted at a very specific group: mothers and women planning to be mothers. Surely, with such a small target group, it is worth doing in order to prevent the dreadful congenital deafness and blindness that some children have when they are born having suffered from this virus.
In conclusion, services for deaf children and their families have some strengths, but there are a number of worries that could affect these children, now and in their future lives.
Baroness Howe of Idlicote (CB)
My Lords, I, too, thank the noble Lord, Lord Hunt, for introducing this important mini-debate, and particularly commend his comment that the older you get, the more likely you are to have problems. As we all know, we are all getting older. Therefore, this is definitely an issue that has to be tackled.
In my case, my hardness of hearing began when I had children. I think that that was inherited, too. Over the years, it has got to the point where there is no further help other than good amplifiers, such as we have in this Chamber. Indeed, I was perhaps one of the victims of an early mistake, which in those days was called mobilisation of the stapes. That also happened to me, and that one is my really deaf ear.
Today, I should like to speak first about the importance of health services for deaf children and young people and, secondly, about support for their families with communication.
I start by highlighting the importance of the newborn hearing screening programme. Many regard that programme as one of the major health successes of the past decade. Prior to that programme, many children born deaf were not diagnosed until as late as three and four years old. Such late diagnosis does significant damage to the deaf child’s language and communication skills and, obviously, to their future prospects. Early diagnosis provides the opportunity to put in place a central support as soon as possible, so that deaf children can achieve their full potential. The National Deaf Children’s Society is clear that that has led to improved outcomes for deaf children already.
It is therefore important that we continue to maintain that programme at the highest possible level and standard. What steps has the Department of Health taken to monitor and protect that service in the context of the Health and Social Care Act and significant changes to health services? Is the department monitoring whether the programme continues to be adequately funded and whether, when their children have been diagnosed as deaf, parents continue to experience a joined-up service between public health and the NHS? Will the existing quality assurance programme continue to include both diagnosis and follow-up interventions in audiology services, the latter being as critical as the former? It is vital that we do not take our eyes off the ball and let the service wither away, so I would welcome the Minister’s assurance on that point. If the noble Baroness, Lady Jolly, cannot give us a response today, perhaps she will see that someone from the department writes to me.
I also highlight the need for health services to be more accessible to deaf young people. The National Deaf Children’s Society’s youth advisory board spent the past year working on a new campaign to improve deaf awareness in health professionals. I understand that it hopes to launch that campaign, called “My life, my health”, early next year. Deaf young people have provided NDCS with numerous examples of poor practice. We have heard of some already. One deaf girl had missed several appointments at her GP because she is unable to hear her name being called. She has now, ironically, been given a final warning not to miss any more appointments. Another deaf person aged 18 no longer wants to rely on her family to access information. She told NDCS:
“My family and friends are fed up with coming with me to help with my communication support”,
but until and unless action is taken to ensure that this information is given in an accessible way, she will continue to be unable to access appointments independently.
Many will be appalled by both of those examples and the continuing existence of poor practice in delivery of health services to deaf children and young people. Do the Government agree that action is needed to promote deaf awareness among health practitioners as well as the provision of accessible information? Maybe the noble Baroness, Lady Jolly, will urge the Government to support this campaign and its aims.
Finally, I would like to highlight the importance of communications support to families with deaf children. I have tabled an amendment to the Children and Families Bill that would require local authorities to ensure that there is sufficient provision of sign language courses to families with deaf children. There is widespread concern that the current provision is far from sufficient or adequate.
Children cannot develop effective language skills if their families cannot communicate with them. This communication support is vital for the social development as well as the educational development of deaf children. However, where sign language is the best option for the child, too many families are being forced to pay huge sums to learn sign language to be able to communicate at all with their own child.
I am aware that the Department for Education has funded various projects to address these concerns. This funding is certainly welcome and appreciated. Is this leading, however, to the step change in sign language provision that we need? I question whether local authorities truly appreciate and understand all the needs of deaf children.
There needs to be a much stronger expectation on local authorities that support on sign language will be provided to families if they need it. We would now regard it as unacceptable if local authorities did not provide short breaks for families with disabled children. Many believe that the Government need to act to make it equally unacceptable for local authorities not to provide support for families wishing to learn sign language.
I hope that the Government will give my amendment to the Children and Families Bill the strongest consideration when it comes for debate before the House. I look forward very much to hearing what the noble Baroness, Lady Jolly, says in her reply.
Lord Rogan (UUP)
My Lords, I, too, thank the noble Lord, Lord Hunt of Kings Heath, for initiating this important debate. In our modern society we excel when it comes to discussing rights, but my experience is that we are usually better at discussing them than doing anything about them.
In this media-driven era, there is a natural temptation and pressure upon government and its agencies to satisfy the rights of those who are most adept at securing air time, and media interest, rather than the rights of those who are most in need. Deafness is nothing new. It is clearly an issue which affects a significant number of people. In Northern Ireland alone, there are more than 200,000 people who are deaf or hard of hearing. That is 15% of people living in Northern Ireland; a significant proportion of the population—and no doubt a rising proportion, given the increasing numbers of people who are living well into old age. I find it perplexing, therefore, given the scale of the issue and society’s familiarity with it, that we seem to fail so miserably at even the basics of providing adequate access to public services, let alone equality of access.
Access to the health services is a special area of concern. As has been mentioned twice, it is particularly disappointing to note that deaf charities in Northern Ireland have raised instances of deaf people being left in the waiting room of audiology clinics because their name was called out. Their name was called out verbally, even after staff had been notified that they were deaf. It is daft.
In 2009 the British Deaf Association in Northern Ireland and the RNID contacted GP practices throughout the Province to ask them about hearing, blind or partially sighted issues. Some of the results were rather concerning. Half of the GP practices were yet to provide any training to staff about deaf, visual, or general disability awareness. Only 15% of GPs had had disability training. Half of all the responding practices also said that, although they had induction loops in their waiting rooms, only 16% had loops in consulting rooms.
Getting an appointment to get to the surgery, however, also seemed unnecessarily difficult, with a general lack of provision to make contact or arrange appointments by e-mail. Deaf people also complained that GP practices and hospitals often did not respond to calls to their minicom system or to faxes. Out-of-hours and emergency access seemed even more problematic, as did the ability to book interpreters. All these issues create a reliance on friends and family, which in turn undermines independence and leads to feelings of isolation and even despair.
The charities have suggested that this collectively points to a lack of general awareness, understanding and insight concerning the needs, circumstances and experiences of people with disabilities. It would also appear that there is an inadequate grasp of the legal obligations placed on public service providers by the Disability Discrimination Act. While access to health services is of most concern, the complaint applies across the board, from jobcentres, benefits offices and leisure facilities to issues such as interpreters for deaf parents at teacher/parent meetings, school correspondence, emergency telephones on the motorway, arts and cultural events—indeed, the entire spectrum of life in a modern welfare society
As the British Deaf Association in Northern Ireland put it, deaf people are currently not afforded access to public services on, or even near, a par with hearing people. Deaf people simply want to be included in everyday society and given the opportunity to make decisions and choices for themselves. Surely it is incumbent upon our Government to play their part to facilitate that process and to ensure that deaf awareness is given greater focus.
Baroness Wilkins (Lab)
My Lords, I congratulate my noble friend Lord Hunt of Kings Heath on securing today’s debate on the needs of deaf people in the provision of public services. Parliament is currently giving a flurry of attention to the needs of deaf people. Let us hope that this results in some strong, positive action and that it will achieve real gains. It is so vitally necessary. I am afraid it is inevitable that I will repeat many of the points that have already been made, largely as a result of the excellent briefing given to us by the National Deaf Children’s Society, but I hope that that will only serve to persuade the Minister to respond positively.
Last week Sir Malcolm Bruce, the right honourable Member for Gordon and chair of the All-Party Group on Deafness, led a debate in the other place asking for recognition of the importance of services for deaf children and young people. This followed a petition, signed by more than 50,000 people, calling on the Government to protect the funding for these vital services. Happily, his Motion was accepted, and I hope that this debate will send the same strong signal—that we should protect services for deaf children and young people.
Yesterday in this House we started the scrutiny in Grand Committee of Part 3 of the Children and Families Bill, which deals with special education. The needs of deaf children and young people will be highlighted by a number of the amendments that I and others have tabled. There needs to be considerable movement by the Government if the support for deaf children and young people is to improve. For instance, the Bill currently relies on parents to police the SEN system but does not provide them with any substantive new rights to hold local authorities to account.
It is on the services for deaf children and young people that I will be focusing today. As we have heard, it is of great concern to us that, according to government figures, only 37% of deaf children achieved five good GCSEs last year compared with 69% of children with no identified SEN. Thirty-seven per cent is a dismal and unacceptably low figure—it is shameful. I acknowledge that improvements have been made in this area over the past five years but, when we consider that deafness is not in itself a learning disability, it remains outrageous that the gap between deaf children and other children is still so wide. There is no reason why the majority of deaf children should not achieve the same as other children, provided that they get the right specialist support. But too many deaf children are not getting the specialist support they need.
Worse still, according to evidence collated by the National Deaf Children’s Society, that support is now being cut in many areas. As we have already heard, freedom of information requests to all the local authorities in England have established that 29% of them plan to cut specialist education services for deaf children this year. A further 25% are either at risk of cutting or undertaking a review of their service and these cuts are happening despite the commitment from the Department for Education that it has protected funding for vulnerable learners.
Surely there is more that the department can do to ensure that local authorities do deliver high-quality services and are held to account when they fail to do so. One such action would be to require Ofsted to begin inspecting these vital services for deaf children. When we consider how much scrutiny mainstream teachers and schools are subject to by Ofsted, it is shocking that teachers of the deaf in specialist support services are subject to virtually none. That can only send a signal that deaf education is less important.
When we consider all the competing pressures that local authorities face, it is hardly surprising that the lack of external scrutiny makes it even easier for local authorities to cut services. A sharper eye of scrutiny would also incentivise local authorities to improve services that are inadequate. I am very pleased to see that the noble Baroness, Lady Brinton, has tabled an amendment to the Children and Families Bill which will address this. I strongly support the amendment and I hope that the Government will give it their strongest possible consideration.
Separately, I am concerned that we need to do more about the recruitment of teachers of the deaf. Teachers of the deaf undergo two years of additional training to gain a mandatory qualification in teaching deaf children. Their important role has been recognised in the new draft SEN code of practice. However, we are recruiting far too few teachers of the deaf if deaf children in the future are to get the support they need. Evidence suggests that around 80% of these teachers are over the age of 50 and, in addition, the number of training departments appears to be reducing. There is also anecdotal evidence that in some areas services are already having to rely on teaching assistants to do the job that would otherwise be done by teachers of the deaf. What steps have the Government taken to assess how many teachers need to be trained as teachers of the deaf to meet future demand and what action is being taken to ensure that they are in place? Does the Minister agree that there needs to be a national recruitment programme?
In last week’s debate, the Children’s Minister referred to the national scholarship fund for teachers’ postgraduate training, which is available to people wishing to train as teachers of the deaf. That is a welcome first step. How many people are currently using this fund to train as teachers of the deaf? Can the Minister reassure me that this fund will be expanded to meet future needs? It is vital that we take action now to ensure that there is an adequate number of teachers of the deaf before it is too late.
I have discussed just two of the areas where action needs to be taken to improve public services for deaf children. I strongly support the points raised by other noble Lords and hope that the Minister will do all she can to persuade the Government to take urgent action. The needs of deaf people have been sidelined for far too long.
Baroness Jolly (LD)
My Lords, this has been an excellent debate. It has been wide-ranging and based on experience and expertise, with many recurring themes. I promise that I will be positive where I can be.
The Government recognise the scale of the issue. One in every 700 babies in England is born with some form of deafness and there are just under 10 million adults living with hearing loss. All these people will, at some point, be in contact with public services. In fact, we know that there are 35,000 children and 1.6 million adults with hearing loss being managed and supported across health and other public sector services. It is therefore absolutely vital that these public services are geared up to support their needs.
The public sector equality duty means that public bodies must have regard to the need to eliminate discrimination and to advance equality of opportunity when making policies and delivering services. Public bodies must make reasonable adjustments for disabled people to ensure that they can use a service that is as close as reasonably possible to the standard usually offered to everyone. I would like to take your Lordships through some detail on how different areas of the public sector are addressing this very important issue.
First, on health and social care, we know that there is a need to improve in the commissioning and integration of health and social care services for people with hearing loss, as well as in the provision of new and innovative models of care. This is why we are looking to develop a new action plan on hearing loss. The action plan will identify the key actions that will make a difference in improving health and social care outcomes for children, young people and adults with hearing loss. The Department of Health is currently engaging with a range of organisations, and aims to publish the action plan as soon as possible.
The new health and social care structures provide the framework to improve access to services and outcomes at a local level. The national adult social care, public health and NHS outcomes frameworks enable us to hold services to account for how they are tackling health inequalities and improving health and well-being. NHS England is developing an information standard around the provision of accessible information and communication support to disabled patients, carers and service users. It is intended to be finalised in late 2014, with organisations being required to comply in 2015. Once implemented, the standard will ensure that disabled patients, service users and carers receive information from NHS bodies and providers of NHS care in formats that they can understand, and that they receive appropriate support to enable them to communicate. All this should help people when they visit their GP. Certainly, at my GP practice, a name comes up: for example, “Jolly to go to room 4”. This is not rocket science. Plenty of practices do it.
The health service has already delivered considerable improvements in services, including reduced waits for the assessment and treatment of hearing problems in adults. Most patients on direct access audiology pathways are now treated within 18 weeks. There is greater choice of hearing aid services through independent high street providers and the new “any qualified provider” model, which offers even greater choice and convenience. We have rolled out a system of voluntary accreditation of hearing service providers to drive up service quality and introduced a payment-by-results tariff for hearing services, which should lead to service innovation.
The noble Lord, Lord Hunt, asked about plans to provide NHS staff with awareness training. What I have just outlined certainly covers that; NHS England will publish guidance on making reasonable adjustments to meet the communication needs of service users. That is expected next year. All NHS staff should have disability awareness training, and within that must come British Sign Language. The noble Lord also asked about annual screenings for over-65s on hearing loss. There are no plans at the moment to introduce such screening, but everyone in that age group should be invited for an annual health check that offers the opportunity to address such problems as hearing and vision, as well as other key health issues.
It is of course not just about assessing and treating deafness. My noble friend Lady Brinton asked what the Government are doing to develop a vaccine against cytomegalovirus. While there are currently no licensed vaccines, possible vaccinations are still being researched. She will appreciate the stringent safety checks that all new medicines and vaccines have to go through, so it will be several years before any vaccine becomes available.
In services for children and young people, we are taking forward measures to support children with sensory impairments, including giving parents in England the opportunity to have their babies’ hearing tested shortly after birth as part of the NHS newborn hearing screening programme. There will also be a more joined-up approach to assessments, which gives clarity on responsibility across the areas of education, health and social care services and a commitment from all of them to provide their services.
To answer the question asked by the noble Lord, Lord Hunt, new school inspection arrangements mean that inspections of schools with resourced provision or specialist units for pupils with sensory impairments are assessed by inspectors with the necessary specialist advice. We are committed to improving the training of teachers and school leaders to help them identify where pupils with hearing loss face barriers to learning and offer the appropriate support. The Department for Education is funding the development of an early support guide for parents of deaf children and giving money to support I-Sign, hosted by the National Deaf Children's Society. This should develop access to sign language for families and education professionals.
My noble friend Lady Brinton made the point about I-Sign not being consistently employed and asked whether we should place a duty on local authorities to provide this support, as they do in some Scandinavian countries. The Children and Families Bill already places duties on local authorities to identify, assess and secure special educational provision for all children and young people with special educational needs. This could include sign language support for those who need it.
My noble friend made a number of additional points on the issue of specialist education support services for deaf children being hit by cuts. We can confirm that we have protected the resources available for SEN provision, including support for deaf children. The Children and Families Bill will include a new duty on local authorities to require them, with their partners, to publish a local offer of services available to families of children with SEN and disabilities.
On the issue of whether we need a national recruitment campaign for qualified deaf teachers, or for teachers to qualify for teaching the deaf, the National Scholarship Fund is available through the Department for Education and provides funding of up to £3,500 for teachers’ postgraduate qualifications and their training, including specialist training for teachers of the deaf. Funding of £2,000 is available to support teaching assistants and support staff to improve their skills. Indeed, 600 teachers have achieved or are working towards a qualification related to special educational needs and a further 500 have applied for the current funding round.
To answer the point made by the noble Lord, Lord Hunt, about the attainment gap, we have ensured that funding is protected. In 2011-12, 71% of deaf children achieved five or more A to C grades in their GCSE, compared with 43% in 2007-08. Over this period, deaf pupils progressed at approximately twice the rate of their peers, closing the attainment gap significantly. This is not to say that we are complacent, but there has been progress. The Government recognise the importance of deaf people being supported and enabled to communicate through BSL where they wish to do so. Schools can offer BSL programmes to pupils with a range of vocationally related BSL and other signing media qualifications, from a simple awareness certificate up to more advanced levels, and there is work to develop a GCSE programme in BSL.
However, it is not just in the areas of health, social care and education where good work is going on. Work is going on across the Government to support the needs of deaf people. We have heard from my noble friend Lady Eaton about the sort of work that has been going on in Bradford.
We have had a few examples of where great progress is being made. Good work is being done to make services more accessible for people with hearing loss across the criminal justice system, welfare, higher education and many other parts of the public sector. I pay tribute to the work of the voluntary sector. We have heard today about organisations such as Action on Hearing Loss, Signature and the National Deaf Children’s Society, which campaign tirelessly to ensure that the needs of deaf people are not forgotten and, in many instances, work alongside the Government to help us develop our policies and ensure that those policies are put into practice.
I hope that in the time allowed I have provided reassurance of the Government’s continued commitment. I will write to noble Lords to answer those questions that have not been covered, and I am more than happy to meet noble Lords to discuss these issues and to see whether we can progress them further.