Community Audiology Debate
Full Debate: Read Full DebateDanny Chambers
Main Page: Danny Chambers (Liberal Democrat - Winchester)Department Debates - View all Danny Chambers's debates with the Department of Health and Social Care
(1 day, 11 hours ago)
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Dr Danny Chambers (Winchester) (LD)
It is a pleasure to serve under your chairship, Mr Vickers. This is an important debate, secured by the hon. Member for Uxbridge and South Ruislip (Danny Beales), but it is quite something to have to follow an eminent and experienced ENT surgeon, the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley), when speaking about hearing and hearing loss—especially as I am just a rudimentary vet.
It is quite common that people bring in a dog that they assume has hearing loss because it can no longer hear its name being called in the park, yet for some reason it can still hear a treat packet or a fridge being opened in another room. On comparative anatomy, the hon. Member for Bury St Edmunds and Stowmarket may be interested to hear that one reason why up to 20% of a caseload in a day of treating small animals can be on ear-related issues is that in humans the ear canal goes straight to the eardrum whereas in dogs it bends around 90° before it gets to the eardrum. Around that corner it is often quite warm and moist, and a lot of bacteria and yeast grow in those conditions.
Peter Prinsley
I am very interested in the story of dogs and the shape of a dog’s ear canal; that is such a helpful explanation. I was often brought dogs, particularly spaniels with big floppy ears, who had ear infections and blockages, and I was always puzzled why it was that the dogs got into such difficulties. The hon. Gentleman’s explanation of the right angle at the bottom of the ear canal is so helpful and I thank him for it.
Dr Chambers
I am honoured to have educated an ENT surgeon. Spaniels do have worse ear problems, given that there is a lack of airflow, and one thing that vets can get experienced at is taking a swab so that we are not using unnecessary antibiotics or inappropriate antibiotics. With a bit of experience, it is fairly easy to smell the difference between Malassezia yeast, pseudomonas bacterial infection or streptococcus intermedius—to anyone who thinks being a vet is glamorous, I say, “Spend a day sniffing ears to determine what type of microbes are down there, and it will change your mind.”
It is very interesting that many Members spoke today about the impact of hearing loss on dementia. We know that dementia is multifactorial—there is no single cause—but certainly my father had hearing loss for a long time, and he developed dementia. Hearing loss certainly affected his quality of life, dementia aside. He lost the confidence to go out to socialise and barely left the farm unless he had to. We are pretty sure that a significant factor in that was that he felt he could not hear what other people were saying. He could not perform business at the market as he used to, because markets are very noisy places.
The Father of the House touched on the fact that one in three adults have either deafness, tinnitus or some other type of hearing issue. What surprised me was that only 38% of people who suspect that they have hearing loss themselves have contacted a professional about it. I read that stat and was quite surprised, but I then realised that for years my partner Emma and other family members have often said, “Why do you have the TV so loud?”. I have also often noticed in a pub everyone else is talking, and I find it really hard to hear the conversation over any external noise, yet I have never gone along and had a hearing test. Quite clearly, I do not hear as well as everyone else in my vicinity, so I should probably get one. That could be a new year’s resolution for me—to go and work out whether I actually have some kind of hearing issues as well.
I also note the weight given to the importance of community audiology, especially when such a high percentage of hearing loss is age-related. Those people have no need to go to a hospital to get the initial assessment, and community audiology could free up hospital time for children and other people with more acute hearing issues that need to be investigated. Audiology is one of the worst performing diagnostic services in the NHS for speed of assessment, with 40% of patients waiting more than six weeks simply for the initial assessment. That is one reason respondents to the British and Irish Hearing Instrument Manufacturers Association are advocating for open self-referral and expanded community clinics simply to minimise those delays. Delivering audiology services in the community costs 15 to 20% less than from a hospital, so it is an economically sensible model as well.
We often call for more community-based services for a whole variety of medical issues to keep costs down. It should be the default for most people with age-related hearing loss. We also urge the Government to consider trialling hearing tests as part of routine health checks for people over 70 and at-risk groups and to investigate how best to support everyone, from GP surgeries to high street pharmacists and opticians, to deliver free earwax removal. They are already being successfully run by some GP practices with positive impacts on health outcomes, and the cost can be small, especially where GPs co-ordinate to pay for a service that covers a large area.
The hon. Gentleman makes a good point that we often hear about national screening programmes. It has just occurred to me that if everybody over the age of 70 was sent a text message through the NHS, summoning them into a screening programme, we could make huge advances in this area, particularly with things such as dementia—because, as he made clear, many people are either embarrassed by hearing loss, or not aware that they have it.
Dr Chambers
I completely agree. As we approach the busiest and loudest time of the year and every shop and pub has music playing, which is fun for most people, it is a good time to urge people to go for a hearing test in the new year, as I will be doing. We urge the Government to look at supporting community-based services so that everyone can get the hearing assessment they need. People need information to be able to act, and if someone does not know their hearing status, they will not know what other problems they will be dealing with in the future.