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[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:03.07,0:00:06.90,Default,,0000,0000,0000,,Lord Ponsonby of Shulbrede
Dialogue: 0,0:00:18.00,0:00:23.40,Default,,0000,0000,0000,,My Lords, I open by thanking the Minister\Nand noble Lords who are going to take part
Dialogue: 0,0:00:23.61,0:00:30.61,Default,,0000,0000,0000,,in this important debate. It is about deaf\Npeople, by which I mean people who are born
Dialogue: 0,0:00:31.66,0:00:38.66,Default,,0000,0000,0000,,or become profoundly deaf before the age of\Nfive. They usually prefer to communicate in
Dialogue: 0,0:00:39.42,0:00:46.42,Default,,0000,0000,0000,,British Sign Language and see themselves as\Npart of the deaf community. By this definition,
Dialogue: 0,0:00:47.15,0:00:52.64,Default,,0000,0000,0000,,there are an estimated 70,000 deaf people\Nin the United Kingdom.
Dialogue: 0,0:00:52.64,0:00:59.64,Default,,0000,0000,0000,,I am speaking to a deaf health study called\NSick of It, launched last week, on 25 March,
Dialogue: 0,0:01:04.61,0:01:09.31,Default,,0000,0000,0000,,which is the largest and most extensive study\Nof the health of deaf people in the world
Dialogue: 0,0:01:09.31,0:01:16.17,Default,,0000,0000,0000,,so far. Most of the study was funded by the\NBig Lottery Fund and carried out by the charity
Dialogue: 0,0:01:16.17,0:01:21.70,Default,,0000,0000,0000,,SignHealth in partnership with the University\Nof Bristol. I am particularly indebted to
Dialogue: 0,0:01:21.70,0:01:26.65,Default,,0000,0000,0000,,Dr Andrew Alexander, SignHealth's medical\Ndirector, who provided me with the briefing
Dialogue: 0,0:01:26.65,0:01:29.36,Default,,0000,0000,0000,,for this debate.
Dialogue: 0,0:01:29.36,0:01:34.47,Default,,0000,0000,0000,,Before now, there has never been any research\Non this scale into the health of deaf people
Dialogue: 0,0:01:34.47,0:01:37.09,Default,,0000,0000,0000,,in this country.\NAlthough there have been a few small studies
Dialogue: 0,0:01:37.09,0:01:44.09,Default,,0000,0000,0000,,looking at access to health-all found it poor-no\NGovernment have ever specifically addressed
Dialogue: 0,0:01:45.61,0:01:51.56,Default,,0000,0000,0000,,the health of deaf people as I have defined\Nthem here. The closest initiative was Mental
Dialogue: 0,0:01:51.56,0:01:57.59,Default,,0000,0000,0000,,Health and Deafness-Towards Equity and Access.\NAlthough this started as a consultation on
Dialogue: 0,0:01:57.59,0:02:03.40,Default,,0000,0000,0000,,mental health, it included a lot on the wider\Nbarriers faced by deaf people. The report
Dialogue: 0,0:02:03.40,0:02:09.47,Default,,0000,0000,0000,,was supported by funding which was received\Nby each primary care trust to help it implement
Dialogue: 0,0:02:09.47,0:02:13.58,Default,,0000,0000,0000,,the recommendations of the report.
Dialogue: 0,0:02:13.58,0:02:20.58,Default,,0000,0000,0000,,Deaf health rarely features on any agenda,\Nwith the notable exception of that of the
Dialogue: 0,0:02:20.69,0:02:25.05,Default,,0000,0000,0000,,House of Lords. Even within health and equality\Nprogrammes, attention is normally focused
Dialogue: 0,0:02:25.05,0:02:30.64,Default,,0000,0000,0000,,on groups with a higher profile. It does not\Nhelp that being deaf is a hidden disability
Dialogue: 0,0:02:30.64,0:02:37.43,Default,,0000,0000,0000,,and that there is so little awareness of the\Nbarriers that deaf people face. This is usually
Dialogue: 0,0:02:37.43,0:02:43.42,Default,,0000,0000,0000,,the case on the health front line as well.\NMost staff will think that speaking louder
Dialogue: 0,0:02:43.42,0:02:49.89,Default,,0000,0000,0000,,or writing things down will solve the problem.\NWhen surveyed, a very high percentage of doctors
Dialogue: 0,0:02:49.89,0:02:54.39,Default,,0000,0000,0000,,wrongly thought that they had communicated\Nwell with their deaf patients.
Dialogue: 0,0:02:54.39,0:03:01.39,Default,,0000,0000,0000,,I turn to the report's methodology and findings.\NThere were three stages to the report: first,
Dialogue: 0,0:03:01.61,0:03:08.61,Default,,0000,0000,0000,,an online survey was conducted by Ipsos MORI;\Nsecondly, personal health assessments were
Dialogue: 0,0:03:09.10,0:03:15.62,Default,,0000,0000,0000,,made of 298 deaf people, including looking\Nat their blood pressure and BMI and taking
Dialogue: 0,0:03:15.62,0:03:22.50,Default,,0000,0000,0000,,blood tests, et cetera; thirdly, there were\Nin-depth interviews of deaf people. The findings
Dialogue: 0,0:03:22.50,0:03:28.74,Default,,0000,0000,0000,,were as follows. First, underdiagnosis and\Nundertreatment of potentially serious conditions
Dialogue: 0,0:03:28.74,0:03:35.66,Default,,0000,0000,0000,,was more common for deaf people. Secondly,\Nhigh blood pressure was almost twice as common
Dialogue: 0,0:03:35.66,0:03:41.85,Default,,0000,0000,0000,,in deaf people as in the rest of the population.\NThirdly, deaf people have generally healthier
Dialogue: 0,0:03:41.85,0:03:46.54,Default,,0000,0000,0000,,lifestyles than the rest of the population\Nin terms of smoking and alcohol but are more
Dialogue: 0,0:03:46.54,0:03:53.48,Default,,0000,0000,0000,,likely to be overweight. Fourthly, there is\Nunderdiagnosis: deaf people are twice as likely
Dialogue: 0,0:03:53.48,0:03:58.76,Default,,0000,0000,0000,,as hearing people to have high blood pressure\Nthat has not been diagnosed and may also be
Dialogue: 0,0:03:58.76,0:04:05.76,Default,,0000,0000,0000,,more likely to have undiagnosed diabetes,\Nhigh cholesterol and cardiovascular disease.
Dialogue: 0,0:04:06.68,0:04:12.23,Default,,0000,0000,0000,,Moving on to poorer treatment, the report\Nalso found that when deaf people have been
Dialogue: 0,0:04:12.23,0:04:18.94,Default,,0000,0000,0000,,diagnosed, they are more likely to be on inadequate\Ntreatment for those conditions. It has been
Dialogue: 0,0:04:18.94,0:04:25.31,Default,,0000,0000,0000,,estimated that if the deaf community had the\Nsame health profile as the general population,
Dialogue: 0,0:04:25.31,0:04:28.90,Default,,0000,0000,0000,,the NHS would save about £30 million per\Nyear.
Dialogue: 0,0:04:28.90,0:04:35.90,Default,,0000,0000,0000,,I will now talk about access and communication.\NA large number of deaf people reported not
Dialogue: 0,0:04:36.48,0:04:43.09,Default,,0000,0000,0000,,seeing their GP because they were put off\Nby the prospect of poor communication. A large
Dialogue: 0,0:04:43.09,0:04:49.34,Default,,0000,0000,0000,,proportion booked appointments by going to\Nthe practice in person-some 45%-whereas very
Dialogue: 0,0:04:49.34,0:04:55.90,Default,,0000,0000,0000,,few hearing people book appointments in this\Nway. Only 15% of deaf people said that their
Dialogue: 0,0:04:55.90,0:05:02.27,Default,,0000,0000,0000,,GP was good at listening to them, compared\Nto 51% of the general population. At most,
Dialogue: 0,0:05:02.27,0:05:09.27,Default,,0000,0000,0000,,30% could use BSL in a consultation even though,\Nin total, 94% would prefer to sign. More than
Dialogue: 0,0:05:09.51,0:05:15.61,Default,,0000,0000,0000,,half had to use an English-based form of communication-for\Nexample, lip reading or writing notes-but
Dialogue: 0,0:05:15.61,0:05:22.61,Default,,0000,0000,0000,,only 5% would prefer to communicate in that\Nway. This disparity between how deaf people
Dialogue: 0,0:05:23.43,0:05:28.68,Default,,0000,0000,0000,,have to communicate and how they would like\Nto communicate is an indictment of the health
Dialogue: 0,0:05:28.68,0:05:35.68,Default,,0000,0000,0000,,service, and an explanation for the poorer\Nhealth outcomes of deaf people. Only 25% of
Dialogue: 0,0:05:36.33,0:05:42.89,Default,,0000,0000,0000,,deaf people have confidence in their doctor,\Ncompared to 67% of the general population.
Dialogue: 0,0:05:42.89,0:05:49.57,Default,,0000,0000,0000,,There is also a wider issue about access to\Ninformation. Because health information is
Dialogue: 0,0:05:49.57,0:05:56.25,Default,,0000,0000,0000,,not widely available in an accessible format,\Na lot of the deaf people studied were unsure
Dialogue: 0,0:05:56.25,0:06:02.97,Default,,0000,0000,0000,,about their health and unsure what their prescriptions\Nwere for or how to take their medicine. While
Dialogue: 0,0:06:02.97,0:06:08.06,Default,,0000,0000,0000,,many hearing patients would find out more\Ninformation from friends, family or the internet,
Dialogue: 0,0:06:08.06,0:06:13.95,Default,,0000,0000,0000,,these options were less available to deaf\Npatients. As a result, few of the deaf people
Dialogue: 0,0:06:13.95,0:06:20.80,Default,,0000,0000,0000,,interviewed through the in-depth process appeared\Nactively engaged with their own personal health
Dialogue: 0,0:06:20.80,0:06:24.53,Default,,0000,0000,0000,,management.
Dialogue: 0,0:06:24.53,0:06:30.49,Default,,0000,0000,0000,,What are the prescriptions for change? I should\Njust say that change from the point of view
Dialogue: 0,0:06:30.49,0:06:36.43,Default,,0000,0000,0000,,of the deaf community is about equal rather\Nthan special treatment.
Dialogue: 0,0:06:36.43,0:06:41.43,Default,,0000,0000,0000,,The first prescription is that systems within\Nthe health service need to be accessible.
Dialogue: 0,0:06:41.43,0:06:45.87,Default,,0000,0000,0000,,From booking an appointment to getting test\Nresults, there should be a communication agreement
Dialogue: 0,0:06:45.87,0:06:52.71,Default,,0000,0000,0000,,for each deaf patient, which is then coded\Nand recorded in their patient record. Secondly,
Dialogue: 0,0:06:52.71,0:06:58.24,Default,,0000,0000,0000,,deaf patients should be able to book appointments\Nonline and be able to use texts to communicate
Dialogue: 0,0:06:58.24,0:07:03.30,Default,,0000,0000,0000,,with services. Thirdly, deaf patients should\Nbe able to communicate during consultations
Dialogue: 0,0:07:03.30,0:07:10.30,Default,,0000,0000,0000,,in their preferred language. Health services\Nmust \Nexpect and plan for deaf patients. Clinicians
Dialogue: 0,0:07:14.81,0:07:20.53,Default,,0000,0000,0000,,should remember that interpreters are not\Njust for deaf people but help the doctor to
Dialogue: 0,0:07:20.53,0:07:26.93,Default,,0000,0000,0000,,understand and diagnose properly. Fourthly,\Nproviders must make sure that staff know how
Dialogue: 0,0:07:26.93,0:07:32.84,Default,,0000,0000,0000,,to book an interpreter and ensure that interpreters\Nare suitably qualified. Fifthly, health information
Dialogue: 0,0:07:32.84,0:07:38.68,Default,,0000,0000,0000,,needs to be made accessible in other formats,\Nincluding BSL and subtitles. Currently, only
Dialogue: 0,0:07:38.68,0:07:45.68,Default,,0000,0000,0000,,10 out of a total of 900 NHS Choices videos\Nare available in BSL. The proposed information
Dialogue: 0,0:07:46.84,0:07:51.83,Default,,0000,0000,0000,,standard on accessibility should be supported\Nwith a funded programme.
Dialogue: 0,0:07:51.83,0:07:58.24,Default,,0000,0000,0000,,I move on to some questions, which I have\Ngiven notice of to the Minister. First, are
Dialogue: 0,0:07:58.24,0:08:03.56,Default,,0000,0000,0000,,there any plans to ensure that NHS Choices\Nincreases the number of videos available in
Dialogue: 0,0:08:03.56,0:08:10.56,Default,,0000,0000,0000,,BSL? Secondly, what would the Minister recommend\Nto a deaf person who wants to see a doctor
Dialogue: 0,0:08:11.67,0:08:17.89,Default,,0000,0000,0000,,but is told no interpreter is available or\Nthat it is too expensive? It was brought to
Dialogue: 0,0:08:17.89,0:08:24.89,Default,,0000,0000,0000,,my attention earlier today by Dr Clare Redstone,\Na GP, that it is very common to experience
Dialogue: 0,0:08:26.11,0:08:33.11,Default,,0000,0000,0000,,problems in booking interpreters. Thirdly,\Nwhat steps will the Government take to encourage
Dialogue: 0,0:08:33.63,0:08:40.55,Default,,0000,0000,0000,,the NHS Executive and Public Health England\Nto promote the health of deaf people? Fourthly,
Dialogue: 0,0:08:40.55,0:08:46.06,Default,,0000,0000,0000,,when can we expect the NHS computer system\Nto be able to tell us how many deaf people
Dialogue: 0,0:08:46.06,0:08:53.06,Default,,0000,0000,0000,,there are and which services they are accessing?\NFifthly, will implementation of the proposed
Dialogue: 0,0:08:53.15,0:08:59.39,Default,,0000,0000,0000,,information standard be supported with a funded\Nprogramme which can help to educate and support
Dialogue: 0,0:08:59.39,0:09:02.15,Default,,0000,0000,0000,,health services?
Dialogue: 0,0:09:02.15,0:09:09.15,Default,,0000,0000,0000,,My sixth question is one that I sent the Minister\Nearlier regarding whether psychological therapies
Dialogue: 0,0:09:15.82,0:09:21.56,Default,,0000,0000,0000,,providing BSL should be the responsibility\Nof specialised commissioners. I understand
Dialogue: 0,0:09:21.56,0:09:26.94,Default,,0000,0000,0000,,that the Minister has since decided that psychological\Ntherapies for deaf people should not be on
Dialogue: 0,0:09:26.94,0:09:33.28,Default,,0000,0000,0000,,the list of prescribed services. Therefore,\Nin the updated situation, my question is:
Dialogue: 0,0:09:33.28,0:09:39.29,Default,,0000,0000,0000,,how can we ensure that psychological services\Nnationwide are available for deaf people?
Dialogue: 0,0:09:39.29,0:09:46.29,Default,,0000,0000,0000,,I understand that there is a very patchy covering\Nat the moment. Lastly, what does the Minister
Dialogue: 0,0:09:49.96,0:09:56.04,Default,,0000,0000,0000,,think would be the best way to raise deaf\Nawareness among staff working in the health
Dialogue: 0,0:09:56.04,0:09:56.41,Default,,0000,0000,0000,,service?
Dialogue: 0,0:09:56.41,0:10:03.41,Default,,0000,0000,0000,,I look forward to the Minister's response.\NI understand that she is working on a cross-governmental
Dialogue: 0,0:10:04.54,0:10:11.54,Default,,0000,0000,0000,,strategy on hearing loss and that the report\Non this is ongoing. My debate today is about
Dialogue: 0,0:10:13.61,0:10:19.27,Default,,0000,0000,0000,,a very specific cohort within that deaf community,\Nand I hope that she will be able to address
Dialogue: 0,0:10:19.27,0:10:23.26,Default,,0000,0000,0000,,the questions that I have raised.
Dialogue: 0,0:10:23.26,0:10:28.38,Default,,0000,0000,0000,,My Lords, I am grateful to the noble Lord,\NLord Ponsonby, for bringing this matter to
Dialogue: 0,0:10:28.38,0:10:32.69,Default,,0000,0000,0000,,debate following the SignHealth report.
Dialogue: 0,0:10:32.69,0:10:38.70,Default,,0000,0000,0000,,I must, first, declare an interest. For about\Nthe past 25 years, I have been a trustee of
Dialogue: 0,0:10:38.70,0:10:44.94,Default,,0000,0000,0000,,the Ewing Foundation for deaf children, a\Ncharity that has, for the past 60 years, helped
Dialogue: 0,0:10:44.94,0:10:49.51,Default,,0000,0000,0000,,to improve the teaching of children who use\Ntheir residual hearing and lip reading to
Dialogue: 0,0:10:49.51,0:10:52.62,Default,,0000,0000,0000,,communicate by speech.
Dialogue: 0,0:10:52.62,0:10:58.59,Default,,0000,0000,0000,,The change in the prospects and outcomes for\Ndeaf children due to the introduction of cochlear
Dialogue: 0,0:10:58.59,0:11:03.27,Default,,0000,0000,0000,,implants, digital hearing aids and newborn\Nhearing screening is one of the most exciting
Dialogue: 0,0:11:03.27,0:11:08.87,Default,,0000,0000,0000,,stories in disability. Noble Lords may have\Nseen the publicity in the papers on Friday,
Dialogue: 0,0:11:08.87,0:11:14.74,Default,,0000,0000,0000,,or even the YouTube film, of the joy of a\Ndeaf girl of 40 hearing for the first time
Dialogue: 0,0:11:14.74,0:11:20.69,Default,,0000,0000,0000,,when her cochlear implants were turned on.\NFor the first time, she can hear music, the
Dialogue: 0,0:11:20.69,0:11:26.22,Default,,0000,0000,0000,,laughter of babies and the songs of birds.\NThis revolution has come from cochlear implants,
Dialogue: 0,0:11:26.22,0:11:31.90,Default,,0000,0000,0000,,which will radically reduce the disabling\Neffects of profound deafness in children and
Dialogue: 0,0:11:31.90,0:11:32.81,Default,,0000,0000,0000,,adults.
Dialogue: 0,0:11:32.81,0:11:38.62,Default,,0000,0000,0000,,The Sick of It report is important and interesting,\Nbut I am afraid that it gives away its self-selected
Dialogue: 0,0:11:38.62,0:11:45.05,Default,,0000,0000,0000,,background. A statistic on the page about\Ncommunication issues claims that 80% of deaf
Dialogue: 0,0:11:45.05,0:11:49.66,Default,,0000,0000,0000,,people want to communicate using British Sign\NLanguage. The noble Lord suggested that that
Dialogue: 0,0:11:49.66,0:11:56.44,Default,,0000,0000,0000,,figure was 93%, but I think it is the definition\Nof "deaf" that accounts for the difference.
Dialogue: 0,0:11:56.44,0:12:01.62,Default,,0000,0000,0000,,That statistic is a conundrum to me, in that\Nthe vast majority of deaf people, using a
Dialogue: 0,0:12:01.62,0:12:07.92,Default,,0000,0000,0000,,more ordinary definition of the word, are\Nelderly people who do not use British Sign
Dialogue: 0,0:12:07.92,0:12:14.92,Default,,0000,0000,0000,,Language. Indeed, the CRIDE report said that\N79% of deaf children use only spoken English.
Dialogue: 0,0:12:16.04,0:12:20.40,Default,,0000,0000,0000,,It may be that the definition of deaf depends\Non who is hearing it.
Dialogue: 0,0:12:20.40,0:12:27.40,Default,,0000,0000,0000,,A strong part of good communication is literacy.\NUnfortunately, communicating through sign
Dialogue: 0,0:12:27.97,0:12:33.77,Default,,0000,0000,0000,,language while learning to read and write\Nin English is like talking in English and
Dialogue: 0,0:12:33.77,0:12:40.77,Default,,0000,0000,0000,,reading and writing in Chinese. I am filled\Nwith admiration for all the children who can
Dialogue: 0,0:12:41.06,0:12:47.22,Default,,0000,0000,0000,,do it. Noble Lords may have strong opinions\Nabout whether tweeting and texting can really
Dialogue: 0,0:12:47.22,0:12:53.96,Default,,0000,0000,0000,,be described as literature but they are fundamental\Nto the lives of many teenagers nowadays. There
Dialogue: 0,0:12:53.96,0:12:59.35,Default,,0000,0000,0000,,is some great technology coming forward. The\NApple digital assistant, Siri, and many other
Dialogue: 0,0:12:59.35,0:13:06.07,Default,,0000,0000,0000,,programs can transcribe your questions, and\Na doctor's replies can be sent from an iPad
Dialogue: 0,0:13:06.07,0:13:13.07,Default,,0000,0000,0000,,to a simultaneous remote caption service.\NAll these new technologies need literacy.
Dialogue: 0,0:13:14.32,0:13:20.11,Default,,0000,0000,0000,,The theme of the report is that good communication\Nis fundamental to good health, and that makes
Dialogue: 0,0:13:20.11,0:13:26.24,Default,,0000,0000,0000,,sense, but it is true not only of deaf patients;\Ncommunication with all patients can be made
Dialogue: 0,0:13:26.24,0:13:28.58,Default,,0000,0000,0000,,better.
Dialogue: 0,0:13:28.58,0:13:34.97,Default,,0000,0000,0000,,Another feature of the report is isolation,\Nand deafness is very isolating. Research has
Dialogue: 0,0:13:34.97,0:13:41.97,Default,,0000,0000,0000,,shown that in old age the combination of cognitive\Ndecline and hearing loss can be fatal. Hearing
Dialogue: 0,0:13:44.35,0:13:49.58,Default,,0000,0000,0000,,loss seems to speed up dementia, so perhaps\Nhearing loss in older patients should be treated
Dialogue: 0,0:13:49.58,0:13:54.58,Default,,0000,0000,0000,,more aggressively when it is first diagnosed,\Nand deaf awareness training given to more
Dialogue: 0,0:13:54.58,0:13:59.44,Default,,0000,0000,0000,,health professionals.
Dialogue: 0,0:13:59.44,0:14:04.12,Default,,0000,0000,0000,,Time after time, surveys suggest that there\Nis a correlation between good health and good
Dialogue: 0,0:14:04.12,0:14:09.50,Default,,0000,0000,0000,,education, so the most powerful advantage\Nto the health of deaf people is to make sure
Dialogue: 0,0:14:09.50,0:14:16.50,Default,,0000,0000,0000,,that they get a great education. Profoundly\Ndeaf children now, thanks to cochlear implants,
Dialogue: 0,0:14:17.72,0:14:23.33,Default,,0000,0000,0000,,can be educated primarily in mainstream schools,\Nwith hearing friends and ordinary prospects
Dialogue: 0,0:14:23.33,0:14:25.52,Default,,0000,0000,0000,,for the future.
Dialogue: 0,0:14:25.52,0:14:31.97,Default,,0000,0000,0000,,But cochlear implants are expensive, although\Nnot so much in their implantation, which,
Dialogue: 0,0:14:31.97,0:14:38.02,Default,,0000,0000,0000,,like everything electronic, is improving technically\Nand reducing in price. The real cost comes
Dialogue: 0,0:14:38.02,0:14:44.86,Default,,0000,0000,0000,,in training the baby or the child who needs\Nto get the most out of their implant. However,
Dialogue: 0,0:14:44.86,0:14:50.43,Default,,0000,0000,0000,,this is so much cheaper than a lifetime of\Ninterpreters. I must compliment all parties
Dialogue: 0,0:14:50.43,0:14:55.84,Default,,0000,0000,0000,,for getting on with the cochlear implant programme\Nand not stinting on this project. Ten thousand
Dialogue: 0,0:14:55.84,0:15:00.31,Default,,0000,0000,0000,,people have had cochlear implants so far.\NThat is a marvellous achievement and it is
Dialogue: 0,0:15:00.31,0:15:05.33,Default,,0000,0000,0000,,changing society. There are now only a very\Nsmall number of children below the age of
Dialogue: 0,0:15:05.33,0:15:11.78,Default,,0000,0000,0000,,five who use sign language, and BSL may be\Nregarded in the future as being used by fewer
Dialogue: 0,0:15:11.78,0:15:17.61,Default,,0000,0000,0000,,and fewer deaf people. Who knows what will\Nhappen? Many other skills have been superseded
Dialogue: 0,0:15:17.61,0:15:22.71,Default,,0000,0000,0000,,by technology. We will have to do our best\Nto support those who continue to use sign
Dialogue: 0,0:15:22.71,0:15:29.71,Default,,0000,0000,0000,,language but they will gradually become a\Ntiny minority of deaf people.
Dialogue: 0,0:15:30.25,0:15:36.90,Default,,0000,0000,0000,,Some 40% of deaf children have disabilities\Nin addition to hearing loss. Deafness and
Dialogue: 0,0:15:36.90,0:15:43.90,Default,,0000,0000,0000,,autism or deaf and blind with a learning disability\Nare combinations that are becoming more common,
Dialogue: 0,0:15:44.01,0:15:51.01,Default,,0000,0000,0000,,partly as a function of doctors saving extremely\Npremature babies who in past years would have
Dialogue: 0,0:15:51.13,0:15:58.13,Default,,0000,0000,0000,,died. These babies can now survive at 22 weeks'\Ngestation, but with multiple problems. Some
Dialogue: 0,0:15:58.23,0:16:03.70,Default,,0000,0000,0000,,parents are better than others at caring for\Na child with challenging behaviour who may
Dialogue: 0,0:16:03.70,0:16:10.70,Default,,0000,0000,0000,,never live independently but, sadly, some\Nchildren are effectively abandoned by their
Dialogue: 0,0:16:10.92,0:16:17.92,Default,,0000,0000,0000,,parents to the state-a sad future for a child\Nfollowing heroic efforts to save an extremely
Dialogue: 0,0:16:18.28,0:16:21.27,Default,,0000,0000,0000,,short pregnancy.
Dialogue: 0,0:16:21.27,0:16:27.64,Default,,0000,0000,0000,,I have two questions for the Minister. The\Nfirst concerns the reducing number, and increasing
Dialogue: 0,0:16:27.64,0:16:33.32,Default,,0000,0000,0000,,age profile of, qualified teachers of the\Ndeaf. The report stresses the importance of
Dialogue: 0,0:16:33.32,0:16:37.72,Default,,0000,0000,0000,,good health education for deaf people. Deaf\Nchildren and young people need to be equipped
Dialogue: 0,0:16:37.72,0:16:43.87,Default,,0000,0000,0000,,with information and strategies to access\Nhealth services independently as adults. To
Dialogue: 0,0:16:43.87,0:16:50.59,Default,,0000,0000,0000,,achieve that, we will need more teachers of\Nthe deaf. How can we get them?
Dialogue: 0,0:16:50.59,0:16:54.91,Default,,0000,0000,0000,,The noble Baroness was asked a very similar\Nquestion in a debate last October by my noble
Dialogue: 0,0:16:54.91,0:16:58.84,Default,,0000,0000,0000,,friend Lady Brinton, and she replied with\Ninformation about the national scholarship
Dialogue: 0,0:16:58.84,0:17:05.08,Default,,0000,0000,0000,,fund. How many teachers have applied for,\Nand how many have been granted, help from
Dialogue: 0,0:17:05.08,0:17:11.75,Default,,0000,0000,0000,,this fund to train as teachers of the deaf?\NIt appears that this fund is not working well
Dialogue: 0,0:17:11.75,0:17:17.34,Default,,0000,0000,0000,,enough to solve the problem, so what else\Ncan be done to encourage more teachers to
Dialogue: 0,0:17:17.34,0:17:20.22,Default,,0000,0000,0000,,work in this specialist area?
Dialogue: 0,0:17:20.22,0:17:26.77,Default,,0000,0000,0000,,Secondly, can we increase the amount of communication\Nin our health service that is duplicated both
Dialogue: 0,0:17:26.77,0:17:33.60,Default,,0000,0000,0000,,verbally and by text? It is far cheaper to\Nhave a text system of booking appointments
Dialogue: 0,0:17:33.60,0:17:39.11,Default,,0000,0000,0000,,than an interpreter, and that expenditure\Nwill benefit not only deaf patients but all
Dialogue: 0,0:17:39.11,0:17:43.75,Default,,0000,0000,0000,,patients who can read and write in English.
Dialogue: 0,0:17:43.75,0:17:50.75,Default,,0000,0000,0000,,My Lords, having seen the title of the SignHealth\Nreport, I was surprised by nothing that I
Dialogue: 0,0:17:54.01,0:17:56.72,Default,,0000,0000,0000,,read in it. If you think about it, when you\Nare dealing with a medical situation, being
Dialogue: 0,0:17:56.72,0:18:03.72,Default,,0000,0000,0000,,able to tell somebody what the matter is has\Nto be a huge advantage. Man as an animal is
Dialogue: 0,0:18:10.97,0:18:15.43,Default,,0000,0000,0000,,supposed to be a compulsive communicator.\NOne major thing that we do is to talk to each
Dialogue: 0,0:18:15.43,0:18:19.55,Default,,0000,0000,0000,,other and if something gets in the way of\Nbeing able to communicate properly, we will
Dialogue: 0,0:18:19.55,0:18:26.55,Default,,0000,0000,0000,,have problems. The question is: how do we\Ndeal with that? We will never get it absolutely
Dialogue: 0,0:18:27.09,0:18:30.12,Default,,0000,0000,0000,,right.
Dialogue: 0,0:18:30.12,0:18:37.12,Default,,0000,0000,0000,,I have to declare an interest. I am chairman\Nof a company called Microlink, which supports
Dialogue: 0,0:18:37.72,0:18:43.12,Default,,0000,0000,0000,,disabled people through its innovations, usually\Ninvolving computing. This has led me to take
Dialogue: 0,0:18:43.12,0:18:48.18,Default,,0000,0000,0000,,a closer look at this area. Indeed, one of\Nour case studies concerned being an online
Dialogue: 0,0:18:48.18,0:18:55.18,Default,,0000,0000,0000,,interpreter. Most of us are online. It is\Na much better use of an interpreter's time
Dialogue: 0,0:18:56.92,0:18:59.68,Default,,0000,0000,0000,,to be able to use British Sign Language online\Nthan it is for him or her to have to follow
Dialogue: 0,0:18:59.68,0:19:02.37,Default,,0000,0000,0000,,a person around.
Dialogue: 0,0:19:02.37,0:19:08.06,Default,,0000,0000,0000,,In addition, if we are supposed to be enhancing\Nthe dignity of a person, we want to give them
Dialogue: 0,0:19:08.06,0:19:15.06,Default,,0000,0000,0000,,as much independence as possible. A translator\Nis an expensive, difficult piece of kit you
Dialogue: 0,0:19:15.52,0:19:22.05,Default,,0000,0000,0000,,may not want in the room when you are talking\Nto your doctor about, for example, sexual
Dialogue: 0,0:19:22.05,0:19:29.05,Default,,0000,0000,0000,,health or reproduction, particularly if they\Nare there all the time. Having something online,
Dialogue: 0,0:19:29.99,0:19:36.99,Default,,0000,0000,0000,,as described here, seems a perfectly sensible\Nway forward but to use it both parties must
Dialogue: 0,0:19:39.04,0:19:45.09,Default,,0000,0000,0000,,know that it is possible and how to access\Nit. Making sure that that information is discerned
Dialogue: 0,0:19:45.09,0:19:51.60,Default,,0000,0000,0000,,throughout the system for the client base\Nand the provider is essential to getting the
Dialogue: 0,0:19:51.60,0:19:58.60,Default,,0000,0000,0000,,best out of it. That must be looked at and\Npeople must know it is available. If it can
Dialogue: 0,0:20:00.72,0:20:07.33,Default,,0000,0000,0000,,be done comparatively easily, which seems\Nto be the case, everyone must know. That would
Dialogue: 0,0:20:07.33,0:20:13.59,Default,,0000,0000,0000,,enhance the dignity of the patient and make\Nthe job of the doctor easier. We can go into
Dialogue: 0,0:20:13.59,0:20:15.14,Default,,0000,0000,0000,,the night speaking about that.
Dialogue: 0,0:20:15.14,0:20:22.14,Default,,0000,0000,0000,,As the noble Lord, Lord Borwick, has mentioned,\Nlots of technologies are language-based. If
Dialogue: 0,0:20:22.95,0:20:29.95,Default,,0000,0000,0000,,you are literate, you would have another means\Nof communication. As someone who is dyslexic,
Dialogue: 0,0:20:32.02,0:20:39.02,Default,,0000,0000,0000,,I have a little story about one of these bits\Nof technology. Through the aforementioned
Dialogue: 0,0:20:43.72,0:20:50.72,Default,,0000,0000,0000,,interest, I saw a wonderful piece of kit which\Naddresses literacy and gives a person some
Dialogue: 0,0:20:51.76,0:20:54.90,Default,,0000,0000,0000,,personal space. The UbiDuo comes from the\NStates, although I do not think that we would
Dialogue: 0,0:20:54.90,0:20:57.97,Default,,0000,0000,0000,,have given it that name. Basically, you use\Ntwo keyboards and two screens that are roughly
Dialogue: 0,0:20:57.97,0:21:04.97,Default,,0000,0000,0000,,the size of small computers, and you get instant\Ntranslation of your communication to someone
Dialogue: 0,0:21:06.39,0:21:12.35,Default,,0000,0000,0000,,else. They can read it and communicate back.\NI was shown this at a conference where everyone
Dialogue: 0,0:21:12.35,0:21:16.31,Default,,0000,0000,0000,,else was oohing and ahing about it. I discovered\Nthat I was the only person who could not use
Dialogue: 0,0:21:16.31,0:21:23.02,Default,,0000,0000,0000,,it because I am dyslexic, which shows that\Neverything has its limitations. However, if
Dialogue: 0,0:21:23.02,0:21:29.91,Default,,0000,0000,0000,,you are informed and know what is going on,\Nyou can overcome that and get through to the
Dialogue: 0,0:21:29.91,0:21:35.06,Default,,0000,0000,0000,,other person. A line of communication can\Nbe established. There are many different types
Dialogue: 0,0:21:35.06,0:21:40.22,Default,,0000,0000,0000,,and uses of language. If we can establish\Nthe fact that they are available and known
Dialogue: 0,0:21:40.22,0:21:46.03,Default,,0000,0000,0000,,about, these problems will be cut.
Dialogue: 0,0:21:46.03,0:21:53.03,Default,,0000,0000,0000,,Most of what we are talking about will cut\Nacross government departments. How would anything
Dialogue: 0,0:21:54.38,0:22:00.65,Default,,0000,0000,0000,,being talked about here not be covered in\None's health employment profile? I bumped
Dialogue: 0,0:22:00.65,0:22:04.24,Default,,0000,0000,0000,,into Mike Penning, the disability Minister,\Nwho said that he is going to try to work across
Dialogue: 0,0:22:04.24,0:22:10.72,Default,,0000,0000,0000,,departments. It is nice to know that disability\Nhas been slightly pushed up and now has a
Dialogue: 0,0:22:10.72,0:22:17.72,Default,,0000,0000,0000,,Minister of State. There will be the same\Nproblems in health, employment and education.
Dialogue: 0,0:22:21.76,0:22:28.76,Default,,0000,0000,0000,,Everything relates and cross-references. How\Nwe deal with that is very important.
Dialogue: 0,0:22:29.90,0:22:36.90,Default,,0000,0000,0000,,When someone leaves a medical establishment,\Nhospital or doctor's surgery, how will they
Dialogue: 0,0:22:43.45,0:22:50.45,Default,,0000,0000,0000,,interpret the lifestyle and support that they\Nwill receive? I know Mike Penning reasonably
Dialogue: 0,0:22:50.49,0:22:56.80,Default,,0000,0000,0000,,well and he is a tenacious individual but\NI do not know how much he and Ministers in
Dialogue: 0,0:22:56.80,0:23:02.44,Default,,0000,0000,0000,,other departments can make sure that this\Nsupport is followed through. If deaf people
Dialogue: 0,0:23:02.44,0:23:08.49,Default,,0000,0000,0000,,are overweight and want healthier lifestyles,\Nit is true that they have more trouble accessing,
Dialogue: 0,0:23:08.49,0:23:15.37,Default,,0000,0000,0000,,for example, exercise and outdoor activity.\NWhat are we doing to make sure that they can
Dialogue: 0,0:23:15.37,0:23:22.37,Default,,0000,0000,0000,,or that they do not have to jump over hurdles?\NWe should be able to take our solution from
Dialogue: 0,0:23:22.84,0:23:25.80,Default,,0000,0000,0000,,one place to another.
Dialogue: 0,0:23:25.80,0:23:32.80,Default,,0000,0000,0000,,We have just heard a very positive description\Nof what might happen with cochlea implants.
Dialogue: 0,0:23:32.82,0:23:37.88,Default,,0000,0000,0000,,That will never deal with all the problems\Nbut it might deal with quite a lot of them.
Dialogue: 0,0:23:37.88,0:23:44.88,Default,,0000,0000,0000,,However, as the noble Lord said, most people's\Nhearing problems are probably late onset.
Dialogue: 0,0:23:46.75,0:23:53.75,Default,,0000,0000,0000,,As with most disabilities, they build up.\NThe deaf community has vociferous factions
Dialogue: 0,0:23:54.83,0:23:59.61,Default,,0000,0000,0000,,within it which will tell you that true deafness\Nis something else, that it is what they have
Dialogue: 0,0:23:59.61,0:24:03.44,Default,,0000,0000,0000,,and not what someone else has, and that their\Napproach and nothing else is the proper one.
Dialogue: 0,0:24:03.44,0:24:09.56,Default,,0000,0000,0000,,They are like all other communities I have\Never met in that regard. However, unless you
Dialogue: 0,0:24:09.56,0:24:15.63,Default,,0000,0000,0000,,can get an approach which covers a variety\Nof ways of dealing with the communication
Dialogue: 0,0:24:15.63,0:24:22.63,Default,,0000,0000,0000,,problem, addresses all those areas and accepts\Nthat they are all equally valid, you will
Dialogue: 0,0:24:23.35,0:24:29.55,Default,,0000,0000,0000,,always create more holes, cracks and barriers\Nthan you should otherwise have.
Dialogue: 0,0:24:29.55,0:24:36.55,Default,,0000,0000,0000,,Finally, I have a story about the aforementioned\NUbiDuo. When Esther McVey was the Minister
Dialogue: 0,0:24:41.40,0:24:46.91,Default,,0000,0000,0000,,for Disabled People, she was at a conference\Nand decided to have a chat with the deaf man
Dialogue: 0,0:24:46.91,0:24:53.22,Default,,0000,0000,0000,,who was doing a demonstration. After a long\Nconversation with aides possibly tugging at
Dialogue: 0,0:24:53.22,0:25:00.22,Default,,0000,0000,0000,,her elbow to get her out of the room, we went\Nalong and said, "This is wonderful. Isn't
Dialogue: 0,0:25:01.35,0:25:06.86,Default,,0000,0000,0000,,it a great piece of kit?". A woman from the\Nnext stall said, "I wonder if she would have
Dialogue: 0,0:25:06.86,0:25:13.86,Default,,0000,0000,0000,,been quite so keen if it wasn't such a tall,\Ngood-looking man on the other side". If my
Dialogue: 0,0:25:15.07,0:25:19.79,Default,,0000,0000,0000,,honourable friend had not noticed that, the\Nwoman on the next stall certainly had. Allowing
Dialogue: 0,0:25:19.79,0:25:26.40,Default,,0000,0000,0000,,someone to interact on a basic human level\Nis what we are after. This is merely an application
Dialogue: 0,0:25:26.40,0:25:31.75,Default,,0000,0000,0000,,that can be used in the healthcare that we\Nare looking at. Unless we approach it like
Dialogue: 0,0:25:31.75,0:25:38.15,Default,,0000,0000,0000,,that, we will miss far more opportunities\Nto enhance people's lives overall than we
Dialogue: 0,0:25:38.15,0:25:39.13,Default,,0000,0000,0000,,should.
Dialogue: 0,0:25:39.13,0:25:46.13,Default,,0000,0000,0000,,My Lords, I congratulate the noble Lord, Lord\NPonsonby, on securing this debate on much
Dialogue: 0,0:25:47.97,0:25:54.97,Default,,0000,0000,0000,,needed improvements for the health needs of\Ndeaf people. Although deaf people have the
Dialogue: 0,0:25:55.13,0:26:02.13,Default,,0000,0000,0000,,advantage, unlike the blind, of being able\Nto see, the fact that deafness is not a visible
Dialogue: 0,0:26:03.36,0:26:10.36,Default,,0000,0000,0000,,disability, as the noble Lord, Lord Ponsonby,\Nhas said, means that other people are not
Dialogue: 0,0:26:10.38,0:26:17.14,Default,,0000,0000,0000,,necessarily aware that you are deaf. Therefore,\Nless immediate attention is given in trying
Dialogue: 0,0:26:17.14,0:26:23.90,Default,,0000,0000,0000,,to help with any problems that the person\Nwill be facing. Perhaps that lack of awareness
Dialogue: 0,0:26:23.90,0:26:30.90,Default,,0000,0000,0000,,of deafness also helps to explain why so few\NMembers of your Lordships' House are taking
Dialogue: 0,0:26:33.32,0:26:36.29,Default,,0000,0000,0000,,part in this important dinner-break debate.
Dialogue: 0,0:26:36.29,0:26:43.29,Default,,0000,0000,0000,,As someone who has had hearing problems since\Nmy children were born, and as I have now reached
Dialogue: 0,0:26:45.52,0:26:51.67,Default,,0000,0000,0000,,the limit of what hearing aids can do to help\Nme understand what people are saying, I have
Dialogue: 0,0:26:51.67,0:26:58.67,Default,,0000,0000,0000,,some, although obviously not a complete, understanding\Nof the problems and frustrations that deaf
Dialogue: 0,0:27:01.46,0:27:08.46,Default,,0000,0000,0000,,patients face. Most definitely I have sympathy\Nwith the concerns so graphically illustrated
Dialogue: 0,0:27:10.33,0:27:17.33,Default,,0000,0000,0000,,in the pamphlet How the Health Service is\NFailing Deaf People. It clearly makes sense
Dialogue: 0,0:27:18.40,0:27:25.40,Default,,0000,0000,0000,,for doctors' surgeries or hospitals to have\Nthe kind of BSL support or other technical
Dialogue: 0,0:27:25.64,0:27:32.42,Default,,0000,0000,0000,,arrangements to hand that the authors of this\Npamphlet are advocating should be routine
Dialogue: 0,0:27:32.42,0:27:39.42,Default,,0000,0000,0000,,but clearly are not. Although I suspect that\Nnot everyone who is deaf will mind having
Dialogue: 0,0:27:41.28,0:27:48.28,Default,,0000,0000,0000,,someone close to them speak to the doctor,\Nthe individual's wishes should be paramount.
Dialogue: 0,0:27:52.86,0:27:59.86,Default,,0000,0000,0000,,Surely, it must be of concern to us all that\Nso many deaf people have a considerably poorer
Dialogue: 0,0:28:02.33,0:28:09.33,Default,,0000,0000,0000,,health record than the average citizen. I\Nwas glad to see from a Healthwatch briefing
Dialogue: 0,0:28:09.37,0:28:16.34,Default,,0000,0000,0000,,sent to me over the weekend that a few areas\Nof the country are beginning to realise the
Dialogue: 0,0:28:16.34,0:28:23.34,Default,,0000,0000,0000,,extent of the problems that deaf or hard-of-hearing\Npatients face. In 2013, Kirklees Healthwatch
Dialogue: 0,0:28:26.34,0:28:31.54,Default,,0000,0000,0000,,followed up numerous concerns identified in\Nits survey of the area. I hope that at least
Dialogue: 0,0:28:31.54,0:28:37.48,Default,,0000,0000,0000,,some of these-for example, deaf awareness\Ntraining being developed and rolled out for
Dialogue: 0,0:28:37.48,0:28:43.52,Default,,0000,0000,0000,,provider staff, including handling phone calls,\Npersonal visitors and booking of BSL interpreters-are
Dialogue: 0,0:28:43.52,0:28:50.52,Default,,0000,0000,0000,,beginning to happen. Healthwatch also reports\Nthe beginnings of awareness and action in
Dialogue: 0,0:28:51.61,0:28:58.61,Default,,0000,0000,0000,,areas such as York, Wakefield, Staffordshire\Nand Stockport. As well as the important reasons
Dialogue: 0,0:28:59.76,0:29:06.76,Default,,0000,0000,0000,,in the pamphlets for the relevant help proposed,\Nthere are other reasons why a greater priority
Dialogue: 0,0:29:07.24,0:29:14.24,Default,,0000,0000,0000,,needs to be given to those who are deaf or\Nin the process of going deaf. Ageing, by itself,
Dialogue: 0,0:29:15.08,0:29:21.78,Default,,0000,0000,0000,,inevitably brings hearing loss. As people\Nare living considerably longer these days,
Dialogue: 0,0:29:21.78,0:29:28.61,Default,,0000,0000,0000,,they will have hearing problems for a longer\Nperiod of their lives. As well as that, the
Dialogue: 0,0:29:28.61,0:29:35.61,Default,,0000,0000,0000,,way that today's young expose their ears to\Nincredibly loud media sounds will inevitably
Dialogue: 0,0:29:35.81,0:29:42.20,Default,,0000,0000,0000,,mean that when age kicks in, their hearing\Nloss is bound to be considerably worse, last
Dialogue: 0,0:29:42.20,0:29:46.86,Default,,0000,0000,0000,,longer and probably start at an earlier age.
Dialogue: 0,0:29:46.86,0:29:51.87,Default,,0000,0000,0000,,Interestingly, in your Lordships' House, despite\Nall the modern hearing loops that are fitted
Dialogue: 0,0:29:51.87,0:29:58.87,Default,,0000,0000,0000,,in the Committee Rooms, which others may also\Nhave found quite difficult to communicate
Dialogue: 0,0:29:58.93,0:30:05.93,Default,,0000,0000,0000,,with, I find that the very best hearing loops\Navailable are those that we can switch into
Dialogue: 0,0:30:06.90,0:30:13.90,Default,,0000,0000,0000,,in the Chamber in itself-where we are at the\Nmoment. This has a great deal to do with the
Dialogue: 0,0:30:14.80,0:30:20.88,Default,,0000,0000,0000,,considerable improvements that have recently\Nbeen completed here, but I suspect that it
Dialogue: 0,0:30:20.88,0:30:26.61,Default,,0000,0000,0000,,is also helped by the way that the microphones\Nall hang down from the ceiling and speakers
Dialogue: 0,0:30:26.61,0:30:33.61,Default,,0000,0000,0000,,are located in the seats of every Bench for\Npeople to listen through.
Dialogue: 0,0:30:33.73,0:30:40.73,Default,,0000,0000,0000,,As in so many other ways, because so many\Nnoble Lords themselves are going through the
Dialogue: 0,0:30:43.79,0:30:50.79,Default,,0000,0000,0000,,stages of ageing, including hearing loss,\Napart from each one of us checking that appropriate
Dialogue: 0,0:30:51.28,0:30:57.28,Default,,0000,0000,0000,,equipment and help are available in our own\Ndoctors' surgeries-which I certainly hope
Dialogue: 0,0:30:57.28,0:31:04.28,Default,,0000,0000,0000,,every one of us here today will do-debates\Nsuch as this that seek government backing
Dialogue: 0,0:31:04.41,0:31:11.41,Default,,0000,0000,0000,,can also help to raise awareness of the necessary\Naction to be taken.
Dialogue: 0,0:31:11.45,0:31:18.45,Default,,0000,0000,0000,,With that in mind, I look forward to what\Nthe Minister can tell us about what the Government
Dialogue: 0,0:31:21.10,0:31:28.10,Default,,0000,0000,0000,,will do to reassure the noble Lord, Lord Ponsonby,\Nabout his six questions and the others that
Dialogue: 0,0:31:28.99,0:31:35.99,Default,,0000,0000,0000,,we have added. These considerable changes\Nmust take place in doctors' surgeries and
Dialogue: 0,0:31:36.41,0:31:43.41,Default,,0000,0000,0000,,hospitals to meet the wide range of needs\Ndescribed so graphically in the pamphlet,
Dialogue: 0,0:31:44.35,0:31:51.35,Default,,0000,0000,0000,,How the Health Service Is Failing Deaf People.\NTo continue with such failure would surely
Dialogue: 0,0:31:54.94,0:31:57.39,Default,,0000,0000,0000,,be a disgrace.
Dialogue: 0,0:31:57.39,0:32:04.39,Default,,0000,0000,0000,,My Lords, I am very grateful to my noble friend\NLord Ponsonby for his initiative and his excellent
Dialogue: 0,0:32:05.57,0:32:12.57,Default,,0000,0000,0000,,speech. I declare my interest as chair of\Nan NHS foundation trust, a consultant and
Dialogue: 0,0:32:13.12,0:32:18.24,Default,,0000,0000,0000,,trainer with Cumberlege Connections and president\Nof GS1.
Dialogue: 0,0:32:18.24,0:32:22.79,Default,,0000,0000,0000,,Parliamentary debates about the quality of\Npublic services to deaf people are all too
Dialogue: 0,0:32:22.79,0:32:28.33,Default,,0000,0000,0000,,infrequent. Therefore, like the noble Baroness,\NLady Howe, I welcome the opportunity to put
Dialogue: 0,0:32:28.33,0:32:34.32,Default,,0000,0000,0000,,that right tonight. As noble Lords have said,\Nit is particularly opportune because of the
Dialogue: 0,0:32:34.32,0:32:40.89,Default,,0000,0000,0000,,publication on 25 March of this excellent\Nreport by the deaf health charity SignHealth.
Dialogue: 0,0:32:40.89,0:32:47.70,Default,,0000,0000,0000,,I was very privileged to speak at the conference\Nheld on 25 March to launch the report.
Dialogue: 0,0:32:47.70,0:32:53.78,Default,,0000,0000,0000,,As my noble friend said, the report makes\Nvery sobering reading. He went through some
Dialogue: 0,0:32:53.78,0:33:00.78,Default,,0000,0000,0000,,of the details, but the headline results of\Nissues in relation to deaf people in the health
Dialogue: 0,0:33:02.17,0:33:07.70,Default,,0000,0000,0000,,service-underdiagnosis, poorer treatment,\Npoorer communication and lack of accessible
Dialogue: 0,0:33:07.70,0:33:14.70,Default,,0000,0000,0000,,health information-are a salutary wake-up\Ncall to us all. As the noble Baroness, Lady
Dialogue: 0,0:33:15.60,0:33:22.60,Default,,0000,0000,0000,,Howe, said, this has been reinforced by some\Ninteresting work by local Healthwatches, which
Dialogue: 0,0:33:22.93,0:33:29.92,Default,,0000,0000,0000,,we were sent over the weekend. The noble Baroness\Nreferred to Kirklees Healthwatch, but I also
Dialogue: 0,0:33:29.92,0:33:36.92,Default,,0000,0000,0000,,notice work in York, Wakefield, Staffordshire,\NEnfield, Islington and Stockport. All of those
Dialogue: 0,0:33:37.36,0:33:44.26,Default,,0000,0000,0000,,local Healthwatches are doing good work in\Ntheir areas. I hope that the Government will
Dialogue: 0,0:33:44.26,0:33:51.26,Default,,0000,0000,0000,,listen to what Healthwatch is saying and act\Non some of its recommendations and proposals.
Dialogue: 0,0:33:52.78,0:33:59.78,Default,,0000,0000,0000,,My noble friend referred to a number of recommendations\Nmade by SignHealth to try to turn the situation
Dialogue: 0,0:34:01.13,0:34:07.52,Default,,0000,0000,0000,,around, such as communications agreements\Nfor each deaf person coming into contact with
Dialogue: 0,0:34:07.52,0:34:14.18,Default,,0000,0000,0000,,the health service. It is surely a sensible\Nrecommendation that they should be able to
Dialogue: 0,0:34:14.18,0:34:21.18,Default,,0000,0000,0000,,book appointments online using SMS text to\Ncommunicate with services. Also, health information
Dialogue: 0,0:34:21.98,0:34:28.10,Default,,0000,0000,0000,,needs to be more accessible in other formats,\Nincluding British Sign Language and subtitles.
Dialogue: 0,0:34:28.10,0:34:33.89,Default,,0000,0000,0000,,Importantly, there is the recommendation on\Npsychological therapies, which ought to be
Dialogue: 0,0:34:33.89,0:34:40.48,Default,,0000,0000,0000,,available to deaf people in British Sign Language\Nnationwide. It has been reported to us that
Dialogue: 0,0:34:40.48,0:34:47.48,Default,,0000,0000,0000,,Ministers have turned that recommendation\Ndown. I would be grateful if the Minister
Dialogue: 0,0:34:47.52,0:34:54.52,Default,,0000,0000,0000,,could update the House on that. If Ministers\Nhave turned it down, does she think that that
Dialogue: 0,0:34:58.79,0:35:05.79,Default,,0000,0000,0000,,is consistent with the Equality Act duty?\NI want to ask the Minister about this more
Dialogue: 0,0:35:08.15,0:35:15.15,Default,,0000,0000,0000,,generally. She knows that individual National\NHealth Service bodies and the department's
Dialogue: 0,0:35:15.72,0:35:22.72,Default,,0000,0000,0000,,arm's-length bodies have public sector equality\Nduties under Section 149 of the Equality Act
Dialogue: 0,0:35:23.15,0:35:30.15,Default,,0000,0000,0000,,2010. This duty requires public authorities\Nto have due regard to eliminate discrimination
Dialogue: 0,0:35:31.81,0:35:37.49,Default,,0000,0000,0000,,between those with and without a protected\Ncharacteristic and to advance equality of
Dialogue: 0,0:35:37.49,0:35:43.18,Default,,0000,0000,0000,,opportunity between those with and without\Na protected characteristic. My understanding
Dialogue: 0,0:35:43.18,0:35:49.08,Default,,0000,0000,0000,,is that that means removing or minimising\Ndisadvantages suffered by people in protected
Dialogue: 0,0:35:49.08,0:35:55.07,Default,,0000,0000,0000,,groups and considering steps to meet the needs\Nof protected groups where they are different
Dialogue: 0,0:35:55.07,0:36:01.67,Default,,0000,0000,0000,,from those of other people. Public authorities\Nare also under a duty to make reasonable adjustments
Dialogue: 0,0:36:01.67,0:36:07.63,Default,,0000,0000,0000,,for disabled people to make sure that a disabled\Nperson can use a service as close as reasonably
Dialogue: 0,0:36:07.63,0:36:14.63,Default,,0000,0000,0000,,possible to the standard usually offered to\Nnon-disabled people. From the SignHealth work,
Dialogue: 0,0:36:16.17,0:36:23.17,Default,,0000,0000,0000,,it is pretty apparent that for many deaf people\Nthat duty is not being effectively applied.
Dialogue: 0,0:36:29.23,0:36:36.23,Default,,0000,0000,0000,,Again, what action are the Government taking\Nto monitor the implementation of the Act's
Dialogue: 0,0:36:36.33,0:36:43.33,Default,,0000,0000,0000,,duty and what action will they take if it\Nis clear that public authorities are failing
Dialogue: 0,0:36:43.88,0:36:50.11,Default,,0000,0000,0000,,in that duty?\NWe have had some debate about the necessity
Dialogue: 0,0:36:50.11,0:36:57.11,Default,,0000,0000,0000,,of interpreting services. I have been contacted\Nby a general practitioner who is particularly
Dialogue: 0,0:36:57.91,0:37:04.91,Default,,0000,0000,0000,,concerned about this issue. She tells me that\Nthere is currently confusion in the NHS about
Dialogue: 0,0:37:05.83,0:37:12.29,Default,,0000,0000,0000,,the funding for interpreters since the reorganisation\Nand replacement of primary care trusts by
Dialogue: 0,0:37:12.29,0:37:19.14,Default,,0000,0000,0000,,clinical commissioning groups. My understanding\Nis that in many parts of the country primary
Dialogue: 0,0:37:19.14,0:37:26.14,Default,,0000,0000,0000,,care trusts funded interpreting services but,\Nsince they were abolished, there seem to be
Dialogue: 0,0:37:27.86,0:37:32.91,Default,,0000,0000,0000,,two problems. One is that clinical commissioning\Ngroups have not always been prepared to continue
Dialogue: 0,0:37:32.91,0:37:39.91,Default,,0000,0000,0000,,to fund those services. Secondly, there has\Nbeen the issue of how GPs might obtain funding
Dialogue: 0,0:37:41.02,0:37:47.07,Default,,0000,0000,0000,,from NHS England, which is the body that they\Nare now in contract with, for interpreting
Dialogue: 0,0:37:47.07,0:37:54.07,Default,,0000,0000,0000,,services within their own surgeries. I understand\Nthat, while at first some GPs were successful,
Dialogue: 0,0:37:55.21,0:38:01.14,Default,,0000,0000,0000,,there are indications that funding is now\Nbeing withdrawn. That means that GPs will
Dialogue: 0,0:38:01.14,0:38:08.14,Default,,0000,0000,0000,,have to pay for interpreting services out\Nof their practice expenses. Again, I would
Dialogue: 0,0:38:09.27,0:38:15.52,Default,,0000,0000,0000,,be interested in what the Minister has to\Nsay about that.
Dialogue: 0,0:38:15.52,0:38:20.74,Default,,0000,0000,0000,,The noble Lord, Lord Borwick, made an interesting\Nspeech and I certainly take his point about
Dialogue: 0,0:38:20.74,0:38:27.67,Default,,0000,0000,0000,,literacy and the achievement of the cochlear\Nimplant programme. However, I was delighted
Dialogue: 0,0:38:27.67,0:38:33.47,Default,,0000,0000,0000,,with the official recognition of British Sign\NLanguage some years ago. I recall the bad
Dialogue: 0,0:38:33.47,0:38:39.62,Default,,0000,0000,0000,,old days when some deaf children were forbidden\Nto use sign language at school. We have all
Dialogue: 0,0:38:39.62,0:38:46.62,Default,,0000,0000,0000,,moved on from that and, for those deaf people\Nwho use sign language, it is important that
Dialogue: 0,0:38:46.83,0:38:53.28,Default,,0000,0000,0000,,interpreters are available in the NHS. I also\Nshare his concern-he raised the point that
Dialogue: 0,0:38:53.28,0:38:59.53,Default,,0000,0000,0000,,we debated in October-about whether enough\Npeople are coming forward to train as teachers
Dialogue: 0,0:38:59.53,0:39:02.52,Default,,0000,0000,0000,,of deaf children. That is a very important\Npoint.
Dialogue: 0,0:39:02.52,0:39:07.46,Default,,0000,0000,0000,,I very much take the point raised by the noble\NLord, Lord Addington, about online interpretation.
Dialogue: 0,0:39:07.46,0:39:14.46,Default,,0000,0000,0000,,He was really saying that that solution was\Ncapable of a much wider interpretation than
Dialogue: 0,0:39:16.21,0:39:23.21,Default,,0000,0000,0000,,simply talking about deaf people themselves.\NWe must surely be on the edge of a revolution
Dialogue: 0,0:39:24.65,0:39:31.65,Default,,0000,0000,0000,,in communications and the use of IT in the\Nhealth service. This could clearly bring great
Dialogue: 0,0:39:34.13,0:39:39.70,Default,,0000,0000,0000,,advantages for many people who find communications\Ndifficult at the moment, but I do not think
Dialogue: 0,0:39:39.70,0:39:44.12,Default,,0000,0000,0000,,it takes away the responsibility of people\Nin the health service to improve the way they
Dialogue: 0,0:39:44.12,0:39:51.12,Default,,0000,0000,0000,,do things now. It is very clear that some\Ndeaf people are finding services very inaccessible
Dialogue: 0,0:39:51.26,0:39:56.80,Default,,0000,0000,0000,,indeed.\NI totally agree with the noble Lord: it is
Dialogue: 0,0:39:56.80,0:40:03.80,Default,,0000,0000,0000,,another way of skinning the cat-that is all.\NThe NHS has a long way to go to use the technology
Dialogue: 0,0:40:04.33,0:40:11.09,Default,,0000,0000,0000,,that the noble Lord has put forward. I welcome\Nthe suggestions that he made.
Dialogue: 0,0:40:11.09,0:40:17.65,Default,,0000,0000,0000,,My noble friend Lord Ponsonby asked the Minister\Na number of questions. I would like to put
Dialogue: 0,0:40:17.65,0:40:24.65,Default,,0000,0000,0000,,forward a number of proposals for the Government\Nto consider. For many years, the outcome of
Dialogue: 0,0:40:25.95,0:40:31.62,Default,,0000,0000,0000,,health services for deaf people has been overlooked.\NWe are talking about a relatively small group
Dialogue: 0,0:40:31.62,0:40:38.62,Default,,0000,0000,0000,,of people-people who inevitably find communication\Ndifficult. Will the Government consider the
Dialogue: 0,0:40:42.73,0:40:49.73,Default,,0000,0000,0000,,appointment of a national champion-perhaps\Na national clinical director-to champion health
Dialogue: 0,0:40:50.14,0:40:56.43,Default,,0000,0000,0000,,services for deaf people? The clinical directors\Nthat the department and NHS England have taken
Dialogue: 0,0:40:56.43,0:41:02.20,Default,,0000,0000,0000,,on have been outstanding in giving leadership\Nin relation to a number of clinical areas.
Dialogue: 0,0:41:02.20,0:41:08.23,Default,,0000,0000,0000,,I wonder whether, for deaf people in particular,\Nhaving a champion at national level could
Dialogue: 0,0:41:08.23,0:41:15.09,Default,,0000,0000,0000,,help disseminate information and really bang\Nheads together to ensure that much more focus
Dialogue: 0,0:41:15.09,0:41:22.09,Default,,0000,0000,0000,,is given to the needs of these people.\NSecondly, will the Minister encourage Healthwatch
Dialogue: 0,0:41:22.17,0:41:28.79,Default,,0000,0000,0000,,to continue to build on its work to give specific\Nfocus on services for deaf people?
Dialogue: 0,0:41:28.79,0:41:33.96,Default,,0000,0000,0000,,Thirdly, will the Minister encourage health\Nand well-being boards at local level to pick
Dialogue: 0,0:41:33.96,0:41:40.96,Default,,0000,0000,0000,,up our concerns about across-the-board services?\NThe noble Lord, Lord Addington, made a very
Dialogue: 0,0:41:41.13,0:41:46.35,Default,,0000,0000,0000,,strong point about the role of the Minister\Nfor the Disabled at national level. At local
Dialogue: 0,0:41:46.35,0:41:52.45,Default,,0000,0000,0000,,level, the health and well-being boards could\Nclearly carry out that same function.
Dialogue: 0,0:41:52.45,0:41:58.14,Default,,0000,0000,0000,,Fourthly, will the Minister encourage the\Ndevelopment of clinical networks in each local
Dialogue: 0,0:41:58.14,0:42:04.08,Default,,0000,0000,0000,,health area so that there is co-ordination\Nof services across primary, secondary and
Dialogue: 0,0:42:04.08,0:42:07.76,Default,,0000,0000,0000,,tertiary care as regards the needs of deaf\Npeople?
Dialogue: 0,0:42:07.76,0:42:14.76,Default,,0000,0000,0000,,Finally, will the Minister institute regular\Nmeetings between deaf organisations and the
Dialogue: 0,0:42:15.03,0:42:21.05,Default,,0000,0000,0000,,NHS within each local health area so that\Nthere can be proper discussion and debate
Dialogue: 0,0:42:21.05,0:42:26.34,Default,,0000,0000,0000,,about the needs of deaf people?\NThis is a very important debate and I am sure
Dialogue: 0,0:42:26.34,0:42:31.20,Default,,0000,0000,0000,,that we all look forward to a positive response\Nfrom the Minister.
Dialogue: 0,0:42:31.20,0:42:38.20,Default,,0000,0000,0000,,My Lords, I thank the noble Lord for securing\Nthis short debate on the health of deaf people,
Dialogue: 0,0:42:41.81,0:42:47.59,Default,,0000,0000,0000,,and I welcome the opportunity to discuss the\Nserious concerns that he raises. This has
Dialogue: 0,0:42:47.59,0:42:54.28,Default,,0000,0000,0000,,been a really good, well informed debate and\Nmany excellent questions have been asked.
Dialogue: 0,0:42:54.28,0:42:59.84,Default,,0000,0000,0000,,I would point out that my scripted speech\Nis six-minutes long, so I hope to answer as
Dialogue: 0,0:42:59.84,0:43:05.71,Default,,0000,0000,0000,,many of the other questions as possible within\Nthe rest of the time available to me. However,
Dialogue: 0,0:43:05.71,0:43:11.82,Default,,0000,0000,0000,,in tested and time-honoured tradition, I will\Nsend a letter to all noble Lords to address
Dialogue: 0,0:43:11.82,0:43:15.65,Default,,0000,0000,0000,,anything that I have not covered.\NI would also like to take this opportunity
Dialogue: 0,0:43:15.65,0:43:20.78,Default,,0000,0000,0000,,to pay tribute to the work of SignHealth and\Nthe efforts that it has made to achieve equal
Dialogue: 0,0:43:20.78,0:43:27.31,Default,,0000,0000,0000,,access to healthcare and better health outcomes\Nfor deaf people. The findings outlined in
Dialogue: 0,0:43:27.31,0:43:33.63,Default,,0000,0000,0000,,its recent report, Sick of It, are truly shocking.\NThe fact that deaf people are more likely
Dialogue: 0,0:43:33.63,0:43:38.86,Default,,0000,0000,0000,,to have undiagnosed conditions such as high\Nblood pressure and diabetes and that they
Dialogue: 0,0:43:38.86,0:43:45.85,Default,,0000,0000,0000,,are more likely to receive inadequate treatment\Nwhen they are diagnosed, is completely unacceptable.
Dialogue: 0,0:43:45.85,0:43:49.84,Default,,0000,0000,0000,,This Government are committed to delivering\Nhealth outcomes that are among the best in
Dialogue: 0,0:43:49.84,0:43:55.68,Default,,0000,0000,0000,,the world for people with hearing loss.\NBefore getting to the main issue of the health
Dialogue: 0,0:43:55.68,0:44:00.86,Default,,0000,0000,0000,,of the deaf population, I would like to spend\Na few seconds outlining service improvements
Dialogue: 0,0:44:00.86,0:44:06.50,Default,,0000,0000,0000,,to those with hearing loss or who are deaf.\NThese include the rollout of a national screening
Dialogue: 0,0:44:06.50,0:44:12.65,Default,,0000,0000,0000,,programme for newborn children; significantly\Nreduced waiting times for assessment and treatment,
Dialogue: 0,0:44:12.65,0:44:18.03,Default,,0000,0000,0000,,with almost all patients now treated within\N18 weeks, with the average being four and
Dialogue: 0,0:44:18.03,0:44:23.49,Default,,0000,0000,0000,,a half weeks; and greater choice of hearing\Naid services-for example, through independent
Dialogue: 0,0:44:23.49,0:44:29.17,Default,,0000,0000,0000,,high street providers. In particular, by taking\Nforward measures which enable the early identification
Dialogue: 0,0:44:29.17,0:44:36.17,Default,,0000,0000,0000,,of deafness, we are able to provide a clear\Ncare pathway for services and enable parents
Dialogue: 0,0:44:36.52,0:44:40.86,Default,,0000,0000,0000,,to make informed choices on communication\Nneeds.
Dialogue: 0,0:44:40.86,0:44:46.85,Default,,0000,0000,0000,,However, as SignHealth's report shows, it\Nis in the most basic way that we are failing
Dialogue: 0,0:44:46.85,0:44:53.54,Default,,0000,0000,0000,,deaf patients. Small adjustments could make\Na real difference by enabling those with hearing
Dialogue: 0,0:44:53.54,0:45:00.30,Default,,0000,0000,0000,,loss to communicate with their health providers.\NHave services thought about how deaf patients
Dialogue: 0,0:45:00.30,0:45:06.04,Default,,0000,0000,0000,,can book a GP appointment if they cannot just\Npick up a telephone? Once they have made an
Dialogue: 0,0:45:06.04,0:45:09.53,Default,,0000,0000,0000,,appointment, will they know when their name\Nis called or will they be left sitting in
Dialogue: 0,0:45:09.53,0:45:15.66,Default,,0000,0000,0000,,the waiting room? Once they get to see their\NGP or hospital clinician, will they be able
Dialogue: 0,0:45:15.66,0:45:22.66,Default,,0000,0000,0000,,to communicate with them? I am sure that SignHealth\Nwould readily identify with the questions
Dialogue: 0,0:45:25.80,0:45:28.78,Default,,0000,0000,0000,,I have posed.\NThe noble Lord, Lord Addington, talked about
Dialogue: 0,0:45:28.78,0:45:34.12,Default,,0000,0000,0000,,the use of technology in communication, and\Nhe brings his personal knowledge to bear.
Dialogue: 0,0:45:34.12,0:45:41.12,Default,,0000,0000,0000,,Online signing is something that might be\Nsensible, and an intelligent use of services
Dialogue: 0,0:45:42.25,0:45:48.77,Default,,0000,0000,0000,,such as Skype might also be helpful. Critical\Nto all of this-and I shall come to it later-
Dialogue: 0,0:45:48.77,0:45:55.06,Default,,0000,0000,0000,,is the co-commissioning of these sorts of\Nservices. That sort of approach would not
Dialogue: 0,0:45:55.06,0:46:02.06,Default,,0000,0000,0000,,only give patients their dignity but also\Nhelp make the GP's job more straightforward.
Dialogue: 0,0:46:05.81,0:46:12.81,Default,,0000,0000,0000,,The noble Baroness, Lady Howe of Idlicote,\Nurged noble Lords to carry out checks in their
Dialogue: 0,0:46:12.83,0:46:18.85,Default,,0000,0000,0000,,own practices. I do not think that anyone\Nwould dare not to do so after that. Certainly
Dialogue: 0,0:46:18.85,0:46:25.50,Default,,0000,0000,0000,,with my own practice in Bodmin, in the heart\Nof Cornwall, I can book online to see a doctor
Dialogue: 0,0:46:25.50,0:46:31.64,Default,,0000,0000,0000,,or a nurse. When I turn up for a visit I do\Nnot talk to a receptionist, I just press a
Dialogue: 0,0:46:31.64,0:46:36.93,Default,,0000,0000,0000,,touch-screen pad which asks me for my date\Nof birth and my gender. It then says, "Ah!
Dialogue: 0,0:46:36.93,0:46:43.77,Default,,0000,0000,0000,,Are you Mrs Jolly?", and tells me to sit down\Nand wait. All those services would work perfectly
Dialogue: 0,0:46:43.77,0:46:49.03,Default,,0000,0000,0000,,well with deaf people and there is no reason\Nwhy they should not be replicated throughout
Dialogue: 0,0:46:49.03,0:46:56.03,Default,,0000,0000,0000,,the land. What happens behind the consulting\Nroom door may not be as good as all of that-I
Dialogue: 0,0:47:00.29,0:47:05.55,Default,,0000,0000,0000,,just do not know.\NThere are currently over 10 million adults
Dialogue: 0,0:47:05.55,0:47:11.36,Default,,0000,0000,0000,,in England living with hearing loss; the World\NHealth Organisation estimates that by 2030
Dialogue: 0,0:47:11.36,0:47:17.76,Default,,0000,0000,0000,,the figure will rise to 14.5 million. It is\Ntherefore vital that health and social care
Dialogue: 0,0:47:17.76,0:47:24.15,Default,,0000,0000,0000,,services are geared up to be able to communicate\Nwith deaf people and those with hearing loss
Dialogue: 0,0:47:24.15,0:47:30.12,Default,,0000,0000,0000,,in order to promote good health and address\Ntheir health needs. All options should be
Dialogue: 0,0:47:30.12,0:47:36.97,Default,,0000,0000,0000,,considered. The noble Lord, Lord Hunt, told\Nthe House about the public sector equality
Dialogue: 0,0:47:36.97,0:47:42.91,Default,,0000,0000,0000,,duty. This requires all public bodies, including\Nthose who provide health and social care,
Dialogue: 0,0:47:42.91,0:47:47.28,Default,,0000,0000,0000,,to, "advance equality of opportunity" and\Nto,
Dialogue: 0,0:47:47.28,0:47:51.37,Default,,0000,0000,0000,,"have due regard to the need to eliminate\Ndiscrimination".
Dialogue: 0,0:47:51.37,0:47:57.45,Default,,0000,0000,0000,,SignHealth's Sick of It report is right to\Nremind deaf people that they have a right
Dialogue: 0,0:47:57.45,0:48:02.91,Default,,0000,0000,0000,,to complain when a service provider has not\Ntaken their particular needs into account.
Dialogue: 0,0:48:02.91,0:48:08.85,Default,,0000,0000,0000,,However, it is up to the service providers\Nto anticipate the requirements of disabled
Dialogue: 0,0:48:08.85,0:48:15.49,Default,,0000,0000,0000,,people and the reasonable adjustments that\Nmay have to be made for them in advance, before
Dialogue: 0,0:48:15.49,0:48:21.52,Default,,0000,0000,0000,,any disabled person attempts to access their\Nservice. The reasonable-adjustment duty is
Dialogue: 0,0:48:21.52,0:48:28.29,Default,,0000,0000,0000,,an anticipatory duty, so it is just not acceptable\Nfor health services not to be equipped to
Dialogue: 0,0:48:28.29,0:48:35.29,Default,,0000,0000,0000,,provide communication support for those who\Nneed it. This may involve the use of British
Dialogue: 0,0:48:38.98,0:48:45.12,Default,,0000,0000,0000,,Sign Language, but it may also involve the\Nuse of basic technology such as display screens
Dialogue: 0,0:48:45.12,0:48:51.34,Default,,0000,0000,0000,,in GP waiting rooms. It may also involve something\Nas simple as text messaging-nearly all noble
Dialogue: 0,0:48:51.34,0:48:57.95,Default,,0000,0000,0000,,Lords referred to that-as all of us become\Nincreasingly reliant upon this and other electronic
Dialogue: 0,0:48:57.95,0:49:02.64,Default,,0000,0000,0000,,forms of communication.\NMy noble friend Lord Borwick talked about
Dialogue: 0,0:49:02.64,0:49:09.64,Default,,0000,0000,0000,,skills possibly being superseded by technology\Nand referred to cochlear implants, texts and
Dialogue: 0,0:49:11.47,0:49:18.20,Default,,0000,0000,0000,,the internet. I defy any noble Lord not to\Nbe touched by the moving story of Joanne Milne
Dialogue: 0,0:49:18.20,0:49:24.56,Default,,0000,0000,0000,,as she heard for the first time this week\Nbut a lot of this will take a long time to
Dialogue: 0,0:49:24.56,0:49:31.56,Default,,0000,0000,0000,,roll out. It will take a while before the\Nyoungsters reach the age of older people who
Dialogue: 0,0:49:34.46,0:49:41.03,Default,,0000,0000,0000,,are deaf or have hearing loss. This will not\Nbe an instant fix.
Dialogue: 0,0:49:41.03,0:49:48.03,Default,,0000,0000,0000,,I am happy to be able to report that progress\Nis being made on the NHS information standard.
Dialogue: 0,0:49:48.54,0:49:54.82,Default,,0000,0000,0000,,As part of the commitment to improve the experience\Nof patients using NHS services and empower
Dialogue: 0,0:49:54.82,0:50:01.82,Default,,0000,0000,0000,,people to be equal partners in their own care,\NNHS England is developing an information standard
Dialogue: 0,0:50:01.86,0:50:07.63,Default,,0000,0000,0000,,for the provision of accessible, personalised\Ninformation. The standard will ensure that
Dialogue: 0,0:50:07.63,0:50:14.63,Default,,0000,0000,0000,,disabled patients, service users and carers\Nreceive information from NHS bodies and providers
Dialogue: 0,0:50:14.67,0:50:21.67,Default,,0000,0000,0000,,of NHS care in formats that they can understand.\NIt also requires that they receive appropriate
Dialogue: 0,0:50:21.72,0:50:28.72,Default,,0000,0000,0000,,support to enable them to communicate with\Nservice providers. Successful implementation
Dialogue: 0,0:50:29.21,0:50:34.87,Default,,0000,0000,0000,,of this information standard will improve\Nthe health outcomes and experience of disabled
Dialogue: 0,0:50:34.87,0:50:40.70,Default,,0000,0000,0000,,people. It will also reduce the number of\Nappointments and screening opportunities missed
Dialogue: 0,0:50:40.70,0:50:47.44,Default,,0000,0000,0000,,by patients who have received invitations\Nor information in formats that are inappropriate
Dialogue: 0,0:50:47.44,0:50:54.44,Default,,0000,0000,0000,,for them. It is intended that the standard\Nwill be finalised in late 2014, with organisations
Dialogue: 0,0:50:55.13,0:51:02.13,Default,,0000,0000,0000,,required to comply in 2015. Alongside the\Nstatutory information standard, NHS England
Dialogue: 0,0:51:03.74,0:51:09.23,Default,,0000,0000,0000,,will publish guidance on making reasonable\Nadjustments to meet the communication needs
Dialogue: 0,0:51:09.23,0:51:16.23,Default,,0000,0000,0000,,of service users with disabilities.\NWe know that there is a need to improve both
Dialogue: 0,0:51:16.53,0:51:20.89,Default,,0000,0000,0000,,the commissioning and integration of health\Nand social care services for people with hearing
Dialogue: 0,0:51:20.89,0:51:27.77,Default,,0000,0000,0000,,loss, as well as the provision of new and\Ninnovative models of care. This is why we
Dialogue: 0,0:51:27.77,0:51:34.15,Default,,0000,0000,0000,,are also developing a new action plan on hearing\Nloss. The action plan will identify the key
Dialogue: 0,0:51:34.15,0:51:40.02,Default,,0000,0000,0000,,actions that will make a real difference to\Nhealth and social care outcomes for children,
Dialogue: 0,0:51:40.02,0:51:45.82,Default,,0000,0000,0000,,young people and adults with hearing loss.\NNHS England is currently engaging with a range
Dialogue: 0,0:51:45.82,0:51:51.55,Default,,0000,0000,0000,,of stakeholders, including the Department\Nof Health, Public Health England, other government
Dialogue: 0,0:51:51.55,0:51:57.40,Default,,0000,0000,0000,,departments and agencies and key stakeholders,\Nand aims to publish the action plan as soon
Dialogue: 0,0:51:57.40,0:51:58.11,Default,,0000,0000,0000,,as possible.
Dialogue: 0,0:51:58.11,0:52:05.11,Default,,0000,0000,0000,,I hope that I have been able to reassure the\NHouse that the Government have a strong commitment
Dialogue: 0,0:52:05.26,0:52:12.00,Default,,0000,0000,0000,,to promoting the needs of deaf people across\Na range of public services but, in particular,
Dialogue: 0,0:52:12.00,0:52:17.40,Default,,0000,0000,0000,,ensuring that deaf people have equal access\Nto health and social care and improved outcomes
Dialogue: 0,0:52:17.40,0:52:24.40,Default,,0000,0000,0000,,equal to people who do not have hearing loss.\NEquality is the watchword.
Dialogue: 0,0:52:26.84,0:52:33.18,Default,,0000,0000,0000,,To answer noble Lords' questions, the noble\NLord, Lord Hunt, asked about the decision
Dialogue: 0,0:52:33.18,0:52:38.49,Default,,0000,0000,0000,,on psychological therapy provided in British\NSign Language and where the responsibility
Dialogue: 0,0:52:38.49,0:52:45.49,Default,,0000,0000,0000,,for that should be in specialised commissioning.\NFollowing advice from the prescribed specialised
Dialogue: 0,0:52:46.02,0:52:52.23,Default,,0000,0000,0000,,services advisory group, and in consultation\Nwith NHS England, Ministers have taken the
Dialogue: 0,0:52:52.23,0:52:58.10,Default,,0000,0000,0000,,decision that responsibility for commissioning\Npsychological therapies for deaf sign language
Dialogue: 0,0:52:58.10,0:53:02.51,Default,,0000,0000,0000,,users should remain with the clinical commissioning\Ngroups.
Dialogue: 0,0:53:02.51,0:53:09.51,Default,,0000,0000,0000,,The noble Lord, Lord Hunt, also made five\Npoints. There was that of the national champion
Dialogue: 0,0:53:12.74,0:53:19.62,Default,,0000,0000,0000,,and how to build on the work thus far. I am\Nhappy to take that back and will write to
Dialogue: 0,0:53:19.62,0:53:25.17,Default,,0000,0000,0000,,him. On health and well-being boards, they\Nshould pick up across-the-board services.
Dialogue: 0,0:53:25.17,0:53:29.22,Default,,0000,0000,0000,,We hope that they are doing so. I suspect\Nthat health and well-being boards will, in
Dialogue: 0,0:53:29.22,0:53:36.22,Default,,0000,0000,0000,,their second report for this coming year,\Npick up on that sort of thing if they are
Dialogue: 0,0:53:37.26,0:53:43.92,Default,,0000,0000,0000,,not doing so already. On co-ordination of\Nservices, again, it should be within the gift
Dialogue: 0,0:53:43.92,0:53:48.33,Default,,0000,0000,0000,,of health and well-being boards to ensure\Nthat social care and all health services are
Dialogue: 0,0:53:48.33,0:53:55.33,Default,,0000,0000,0000,,not only properly commissioned but also properly\Nco-ordinated. It sounds an admirable idea
Dialogue: 0,0:53:56.14,0:54:00.27,Default,,0000,0000,0000,,that there should be regular meetings with\Nthe NHS in each local area for people with
Dialogue: 0,0:54:00.27,0:54:07.27,Default,,0000,0000,0000,,hearing loss and deafness. I imagine many\Npeople with other sorts of disability would
Dialogue: 0,0:54:07.77,0:54:11.44,Default,,0000,0000,0000,,like to see that as well. Perhaps that is\Nsomething that Healthwatch might be able to
Dialogue: 0,0:54:11.44,0:54:16.12,Default,,0000,0000,0000,,facilitate.
Dialogue: 0,0:54:16.12,0:54:21.86,Default,,0000,0000,0000,,Do GPs have to pay for their translation services?\NEach provider of a public service is responsible
Dialogue: 0,0:54:21.86,0:54:27.78,Default,,0000,0000,0000,,for ensuring that they make reasonable adjustments\Nto meet the needs of disabled people. This
Dialogue: 0,0:54:27.78,0:54:32.99,Default,,0000,0000,0000,,is not funded centrally but must be found\Nfrom within local budgets.
Dialogue: 0,0:54:32.99,0:54:39.77,Default,,0000,0000,0000,,The noble Lord, Lord Addington, asked about\Nco-ordinating help for deaf people in other
Dialogue: 0,0:54:39.77,0:54:45.11,Default,,0000,0000,0000,,fields, such as education and employment.\NThe Minister of State for Disabled People,
Dialogue: 0,0:54:45.11,0:54:52.11,Default,,0000,0000,0000,,in his capacity as chair of the interdepartmental\Ngroup on disability, recently wrote to Ministers
Dialogue: 0,0:54:52.80,0:54:58.47,Default,,0000,0000,0000,,in other government departments to ask what\Ntheir departments are doing to support their
Dialogue: 0,0:54:58.47,0:55:05.47,Default,,0000,0000,0000,,deaf users.\NOn the questions of the noble Lord, Lord Ponsonby,
Dialogue: 0,0:55:06.22,0:55:13.22,Default,,0000,0000,0000,,about plans to ensure that NHS Choices increases\Nthe number of videos available in BSL, NHS
Dialogue: 0,0:55:14.52,0:55:21.49,Default,,0000,0000,0000,,Choices is very keen to provide more BSL content.\NIt has approached SignHealth and in turn secured
Dialogue: 0,0:55:21.49,0:55:26.29,Default,,0000,0000,0000,,funding for the existing BSL videos. Noble\NLords might be interested to know that there
Dialogue: 0,0:55:26.29,0:55:31.95,Default,,0000,0000,0000,,are videos available on: breast cancer, diabetes,\Nheart disease, lung cancer, prostate cancer,
Dialogue: 0,0:55:31.95,0:55:38.68,Default,,0000,0000,0000,,back pain, depression and low mood, getting\Ntested for Chlamydia, preventing high cholesterol
Dialogue: 0,0:55:38.68,0:55:42.95,Default,,0000,0000,0000,,and tinnitus. Those are the ones currently\Nsigned.
Dialogue: 0,0:55:42.95,0:55:49.95,Default,,0000,0000,0000,,What would the Minister recommend to a deaf\Nperson who wants to see a doctor but is told
Dialogue: 0,0:55:50.93,0:55:56.09,Default,,0000,0000,0000,,that no interpreter is available? We recommend\Nthat they lodge a formal complaint with the
Dialogue: 0,0:55:56.09,0:56:01.76,Default,,0000,0000,0000,,GP practice. If the complaint is not resolved,\Nwe recommend that the complaint is escalated
Dialogue: 0,0:56:01.76,0:56:08.76,Default,,0000,0000,0000,,to CCG or NHS England as set out in the complaints\Nprocedure.
Dialogue: 0,0:56:10.87,0:56:14.63,Default,,0000,0000,0000,,What does the Minister think would be the\Nbest way to raise deaf awareness among staff
Dialogue: 0,0:56:14.63,0:56:19.95,Default,,0000,0000,0000,,working in the health service? It is ultimately\Nthe responsibility of individual employers
Dialogue: 0,0:56:19.95,0:56:25.41,Default,,0000,0000,0000,,to support the development of the staff they\Nemploy. However, Health Education England
Dialogue: 0,0:56:25.41,0:56:30.06,Default,,0000,0000,0000,,will provide leadership and work with local\Neducation training boards-LETBs-regulatory
Dialogue: 0,0:56:30.06,0:56:36.76,Default,,0000,0000,0000,,bodies and health care providers to ensure\Nprofessional and personal development continues
Dialogue: 0,0:56:36.76,0:56:40.65,Default,,0000,0000,0000,,beyond the end of formal training.
Dialogue: 0,0:56:40.65,0:56:46.12,Default,,0000,0000,0000,,What steps will the Government take to encourage\NNHS England and Public Health England to promote
Dialogue: 0,0:56:46.12,0:56:52.60,Default,,0000,0000,0000,,the health of deaf people? The NHS is a universal\Nservice for the people of England and NHS
Dialogue: 0,0:56:52.60,0:56:58.78,Default,,0000,0000,0000,,England is under specific legal duties in\Nrelation to tackling health inequalities and
Dialogue: 0,0:56:58.78,0:57:05.05,Default,,0000,0000,0000,,advancing equality. The Government will hold\NNHS England to account for how well it discharges
Dialogue: 0,0:57:05.05,0:57:07.84,Default,,0000,0000,0000,,these duties.
Dialogue: 0,0:57:07.84,0:57:13.34,Default,,0000,0000,0000,,Can we expect NHS computer systems to be able\Nto tell us how many deaf people there are
Dialogue: 0,0:57:13.34,0:57:19.81,Default,,0000,0000,0000,,and which services they are accessing? The\Nshort answer is regrettably no, not yet. However,
Dialogue: 0,0:57:19.81,0:57:26.37,Default,,0000,0000,0000,,the new system being commissioned by NHS England\Nto upgrade the hospital episodes statistics-the
Dialogue: 0,0:57:26.37,0:57:33.37,Default,,0000,0000,0000,,HES service-will mean that they include a\Nricher source of hospital data, plus data
Dialogue: 0,0:57:33.61,0:57:39.21,Default,,0000,0000,0000,,from care provided outside hospital. While\Nthis will not tell us how many deaf people
Dialogue: 0,0:57:39.21,0:57:46.21,Default,,0000,0000,0000,,there are, it will tell us about deaf people's\Naccess of services. I am sure other improvements
Dialogue: 0,0:57:46.57,0:57:53.37,Default,,0000,0000,0000,,to care data in time will be able to give\Nus the number of deaf people there are.
Dialogue: 0,0:57:53.37,0:57:57.85,Default,,0000,0000,0000,,Will implementation of the proposed information\Nstandard be supported by a funded programme
Dialogue: 0,0:57:57.85,0:58:03.64,Default,,0000,0000,0000,,which can help to educate and support? As\Npart of the engagement activity, we asked
Dialogue: 0,0:58:03.64,0:58:10.37,Default,,0000,0000,0000,,health and care professionals and organisations\Nto advise us as to the challenges they experience
Dialogue: 0,0:58:10.37,0:58:15.55,Default,,0000,0000,0000,,in meeting the communication needs of patients,\Ncarers and services users, as well as the
Dialogue: 0,0:58:15.55,0:58:22.55,Default,,0000,0000,0000,,ways they have identified to overcome the\Nchallenges. These will be reviewed. The intention
Dialogue: 0,0:58:22.98,0:58:28.22,Default,,0000,0000,0000,,is that the findings will inform the drafting\Nof the standard itself and the development
Dialogue: 0,0:58:28.22,0:58:33.87,Default,,0000,0000,0000,,of supporting tools. Regarding the psychological\Ntherapies question, following a device from
Dialogue: 0,0:58:33.87,0:58:40.87,Default,,0000,0000,0000,,the prescribed specialised services group,\NMinisters have decided that these services
Dialogue: 0,0:58:45.77,0:58:48.11,Default,,0000,0000,0000,,should be commissioned by CCGs.
Dialogue: 0,0:58:48.11,0:58:55.10,Default,,0000,0000,0000,,I move on to the question of the noble Lord,\NLord Borwick: what can be done to encourage
Dialogue: 0,0:58:55.10,0:58:59.52,Default,,0000,0000,0000,,more teachers to work in this specialist area?\NSchools and local authorities are responsible
Dialogue: 0,0:58:59.52,0:59:05.79,Default,,0000,0000,0000,,for assessing their workforce and have adequate\Nrecruitment and training strategies in place.
Dialogue: 0,0:59:05.79,0:59:11.98,Default,,0000,0000,0000,,We expect authorities to work with schools\Nso that they know and build the appropriate
Dialogue: 0,0:59:11.98,0:59:17.69,Default,,0000,0000,0000,,skills for the teaching workforce, and the\NDfE is funding scholarships for teachers to
Dialogue: 0,0:59:17.69,0:59:24.69,Default,,0000,0000,0000,,develop their knowledge and skills, including\Npostgraduate qualifications. Regarding the
Dialogue: 0,0:59:25.69,0:59:32.69,Default,,0000,0000,0000,,question of texting information, this sort\Nof thing is a local decision. I have told
Dialogue: 0,0:59:33.93,0:59:40.93,Default,,0000,0000,0000,,noble Lords how my local GP practice chose\Nto sort it, and others may choose to use texts.
Dialogue: 0,0:59:41.27,0:59:48.27,Default,,0000,0000,0000,,On teacher numbers, so far 600 teachers have\Nachieved or are working towards a qualification
Dialogue: 0,0:59:49.11,0:59:54.75,Default,,0000,0000,0000,,relating to special education needs, and a\Nfurther 500 have applied for the current funding
Dialogue: 0,0:59:54.75,1:00:01.75,Default,,0000,0000,0000,,round. I have exhausted the supply of responses\Nfrom the Dispatch Box, but I feel absolutely
Dialogue: 0,1:00:05.07,1:00:12.07,Default,,0000,0000,0000,,sure that when we go through Hansard, many\Nmore questions that will come to light, so
Dialogue: 0,1:00:12.84,1:00:19.84,Default,,0000,0000,0000,,we will write a letter to all noble Lords\Nwho have taken part in \Nthe debate.