Lord Borwick
Main Page: Lord Borwick (Conservative - Excepted Hereditary)
Lord Borwick (Con)
My Lords, I am grateful to the noble Lord, Lord Ponsonby, for bringing this matter to debate following the SignHealth report.
I must, first, declare an interest. For about the past 25 years, I have been a trustee of the Ewing Foundation for deaf children, a charity that has, for the past 60 years, helped to improve the teaching of children who use their residual hearing and lip reading to communicate by speech.
The change in the prospects and outcomes for deaf children due to the introduction of cochlear implants, digital hearing aids and newborn hearing screening is one of the most exciting stories in disability. Noble Lords may have seen the publicity in the papers on Friday, or even the YouTube film, of the joy of a deaf girl of 40 hearing for the first time when her cochlear implants were turned on. For the first time, she can hear music, the laughter of babies and the songs of birds. This revolution has come from cochlear implants, which will radically reduce the disabling effects of profound deafness in children and adults.
The Sick of It report is important and interesting, but I am afraid that it gives away its self-selected background. A statistic on the page about communication issues claims that 80% of deaf people want to communicate using British Sign Language. The noble Lord suggested that that figure was 93%, but I think it is the definition of “deaf” that accounts for the difference. That statistic is a conundrum to me, in that the vast majority of deaf people, using a more ordinary definition of the word, are elderly people who do not use British Sign Language. Indeed, the CRIDE report said that 79% of deaf children use only spoken English. It may be that the definition of deaf depends on who is hearing it.
A strong part of good communication is literacy. Unfortunately, communicating through sign language while learning to read and write in English is like talking in English and reading and writing in Chinese. I am filled with admiration for all the children who can do it. Noble Lords may have strong opinions about whether tweeting and texting can really be described as literature but they are fundamental to the lives of many teenagers nowadays. There is some great technology coming forward. The Apple digital assistant, Siri, and many other programs can transcribe your questions, and a doctor’s replies can be sent from an iPad to a simultaneous remote caption service. All these new technologies need literacy.
The theme of the report is that good communication is fundamental to good health, and that makes sense, but it is true not only of deaf patients; communication with all patients can be made better.
Another feature of the report is isolation, and deafness is very isolating. Research has shown that in old age the combination of cognitive decline and hearing loss can be fatal. Hearing loss seems to speed up dementia, so perhaps hearing loss in older patients should be treated more aggressively when it is first diagnosed, and deaf awareness training given to more health professionals.
Time after time, surveys suggest that there is a correlation between good health and good education, so the most powerful advantage to the health of deaf people is to make sure that they get a great education. Profoundly deaf children now, thanks to cochlear implants, can be educated primarily in mainstream schools, with hearing friends and ordinary prospects for the future.
But cochlear implants are expensive, although not so much in their implantation, which, like everything electronic, is improving technically and reducing in price. The real cost comes in training the baby or the child who needs to get the most out of their implant. However, this is so much cheaper than a lifetime of interpreters. I must compliment all parties for getting on with the cochlear implant programme and not stinting on this project. Ten thousand people have had cochlear implants so far. That is a marvellous achievement and it is changing society. There are now only a very small number of children below the age of five who use sign language, and BSL may be regarded in the future as being used by fewer and fewer deaf people. Who knows what will happen? Many other skills have been superseded by technology. We will have to do our best to support those who continue to use sign language but they will gradually become a tiny minority of deaf people.
Some 40% of deaf children have disabilities in addition to hearing loss. Deafness and autism or deaf and blind with a learning disability are combinations that are becoming more common, partly as a function of doctors saving extremely premature babies who in past years would have died. These babies can now survive at 22 weeks’ gestation, but with multiple problems. Some parents are better than others at caring for a child with challenging behaviour who may never live independently but, sadly, some children are effectively abandoned by their parents to the state—a sad future for a child following heroic efforts to save an extremely short pregnancy.
I have two questions for the Minister. The first concerns the reducing number, and increasing age profile, of qualified teachers of the deaf. The report stresses the importance of good health education for deaf people. Deaf children and young people need to be equipped with information and strategies to access health services independently as adults. To achieve that, we will need more teachers of the deaf. How can we get them?
The noble Baroness was asked a very similar question in a debate last October by my noble friend Lady Brinton, and she replied with information about the national scholarship fund. How many teachers have applied for, and how many have been granted, help from this fund to train as teachers of the deaf? It appears that this fund is not working well enough to solve the problem, so what else can be done to encourage more teachers to work in this specialist area?
Secondly, can we increase the amount of communication in our health service that is duplicated both verbally and by text? It is far cheaper to have a text system of booking appointments than an interpreter, and that expenditure will benefit not only deaf patients but all patients who can read and write in English.