Health: Deaf People

Lord Hunt of Kings Heath Excerpts

Monday 31st March 2014 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very grateful to my noble friend Lord Ponsonby for his initiative and his excellent speech. I declare my interest as chair of an NHS foundation trust, a consultant and trainer with Cumberlege Connections and president of GS1.

Parliamentary debates about the quality of public services to deaf people are all too infrequent. Therefore, like the noble Baroness, Lady Howe, I welcome the opportunity to put that right tonight. As noble Lords have said, it is particularly opportune because of the publication on 25 March of this excellent report by the deaf health charity SignHealth. I was very privileged to speak at the conference held on 25 March to launch the report.

As my noble friend said, the report makes very sobering reading. He went through some of the details, but the headline results of issues in relation to deaf people in the health service—underdiagnosis, poorer treatment, poorer communication and lack of accessible health information—are a salutary wake-up call to us all. As the noble Baroness, Lady Howe, said, this has been reinforced by some interesting work by local Healthwatches, which we were sent over the weekend. The noble Baroness referred to Kirklees Healthwatch, but I also notice work in York, Wakefield, Staffordshire, Enfield, Islington and Stockport. All of those local Healthwatches are doing good work in their areas. I hope that the Government will listen to what Healthwatch is saying and act on some of its recommendations and proposals.

My noble friend referred to a number of recommendations made by SignHealth to try to turn the situation around, such as communications agreements for each deaf person coming into contact with the health service. It is surely a sensible recommendation that they should be able to book appointments online using SMS text to communicate with services. Also, health information needs to be more accessible in other formats, including British Sign Language and subtitles. Importantly, there is the recommendation on psychological therapies, which ought to be available to deaf people in British Sign Language nationwide. It has been reported to us that Ministers have turned that recommendation down. I would be grateful if the Minister could update the House on that. If Ministers have turned it down, does she think that that is consistent with the Equality Act duty?

I want to ask the Minister about this more generally. She knows that individual National Health Service bodies and the department’s arm’s-length bodies have public sector equality duties under Section 149 of the Equality Act 2010. This duty requires public authorities to have due regard to eliminate discrimination between those with and without a protected characteristic and to advance equality of opportunity between those with and without a protected characteristic. My understanding is that that means removing or minimising disadvantages suffered by people in protected groups and considering steps to meet the needs of protected groups where they are different from those of other people. Public authorities are also under a duty to make reasonable adjustments for disabled people to make sure that a disabled person can use a service as close as reasonably possible to the standard usually offered to non-disabled people. From the SignHealth work, it is pretty apparent that for many deaf people that duty is not being effectively applied. Again, what action are the Government taking to monitor the implementation of the Act’s duty and what action will they take if it is clear that public authorities are failing in that duty?

We have had some debate about the necessity of interpreting services. I have been contacted by a general practitioner who is particularly concerned about this issue. She tells me that there is currently confusion in the NHS about the funding for interpreters since the reorganisation and replacement of primary care trusts by clinical commissioning groups. My understanding is that in many parts of the country primary care trusts funded interpreting services but, since they were abolished, there seem to be two problems. One is that clinical commissioning groups have not always been prepared to continue to fund those services. Secondly, there has been the issue of how GPs might obtain funding from NHS England, which is the body that they are now in contract with, for interpreting services within their own surgeries. I understand that, while at first some GPs were successful, there are indications that funding is now being withdrawn. That means that GPs will have to pay for interpreting services out of their practice expenses. Again, I would be interested in what the Minister has to say about that.

The noble Lord, Lord Borwick, made an interesting speech and I certainly take his point about literacy and the achievement of the cochlear implant programme. However, I was delighted with the official recognition of British Sign Language some years ago. I recall the bad old days when some deaf children were forbidden to use sign language at school. We have all moved on from that and, for those deaf people who use sign language, it is important that interpreters are available in the NHS. I also share his concern—he raised the point that we debated in October—about whether enough people are coming forward to train as teachers of deaf children. That is a very important point.

I very much take the point raised by the noble Lord, Lord Addington, about online interpretation. He was really saying that that solution was capable of a much wider interpretation than simply talking about deaf people themselves. We must surely be on the edge of a revolution in communications and the use of IT in the health service. This could clearly bring great advantages for many people who find communications difficult at the moment, but I do not think it takes away the responsibility of people in the health service to improve the way they do things now. It is very clear that some deaf people are finding services very inaccessible indeed.

[Lord Addington]

I totally agree with the noble Lord: it is another way of skinning the cat—that is all.

[Lord Hunt of Kings Heath]

The NHS has a long way to go to use the technology that the noble Lord has put forward. I welcome the suggestions that he made.

My noble friend Lord Ponsonby asked the Minister a number of questions. I would like to put forward a number of proposals for the Government to consider. For many years, the outcome of health services for deaf people has been overlooked. We are talking about a relatively small group of people—people who inevitably find communication difficult. Will the Government consider the appointment of a national champion—perhaps a national clinical director—to champion health services for deaf people? The clinical directors that the department and NHS England have taken on have been outstanding in giving leadership in relation to a number of clinical areas. I wonder whether, for deaf people in particular, having a champion at national level could help disseminate information and really bang heads together to ensure that much more focus is given to the needs of these people.

Secondly, will the Minister encourage Healthwatch to continue to build on its work to give specific focus on services for deaf people?

Thirdly, will the Minister encourage health and well-being boards at local level to pick up our concerns about across-the-board services? The noble Lord, Lord Addington, made a very strong point about the role of the Minister for the Disabled at national level. At local level, the health and well-being boards could clearly carry out that same function.

Fourthly, will the Minister encourage the development of clinical networks in each local health area so that there is co-ordination of services across primary, secondary and tertiary care as regards the needs of deaf people?

Finally, will the Minister institute regular meetings between deaf organisations and the NHS within each local health area so that there can be proper discussion and debate about the needs of deaf people?

This is a very important debate and I am sure that we all look forward to a positive response from the Minister.