Hearing Loss in Adulthood

Norman Lamb Excerpts

Tuesday 12th November 2013 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

It is a pleasure to serve under your chairmanship for the first time, Madam Deputy Speaker. I congratulate the hon. Member for Nottingham South (Lilian Greenwood) on securing the debate and championing this cause. I will state at the start that I am very happy to maintain a dialogue with her on this, because she has made a powerful case and clearly a lot of progress could be made not only by the Government, but across the health and care system. I am happy to assist in that regard. I also pay tribute to my hon. Friend the Member for Eastbourne (Stephen Lloyd), who has done a lot of work in championing this cause, as the hon. Lady mentioned, and the Ear Foundation for its work on this important issue.

The hon. Lady made a good case for why this is so important. She talked about the importance of basic communication and the fact that hearing loss can affect mental health as well as physical health and lead to withdrawal from social activities. She talked about the cost to society, the impact on employment and the fact that there is poor deaf awareness among health professionals and that better training is needed. I absolutely agree with her on all those points.

Over 10 million adults in England are living with hearing loss. Some of them will have been among the one in 700 babies in England born with hearing loss, but many will be among the growing number who develop a hearing impairment during their lifetimes. For some people that will be the sort of age-related hearing loss that many of us will experience as we grow older and that will become increasingly common because of our ageing population, but for many others hearing loss is acquired and should therefore be avoidable.

The World Health Organisation considers half of all cases of hearing loss to be preventable—for example, by immunisation, early treatment or reducing exposure to noise. In fact, it identifies exposure to excessive noise as the major avoidable cause of permanent hearing impairment worldwide. In developed countries, it is at least partially responsible for more than a third of all hearing impairments. As a result of the UK’s ageing population, the impact of working with noisy machinery and exposure to loud music and other loud noises, the World Health Organisation predicts that by 2030 there will be an estimated 14.5 million people in the UK with hearing loss, and adult-onset hearing loss will be among the UK’s top 10 disease burdens. That demonstrates the scale of the concern.

We have to take hearing loss seriously, which is why we are currently looking to develop the action plan on hearing loss, which the hon. Lady mentioned, so that we can achieve better outcomes for all those with hearing loss and related conditions. The action plan will identify key actions that will make a real difference in improving health and social care outcomes for children, young people and adults with hearing loss and generally improving the hearing health of the population.

The Department of Health is engaging with a range of organisations in developing this action plan, and as Baroness Jolly mentioned, we aim to publish it as soon as possible. I will get back to the hon. Lady with an indication of the likely publication day. It is time that we set a target date and then focused minds on getting it published.

[Jim Shannon]

We have a UK-wide diabetes strategy, and in my intervention on the hon. Member for Nottingham South (Lilian Greenwood) I suggested a UK-wide strategy on deafness as well. Will the Minister consider that?

[Norman Lamb]

My responsibilities stretch only to England, but clear co-ordination and joint working with the devolved Administrations absolutely make sense on an issue that transcends borders, so I agree with the ambition that the hon. Gentleman sets.

This cannot just be about prevention because that is not always possible; it is also about dealing with the consequences of hearing loss. The Government are committed to delivering health outcomes that are among the best in the world for people with hearing loss. We are developing measures to identify those with hearing loss as early as possible, including the roll-out of a national hearing screening programme for newborn babies that enables the early identification of deafness, providing a clear care pathway for services and allowing parents to make informed choices on communication needs.

Today, however, we are focusing on adults with hearing loss. I realise that there is currently considerable interest on hearing loss screening for adults, which the hon. Lady mentioned. The UK National Screening Committee advises Ministers and the NHS in all four countries on all aspects of screening policy. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria. In 2009, the committee recommended that routine screening for adults’ hearing loss should not be offered because of a lack of evidence to warrant such a screening programme. However, as part of its three-year review policy cycle, the committee is reviewing the evidence for a national adult hearing screening programme. A public consultation will be held shortly and details will be available on the committee’s website. I encourage the Ear Foundation and many others to contribute to that consultation.

We welcome the recent report by the Ear Foundation, which clearly sets out the benefits of cochlear implants for children and adults. Abigail’s story, as told by the hon. Lady, demonstrates what a massive impact that can have on an individual’s life. It completely transformed her life, and no doubt that experience is repeated very many times around the country. The report will be of enormous use to NICE if it decides to update the technology appraisal that it published in 2009. I encourage the Ear Foundation to engage with NICE. I am sure that it is already in touch, but it is very important for it to provide any emerging evidence to NICE to help it to update, if necessary, the guidance provided on implants.

A large number of services are already commissioned for people with hearing loss, and a number of specialist centres in England provide implants for children and adults. It is important that GPs understand the criteria for referral, as well as the obvious benefits of this technology for people with hearing loss. That touches on the hon. Lady’s point about the importance of health professionals, whether GPs or anyone else in the health system, gaining a better understanding of the potential for this technology. There have been considerable improvements to services for people with hearing loss in recent years, including reduced waits for assessment and treatment to within 18 weeks—a significant advance.

[Lilian Greenwood]

I thank the Minister for his positive response to the questions that I posed. What will he personally do to ensure that such training and updating on hearing technologies by health professionals and GPs takes place?

[Norman Lamb]

I do not want to give a bland answer, but I take this issue very seriously. I have noted what the hon. Lady has said. Health Education England is responsible for the training of health professionals. I will pursue the hon. Lady’s point and would be very happy to report back to her.

There is now a greater choice of hearing aid services through independent high street providers—which are easily accessible for members of the public—and the new any-qualified-provider commissioning model offers even greater choice and convenience.

We have also asked NICE to produce clinical guidelines and related quality standards for the assessment and management of adult-onset hearing loss and guidelines for the assessment and management of tinnitus, which the hon. Member for Strangford (Jim Shannon) has referred to in the context of Northern Ireland. Those guidelines will be scheduled into NICE’s development programme over the coming months.

Enabling those with hearing loss to have the same opportunities and to live as independently as everyone else is essential. It is therefore vital that public services are geared up to help and support them. Public authorities, including health and social care bodies, are required by the Equality Act 2010 to make reasonable adjustments for disabled people, to ensure that they can use a service as close as is reasonably possible to the standard usually offered to everyone else. The Department of Health has agreed to explore with its partners what more can be done to accommodate the communication needs of disabled service users.

Work is going on across the Government to support the needs of people with hearing loss. The Department for Transport’s Access for All programme has delivered access improvements at 1,100 stations since 2006, including induction loops at ticket offices and help points on platforms. The hon. Member for Nottingham South mentioned the specific problems that people face when travelling and the anxiety caused by worrying about not hearing an announcement. There will be facilities on platforms for deaf users and systems that show train information on LED display screens. Last year, a further £100 million was announced to extend the programme until 2019.

Courthouses have been provided with hearing loops since December 2012. In policing, police link officers for deaf or hard-of-hearing people use and are qualified in British sign language and work with the community to raise awareness of how to access the police. Staff in Derbyshire have passed level 1 of their training with Action on Hearing Loss, and they accepted an Action on Hearing Loss charter mark, “Louder than Words”, recognising the efforts they have made to communicate more effectively with deaf people. I pay tribute to those parts of the public sector that have made the effort to improve the way in which they communicate. Far more needs to be done, but they are the exemplars that others should follow. For those who do not use BSL, text relay, which enables deaf and hard-of-hearing people to text the police, is in place in most emergency call centres.

I hope that those examples give a flavour of some of the work that is being done across the public sector and confirm the Government’s continued commitment not only to preventing, but to treating hearing loss and promoting and protecting those affected.

[Lilian Greenwood]

Will the Minister give way?

[Norman Lamb]

The hon. Lady is just in time.

[Lilian Greenwood]

Before the Minister concludes his speech, will he address my specific suggestion to establish a lead commissioner for audiology, to ensure that there is a focus on good commissioning across the health service?

[Norman Lamb]

I will discuss that suggestion with NHS England, because that is its responsibility under the new design of the health system.

Let me end by congratulating the hon. Lady again on raising this really important issue, and I repeat that I am happy to engage with her to try to make progress.

Question put and agreed to.