Deafness and Hearing Loss — [Steve McCabe in the Chair]

Backbench Business – in Westminster Hall at 1:30 pm on 30th November 2017.

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Photo of Steve McCabe Steve McCabe Labour, Birmingham, Selly Oak 1:30 pm, 30th November 2017

I draw hon. Members’ attention to the fact that our proceedings are being made accessible for people who are deaf or have problems with hearing, and the interpreters are using British Sign Language. If Members bear that in mind while making their contributions, that will be helpful for everyone.

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse 1:31 pm, 30th November 2017

I beg to move,

That this House
has considered deafness and hearing loss.

It is a pleasure to see you in the Chair, Mr McCabe. I am even more pleased to see that our debate is being interpreted into sign language, which I believe is a parliamentary first; we may be making history, which is great for all of us who are here to participate. I am grateful to the Backbench Business Committee for the opportunity to introduce the debate, and am very pleased that so many colleagues have been able to join us to contribute to this important discussion. It is good to see the Minister in his place, even though the subject is not exactly in his brief, and I look forward to hearing the winding-up speeches from him and from the Opposition spokespersons.

I place on the record my thanks to the UK Council on Deafness, Action on Hearing Loss, the National Deaf Children’s Society, Deaf Plus, the Adult Cochlear Implant Action Group and Brian Lamb, DeaflympicsGB, Access Bedford, the network Three and the House of Commons Library for their assistance in preparing for the debate. That is a long list, but given that 11 million people across the UK are living with hearing loss, it could have been much longer. The UK Council on Deafness, for example, represents 43 deafness or hearing loss organisations and has produced a collective briefing. I should also declare that I wear two hearing aids of my own and am chair of the all-party group on deafness.

There are too many issues for me to raise personally and it would be unfair not to share the time available as equitably as possible among hon. Members present, so the bulk of my speech, which I have timed at 13 and a half minutes, will focus on three key issues: Access to Work, legal recognition of British Sign Language and the implementation of the national action plan on hearing loss. First, however, I would like to put down a brief marker on several other issues that I do not have time to raise in detail.

I secured an Adjournment debate on cochlear implants in March, in which the then Minister David Mowat advised me that the National Institute for Health and Care Excellence would consult on new proposals by the end of the summer. We are still awaiting that consultation, so any information from the Minister would be very welcome.

Requests to improve paediatric audiology services across the country by accrediting them through the IQIPS —improving quality in physiological services—programme have been made for some time. I would welcome an update on any progress on voluntary accreditation or, if that has proved unsatisfactory, on whether the Government have given more thought to making it compulsory.

On Deaflympics, any information from the Minister about discussions between his Department and the Department for Digital, Culture, Media and Sport on support for our deaf athletes would be very welcome.

On early years intervention, the first three and a half years are critical for the development of listening and spoken language. I would be grateful for any update from the Minister on Government thinking about ensuring that auditory-verbal is put on the patient pathway as a follow-up to the newborn hearing screening.

Finally, I have some positive news about telecommunication services: the briefing from Three shared how it provides services for its deaf or hard-of-hearing customers. I also have some good news from Deaf Plus, whose BSL advice line was shortlisted this week for a national Helplines Partnership award. Well done!

Let me return to my three key issues, beginning with Access to Work. One person in six in the UK—or approximately 11 million people—is living with some form of hearing loss, and estimates show that nearly 90,000 use British Sign Language as their first language. The Government’s Access to Work scheme provides grants to disabled people to enable them to have equal participation in the workforce. It has revolutionised the career opportunities of deaf people, shattering the glass ceiling that had limited them to manual jobs. It has been largely due to Access to Work that deaf people have progressed as far as their talent allows: there are now deaf chief executive officers, deaf Ministry of Justice intermediaries and deaf theatre directors, among other senior professionals.

In March 2015, however, the then Minister for Disabled People, Mr Harper, announced that the Government would impose a cap. The cap means that the scheme no longer properly supports those deaf and disabled people for whom support costs are more expensive. For deaf people who are self-employed or entrepreneurs, there is no employer to make up the difference between the award and the need. In a recent written answer, the Department for Work and Pensions indicated that it was unable to state the number of people still in receipt of awards above the cap.

The UK Council on Deafness conducted its own survey to establish the impact of the cap on deaf people. It received 87 responses, including 60 from those who will be capped in April 2018—a high response rate, given that fewer than 200 people were identified in the equality assessment as potentially in that situation. Deaf people tell us that they are already avoiding applying for work in professional, managerial and senior roles that will be capped. The cap on Access to Work awards risks imposing a glass ceiling for deaf and disabled people in their work. Some 46% said that they would not apply for promotions, 20% said they had not applied because they were worried, and 44% said that they would stay with their current employer for as long as possible because they were worried about a new employer.

Will the Government look again at the evidence opposing the cap on Access to Work awards? Do the Government accept that the cap on Access to Work grants is set too low? The Secretary of State amended it from £42,100 to £43,000 in his statement today, but that is still too low. If the Government will not remove the cap, will they consider raising it to a level that provides deaf people with more of the support they need? Finally, have the Government considered that they may inadvertently have created legitimate financial grounds on which employers can discriminate against job applicants who use BSL? I recognise that those are questions mainly for the DWP, but if the Minister cannot respond to them today, I would be grateful if he ensured they were passed on to the appropriate quarter. In answer to my question in the Chamber about an hour ago, the Secretary of State said that the Government were still looking at evidence. I hope that means that the door is still open, because increasing the threshold by £1,000 clearly does not cut it.

In general employment terms, there are hurdles to getting into work for people with hearing loss anyway. In a YouGov survey commissioned by Action on Hearing Loss, 35% of business leaders stated that they did not feel confident about their business employing a person with hearing loss, while 57% agreed that there is a lack of available support or advice for employers about employing people with hearing loss. Access to Work is still the DWP’s best-kept secret: 63% of the business leaders polled had never heard of it.

Let me move on to British Sign Language. BSL is the first or preferred language of more than 80,000 deaf people in the UK, and more than 150,000 people use it at home. In 1987, the British Deaf Association launched a call for the legal recognition of BSL, and in 2003, following extensive lobbying, BSL was officially recognised as a language in its own right by the DWP.

In 2009, the UK Government ratified the United Nations Convention on the Rights of Persons with Disabilities, which states that Governments must uphold rights by

“Accepting and facilitating the use of sign languages…in official interactions” and by

“Recognizing and promoting the use of sign languages.”

Despite formal recognition by the UK Government that BSL is a language in its own right, there has been no further progress towards establishing a legal status for BSL.

In the devolved Administrations, the situation is different. In 2012, a consultation for a British Sign Language Act in Scotland was initiated, culminating in the passing of the British Sign Language (Scotland) Act 2015. In 2017, the Scottish Government published their first BSL national plan. In 2016, a sign language framework consultation was launched in Northern Ireland. Despite those developments, however, there is still no pathway in place for legal recognition of BSL across the UK. With such legal recognition of BSL would come the rights of deaf people, and the benefits for deaf people and for wider society would be far-reaching.

On education, deaf children are 42% less likely to achieve five or more GCSEs at grade C or above than their hearing peers, but there is no reason a deaf child should do any worse than a hearing child. On health, 70% of deaf people who have not been to a GP recently wanted to go but did not, mainly because there was no interpreter available. Deaf people who have been told that they might have high blood pressure are three times more likely than everyone else not to have it under control. Deaf people are almost twice as likely as others to experience mental health issues, which can be exacerbated by social exclusion. A health economics study showed that eliminating poor diagnosis could save the NHS £30 million annually—and it is worth noting that 90% of deaf children are born into hearing families.

The call to Government is that the deaf community want them to acknowledge the benefits of legal recognition of BSL and commit to establishing a UK-wide sign language framework consultation for a UK-wide sign language Act. The British Deaf Association is asking for this consultation process to be led by an appropriate Department whose remit covers language. However, that is another major obstacle and it prompts a question for the Minister: which Department and which Minister lead on BSL? I have been writing for some time to try to find out. I even tabled a parliamentary question to the Cabinet Office and the answer that question elicited was that

“all Government departments have a responsibility to create inclusive communications. This does not mean promoting BSL as an activity in itself but it does mean identifying and meeting the communication needs of the audiences we are targeting”.

I am sorry, Minister, but that answer is nowhere near clear enough and I think it demonstrates why BSL is stranded. No Department is responsible for it; no Minister is responsible for it; there is no champion in Government who is responsible for it; there is no advocacy for it; and there is no progress on it.

Finally on BSL, there is the case for a British Sign Language GCSE. Although BSL is a recognised language within the UK, a GCSE that can be taught in schools is not available. A GCSE on BSL has already been piloted and is largely ready to go, but the Department for Education is declining to give it the go-ahead. There is a principle of fairness and justice here. BSL is an official language in the UK that is used by tens of thousands of people. Not allowing BSL to be taught as a GCSE implies that it has a lower status and importance than other subjects, and that could even be seen as discriminatory against deaf people. Also, we do not have enough deaf interpreters. Judging by the briefings that we have all received, I think that there are 800 to 900 registered deaf interpreters, which is clearly inadequate to deal with more than 100,000 people.

The last of the three issues that I will raise today is the implementation of the action plan on hearing loss. When the Department of Health and NHS England published that plan in March 2015, it was widely welcomed. This cross-Government plan not only recognised hearing loss as a major public health issue, but highlighted the major impacts of hearing loss. It also committed the Government to improving services for everyone living with hearing loss. In addition, it set out the need to reduce variation in the provision of services, through the development of guidelines by NICE on adult-onset hearing loss.

The action plan set out five key objectives in the following areas: earlier diagnosis; good prevention; integrated services; increased independence and ageing; and good learning outcomes. There was wide support for the plan. As part of the implementation, NHS England published its new national commissioning framework for hearing loss services in July 2016. It is essential that information about that framework is properly disseminated by NHS England and that the framework is fully adopted by clinical commissioning groups. To help with that dissemination, in September, NHS England published its “What Works Guides—Action Plan on Hearing Loss”, which provides advice to commissioners and providers on supporting people with hearing loss in a variety of different settings.

NHS England is also set to publish guidance imminently, setting out the need for health and wellbeing boards to consider people with hearing loss when they are commissioning services, as well as considering its data tool. In this case, the requests made of Government would be fairly straightforward to meet, because the frameworks are in place.

The UK Council on Deafness is asking the Government to work with NHS England, commissioners and professional bodies for medical professionals to raise the importance of early diagnosis of hearing loss; produce an analysis of the case for hearing screening, potentially adding it to the NHS health check that is provided to people in England aged between 40 and 70; and raise the importance of promoting the commissioning framework through NHS England. The framework provides a clear alternative to the decommissioning of hearing aids, and CCGs should be aware of it when designing and commissioning local services.

It is fair to say that on the three major issues I have raised today the Government have a mixed report card. On Access to Work, the Government started very positively, then faltered and now could be going backwards. We need the response of the Secretary of State for Work and Pensions to my question in the main Chamber today on the need to continue to look at the evidence to make serious progress, because the evidence, as I hope I have laid out, is very much there.

On BSL, the Government never really got started. That is not just the Minister’s Government; that is “the British Government”, a phrase that covers both sides of the Chamber. We are still stalled on BSL and there is no sign of an ignition switch to start us moving again. We need a champion of BSL in Government.

On the action plan, the Government started well and maintained progress, but they need to move through the gears now to ensure that that progress continues and secures the promised outcomes. We only need more of the same, because the start in this area was welcomed by the whole deaf and hearing loss community.

Finally, this is an important debate and I am grateful that so many colleagues have managed to be here to participate. I am also grateful for the opportunity to open the debate and I look forward to the contributions that will follow.

Photo of Iain Stewart Iain Stewart Conservative, Milton Keynes South 1:48 pm, 30th November 2017

It is a great pleasure to serve under your chairmanship, Mr McCabe.

I start by congratulating Jim Fitzpatrick on securing this debate and on setting out his case with his customary courtesy and passion. He has been a champion of these issues for many years, so I pay him heartfelt tribute for that.

As the hon. Gentleman said, this is the first debate in the House to be transmitted via British Sign Language. Unfortunately, news of that came too late for one of my constituents, Christopher Jones, who wanted to attend, but decided not to travel down from Milton Keynes because he did not think that this facility would be available. Mr McCabe, perhaps you could report back to the Speaker and the Panel of Chairs that we should consider providing this interpretation not only during debates on this subject, but during general debates more widely, so that we are as accessible as possible to all our constituents.

I will focus on the introduction of a nationwide telecommunication relay service—something that Mr Jones came to see me about a few weeks ago. In most advanced economies, a nationwide TRS provides functionally equivalent telephone transmission services to deaf and hard-of-hearing individuals. A TRS is a telephone transmission service that allows an individual who is deaf or hard of hearing to have the same telephone availability as someone who is of good hearing. As telephone services and technologies evolve, so does the scope and achievement of functional equivalence. At one time, typed text communication was considered the functional equivalent of voice communication, but in the 21st century, captioning, video and other technologies have changed what equivalency means. The gaps between what is available to hearing individuals and those with hearing deficiency are growing. Sadly, the UK, which was the first to introduce such systems, now lags well behind other countries such as the USA, Australia, Canada and New Zealand.

The issue of functionally equivalent telephone services must be addressed. It includes, but is not limited to: the unrestricted availability of relay services 24 hours a day, seven days a week; emergency preparedness and response, to ensure the delivery of relay services in the event of disruptions to telecommunications services; international capacity; and access to the full array of existing telephone services offered by telecommunications companies. Competition, innovation and choice are important, so that users can access a wide range of services. What works for some people in some circumstances might be different from what others need. There are different facilities available, and it is important that each user can choose the system that works best for them at any one time. That might mean one individual having different things at different times. My constituent said that he would use one means to communicate with his family, and a different one for business conversations. Many other issues need to be considered.

While these may seem like lofty goals, they are being delivered in the countries I mentioned. For example, Australia provides the following relay services: textphone to voice and voice to textphone; textphone voice carry-over; textphone hearing carry-over; speech to speech; video relay services; internet relay; mobile text relay; mobile SMS relay; captioned telephone for phone and web; and captioned telephone to Braille display. In Australia, the system has operated as a national service since 1995 and is available to every Australian at no additional cost, 24 hours a day, seven days a week.

A number of studies since the system’s introduction have looked at its impact. We might think some of the findings are obvious, but it is important to mention them. Access to enhanced relay services is positively associated with reductions in feelings of frustration with telephone use. It gives individuals a much higher quality of life. It not only allows access to work, as the hon. Member for Poplar and Limehouse mentioned, but is proven to reduce the wider health consequences that can arise from isolation, such as mental health issues. The cost saving is likely to exceed the cost of introducing the service. I think I heard him mention that £30 million annually could be saved from the health and social care budget if many of these feelings of social exclusion were dealt with.

Ironically, my constituent was involved in designing and setting up such a system many years ago. It had to close down in 2008 as he could not make it work, and part of the problem was bureaucratic muddle and delay. The issue is often cross-departmental. We have a Minister from the Department of Health here, but the matter is as much for the Department for Digital, Culture, Media and Sport and the Department for Work and Pensions. The potential benefits of the system my constituent introduced could not be realised because there was buck-passing and delays, and the approach was not joined up.

My call today is for the Minister to take away these points and discuss them with his colleagues in DWP and DCMS, and to drive forward the introduction of a nationwide service in this country. It is embarrassing that while we were one of the first to introduce such systems, we have fallen back over a number of decades. Other countries are now way ahead of us. I urge the Minister and his colleagues to look at the evidence, particularly from Australia, on what can be done cost-effectively. This is not just about money; it is about quality of life. We owe it to all our constituents to give them as much access to the world of work and public services as anyone else, and my suggestion is a fairly straightforward way to do that. I urge the Minister to look at the evidence from other countries and discuss it with his colleagues.

Photo of Pat McFadden Pat McFadden Labour, Wolverhampton South East 1:56 pm, 30th November 2017

I begin by echoing the tribute paid to my hon. Friend Jim Fitzpatrick for securing this debate. As we have heard, there are a number of dimensions and aspects to deafness, but I want to focus on one issue: the criteria for receiving cochlear implants under the NHS. My argument today is simple: the criteria should be reviewed so that it is easier to get an implant. That would transform the lives of those who need this technology, and improve the lives of their families and loved ones. It would be a prudent investment, because it would obviate the need for more expenditure further down the line as a consequence of people not receiving the implants they desperately need.

I will tell the story of my constituent, Lamina Lloyd. Until last year, Lamina had a flourishing career as the manager of a local citizens advice bureau. However, Lamina has Meniere’s disease, which has resulted in progressive hearing loss—so much so that last year she had to give up work. She has two children who themselves have additional needs. She can no longer hear her children, who have to act as her ears. She describes her family as having gone from being an outdoor family to one that rarely leaves the house. Lamina is an intelligent, capable person, but hearing loss has meant the end of her career, a diminishment in the quality of her family life, and increasing isolation.

To try to alleviate her condition, Lamina wears the most powerful hearing aids available, turned up to maximum volume, but they make little difference and give her frequent ear infections and headaches from their feedback and squealing noises. She can no longer hear music or follow conversations, yet she has been in a battle—that is the only word for it—for the past two years to try to get a cochlear implant. She falls just 5 dB short, which is no more than a whisper, of the 90 dB hearing loss threshold for consideration for an implant. That threshold is one of the strictest in the western world. It is estimated that only 5% of those who could benefit from the technology get access to it in the UK.

Lamina describes her condition as being too deaf to hear, yet not deaf enough to get the help that could make a huge difference to her life. Her hearing has deteriorated even further in recent months, and she has an appointment to be assessed at the Queen Elizabeth Hospital in Birmingham in two weeks’ time, but she and many others in her position have serious reservations about how the assessments are made. The Bamford-Kowal-Bench test uses short sentences in lab conditions. It does not replicate normal conversation or real-world conditions. Lamina and many others feel that that tool is not fit for the purpose of properly measuring hearing ability and hearing loss.

Even if Lamina is approved for an implant, why has it taken so long? Why do we put people and their families through such pain before giving them the help that could be life changing? My hon. Friend the Member for Poplar and Limehouse raised those issues in an Adjournment debate earlier this year, and briefly at the beginning of his speech today. He was told earlier this year that the National Institute for Health and Care Excellence was launching a consultation on the relevant guidelines. That has not happened. The guidelines have been in place since 2009, but technology and costs have moved on a great deal since then.

I wish to ask the Minister a few questions. If he cannot respond to them all today, I would be very happy for him to consult with colleagues and write to me, and other Members participating in the debate, with a more considered response. First, why has the NICE consultation, which we were promised would be launched in summer this year, not yet been launched, and when will it be? Secondly, does he agree that Lamina’s case and many similar cases around the country show that there is an overwhelming argument for revising those criteria?

Thirdly, whatever hearing loss threshold is picked, does the Minister agree that the hearing loss test needs to be done in real-world conditions that approximate to how people actually live their lives and conduct conversations, and so on? Fourthly, and perhaps most fundamentally, why does it take so long for people to get an implant? Why is it such a battle? The NHS is there for those who need it; it should not be an organisation that people have to battle with to get the treatment that they need. Had my constituent been helped earlier, she might still be in a job. She would not need to rely on the state for financial support, and her family would not have had to go through the huge difficulties that they have all been through together over the last couple of years.

It is time for a step change in the urgency with which the issue of cochlear implants is treated. The guidelines must be revised. NICE needs to move on that soon, so that the suffering of my constituent Lamina Lloyd, and the many people around the country who are in a similar position, can be alleviated.

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse

On a point of order, Mr McCabe. I asked my staff to monitor the transmission of the sign language. It is not being broadcast; the cameras do not meet the interpreters. Westminster Hall debates do not have subtitles, unlike in the main Chamber. Obviously I would very much appreciate it if you took that matter back to the Panel of Chairs and discussed it in due course.

Photo of Steve McCabe Steve McCabe Labour, Birmingham, Selly Oak

I understand that the sign language is being filmed today, and when the debate is re-broadcast it will appear in a box, as is normal in other TV transmissions. Obviously this is an early stage. I will report back on how the whole debate goes and any points that Members raise, but I understand that the arrangements for today are that when the debate is re-broadcast, the sign language will appear.

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse

I am grateful for that clarification, Mr McCabe.

Photo of Kelly Tolhurst Kelly Tolhurst Conservative, Rochester and Strood 2:03 pm, 30th November 2017

It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate Jim Fitzpatrick on securing this important debate; it is a real pleasure for me to speak in it. I also think it is an absolutely fantastic move that today’s debate is being signed. I advocate that more debates held in the Chamber be signed. It should be the norm in the House of Commons, not an exception to the rule.

I was very keen to speak in this debate about deafness and hearing loss, because it has had a major effect on my family. Rather than focusing on the many issues that affect deaf people in this country, I want to share with hon. Members an example of how deafness has affected my life.

Twenty-five years ago, at the age of 40, my mum lost her hearing literally overnight, due to a virus. She woke up one morning and could not hear any more. She had not been ill and had never had any hearing problems, but she went from being a hearing person one day to having no hearing the next day. At that time, we had a really good ear, nose and throat hospital in Maidstone. About a week after my mum lost her hearing, my father took her there, and it was confirmed that she had no hearing. The hospital staff put her on steroids and told her that it was due to a virus, that the hairs in her ears had died and that it was very unlikely she would ever get her hearing back.

That was absolutely devastating for my mother and for us all—my sister, myself and my dad. It changed her —and our—life fundamentally. We could not communicate with her; everything had to be written down. My mum could not sign or lip-read, so she was flung into isolation and, quite honestly, a state of depression. It was a really tough time. She had two teenage girls who were at that time very much into their singing, and all of a sudden, my mum had to accept that she would never again be able to hear her daughters sing.

Due to the abruptness of her hearing loss, it was really difficult to mitigate some of the emotional damage she suffered. The NHS looked after her and the staff tried to help her. They gave her lip-reading classes and offered her support with a counsellor; they even put her in contact with another lady in the country who had lost her hearing overnight, but my mum was still mourning the loss of something that she was never going to get back. Importantly, she was never told that she was a candidate to have a cochlear implant—that reinforces the point made by Mr McFadden.

Deafness is the invisible disability. My mum did not look like she had a disability. Her voice sounded like it always had, because she had been a hearing person for 40 years, but I saw and experienced at first hand the major barriers that people who are deaf have to face. I recognise that there are strong differences between individuals who have been born deaf, those who have gradual hearing loss, and those who had hearing loss as a small child, perhaps due to meningitis or some other illness, but the biggest thing for my mum was that she did not have any deaf friends. We did not even know any deaf people.

Particularly acute was the fact that my mum’s opportunities were severely limited. She had looked after me and my sister at home, but was looking forward to going back to work because we were now in our teens. All of a sudden, she found that she was unable to work, because she did not have the confidence, and it was very difficult for her to understand anyone at that time. The opportunities open to her were therefore extremely limited.

Eventually, after eight years, my mum decided that she wanted to do something about her hearing loss. She went to the doctors, and they talked to her about whether she could be a candidate for a cochlear implant. She was told that she would have been able to access one immediately, because of the severity of her hearing loss, but it then took another two years for her to have an implant, because 25 years ago the funding was quite a challenge, due to the fact that such procedures were not as frequent as they are now.

After 10 years of suffering, being isolated, suffering with depression and being unable to go back to work, she finally had the cochlear implant. Sadly for her, after a year of travelling to St Thomas’ hospital, with its fabulous technicians, led by Terry Nunn, it was decided that the cochlear implant had not worked. She therefore had to go back for a further implant. Many people will not understand that a cochlear implant does not bring someone’s hearing back. They do not hear like they did when they were a hearing person, but it gives them some quality of life.

Technology has changed, and 25 years on, cochlear implants are available not just in London, but all over the country. What is very clear is that the sooner someone has a cochlear implant after the loss of hearing, the greater impact it will have on how that person hears. I was extremely worried on reading the reports, which have already been mentioned, that some clinical commissioning groups are now looking at stopping hearing aid provision. One of the only things that kept my mother going through those 10 years was that she was using a hearing aid. It did not help her hearing—all it did was accentuate the background noises and cut out some of her tinnitus some of the time—but if she had not had access to that service in the time before having a cochlear implant, it would have been even worse. In my view, hearing aids are a cheap way of having an impact on people who are suffering from gradual hearing loss. I find it quite frightening that CCGs would even be considering stopping that support, and I think it is a dangerous road to go down.

As hon. Members have already said, hearing loss, even if it is mild, sends people into isolation. They might not put themselves into certain situations because of fear of not understanding or not being able to hear what is going on. I used to go into the supermarket with my mother and people would ask her if she would like a carrier bag, but because she did not hear them, they would think she was rude. They might make a rude comment to her because of that, but she actually could not hear them. Hearing aids are massively important and can be an important way of keeping people out of that isolation and of maintaining their contact with the health service so that the hearing loss can be monitored.

It is not often talked about, but people who suffer from hearing loss and deafness are also very embarrassed by their disability. If it was physically visible, everybody would be talking about that kind of disability. People would be banging the drum and asking for support from the Government and different organisations; but deaf people work, get on with their lives and rarely moan very much. They put up with quite a lot. Because they do not have a visible characteristic, it is very difficult for hearing people to truly understand the isolation, depression and mental health issues that they are subjected to.

I have spoken today very much from an emotional point of view about a real-life situation that has affected me. I hope that what I have said has illustrated that deafness can take many different forms; it occurs not just in old age, or from birth. For too long, deaf people have been disadvantaged and isolated. It is really good to have this debate, and I join the hon. Member for Poplar and Limehouse in supporting the cause of the UK Council on Deafness. All its recommendations are well thought out, meaningful and realistic asks. I hope that anyone who is deaf who watches this debate next week will see that it is good to have such debates in Parliament, and that we care about deafness in this country and the people that suffer from it. I am pleased to have been able to speak today.

Photo of Stephen Lloyd Stephen Lloyd Liberal Democrat, Eastbourne 2:14 pm, 30th November 2017

It is a privilege to serve under your chairmanship, Mr McCabe. I join other hon. Members in congratulating Jim Fitzpatrick on securing the debate. I was chair of the all-party parliamentary group on deafness, but was rudely interrupted in 2015 when something else happened. It is a pleasure to be back and to serve as vice-chair of the APPG under the hon. Gentleman’s excellent chairmanship.

I commend the previous speakers’ comments about cochlear implants. I remember 20 or 30 years ago, when they really began to take off. The difference between now and then is absolutely huge. That overlaps with what Kelly Tolhurst described of her mother’s experience. I thank her for that moving speech. Her mum will be proud of her, I am absolutely sure of that. I can relate to a lot of the things that her mum went through. I have been deaf for about 50 years of my life.

Cochlear implants have made a huge difference and the improvement is absolutely massive. The Minister is from the Department of Health—he is an old colleague from coalition days; it is good to see him—and I ask him to explore how cochlear implants can be ever more available, because they do much more now and they do it much earlier. They are a game-changer. For many years after they first came out, a long, long time ago, they really did not make that much of a difference. There was vigorous opposition from a lot of the British Sign Language community, and I understand why. That has changed a great deal over the years and cochlear implants are now, in many ways, the future for transforming deafness. I never really believed it in the old days, but now I do, because of the advances.

I would like to cover a few areas, a couple from the UK Council on Deafness angle and a couple specifically because we have a Health Minister here. British Sign Language is a different language. I am hard of hearing and have been since having measles when I was six. Sometimes, people might say to me, “Stephen, are you a member of the deaf community?” and I would say, “No, I am a member of the hearing community. I just don’t hear very well.” That is an important point, because they are completely different. The deaf community is a community. The BSL community is a completely different community, with cultural norms and a different language. BSL is not even a direct translation of my speech; it is different. Sometimes people do not understand that. They would say to me, “Why don’t you learn BSL?” and I would say, “Because I am a member of the hearing community, I just don’t hear very well, and it is a different language.” I am very supportive of profoundly deaf people trying to get BSL as a recognised language, as has happened, I believe, in Holyrood in Scotland.

I remember just before 2015 having meetings with a number of people down from Scotland and we were watching that development with great interest. Once it happens in one legislative House, it is very hard for other legislative Houses not to follow, so I say good luck with that up in Scotland, because it is a game-changer. It will happen eventually in Westminster. When it does, it is not just a label. When a nation says that a language is a statutory language, it means it is accessible and that public bodies have to provide information in that language, and that will make a huge difference for a lot of profoundly deaf people. I will tell hon. Members why and give one very good example.

I have been involved for many years in politics around deafness as a trustee of this or a patron of that, or what have you. I knew a lot of people who are profoundly deaf working in that area, including from the British Deaf Association. I just came from a statement this morning in which the Secretary of State for the Department for Work and Pensions mentioned that about 50% of disabled people are out of work. I tell you what, Mr McCabe, it is a hell of a lot higher than that for the profoundly deaf. I do not have the figures because no one really finds them. The DWP—it used to drive me crazy when I was here before—will not slice the different disabilities up. It just says “problems with deafness and problems with visual impairment”, which completely denies the separateness of deafness. Off the bat, though, I would say that profoundly deaf people have an unemployment rate of around 70%, which is just ridiculous. How can we possibly have 100,000 people—if not more—of adult working age and have such barriers that 70% are unemployed? It is a blooming outrage! Now that I am back in the House, which is wonderful for the people of Eastbourne—I thank them—I am determined to lobby hard to make BSL an accepted language.

I am also keen to join the hon. Member for Poplar and Limehouse in lobbying on Access to Work. The Government have done a great thing with Access to Work—I think it was John Major’s Government that started it. Access to Work is a good thing which has made a huge difference to a lot of people, and I am a big supporter or it, but there is a challenge. It has made a great difference for people who are in work and acquire a disability through illness, a catastrophic incident or what have you—it has been fantastic in helping them to stay in work. I want it to be improved, particularly in the small and medium-sized enterprises sector, so that SMEs understand that they can employ people with disabilities. Access to Work provides a lot of the money that will buy an induction loop, put in a ramp, or do whatever is necessary to help an employer take on a disabled person. That is really important. Corporates kind of get it—they are huge, and they have massive human resources departments and pots of money, so they try to do their best. It is much harder for an SME employing three people. If I were the director of a plumber working seven days a week, and someone with disability came to see me, it would be so much easier to say, “No, no,” and find an excuse not to employ them. Access to Work often provides the money that allows the SME to take on that disabled person.

I will let the House into a vast secret. I say this with authority, because I used to be a consultant in this area for years. If a business employs disabled people, they get lower churn.

Photo of Stephen Lloyd Stephen Lloyd Liberal Democrat, Eastbourne

I have seen that in call centres, in businesses and in numerous other areas. I used to be very involved with the Federation of Small Businesses, and I am sure I will be again now I am back. Lower churn is really important for businesses if a lot of their spend goes on employing people. At a later date, I will explain why it leads to lower churn, but it does.

Photo of Matt Western Matt Western Labour, Warwick and Leamington

The hon. Gentleman is talking about the challenges that SMEs have in employing people with such impairments. Does he agree that it is difficult for many people who suffer from deafness or failing hearing to progress within organisations because of the cap? It is therefore almost self-enforcing that those people are pressed into part-time working.

Photo of Stephen Lloyd Stephen Lloyd Liberal Democrat, Eastbourne

That is a very good example. I have no hearing on my left, so I could not hear the hon. Gentleman trying to intervene. Jim knows to punch me.

The hon. Gentleman is right. There are issues to do with Access to Work. As it has expanded and cost a lot more money over the years, the Government—I am not chucking stones, as I know how challenging it is to work within the Budget envelope—have introduced more and more caps. Rather than focusing on different ways of capping Access to Work, I would like the DWP—the Minister can go back and tell his colleagues—to focus on better and more creative ways to use the money. I know from years of experience—colleagues will have to take my word for it—that the majority of disabled people who get into a job, are properly managed and have the right support, stay there for years. That costs much less money than constantly having to re-employ. I thank the hon. Gentleman for the intervention.

I want to talk about two key areas that are specific to the Minister’s brief. One of the things I fought for last time I was here—I am going to do so now as the Minister is in Health—was an automatic invitation for a hearing aid screening whenever someone hits pension age. That would be at 65 or 66, although that was under the coalition—I think retirement age is 150 now. That is significant because something like 50% of people over the age of 65, heading up to 60% as they get older, begin to get age-onset hearing loss. My hearing loss is not age-onset, although I am old enough now—it was measles, as I said—and the hon. Member for Poplar and Limehouse is far too young, so his cannot possibly be age-onset. The thing with hearing loss is that the vast majority of people ignore it for 15 years because it is not a sexy disability. Kelly Tolhurst flagged that up, and it is true. People start losing their hearing, they do not admit to it, their husband or wife goes potty, the volume is turned up massively on the television, and eventually their kids drag them to the audiology department, if it is still open—we will come to that—in their mid-70s.

The problem with that—there is significant data to prove this, which I will happily share with the Minister another time—is that the longer someone takes to get a hearing aid, the lower the chance of it working. The difference between a 75-year-old and a 65-year-old in acuity terms is enormous. Hearing aids are not like glasses. If I cannot see properly, I put glasses on and I have 20:20 vision. Hearing aids do not replace lost sound; all they do is amplify the residual hearing. Let me try to explain that to colleagues very quickly. Imagine a radio with a battery that is running down. If the volume is turned up, it makes a lot more sound, but it is very discordant. That is what hearing aids do.

I was pressing very hard for the Department of Health to run a pilot so that all people who get to pensionable age receive an invite to audiology or wherever—it could be a pharmacy, for that matter—to have a hearing test. My rationale for that, which was supported by pretty much every group that could possibly be imagined, including NICE, was that if people get in early, they are forced to accept they are losing their hearing. They get a hearing aid, and ipso facto it is much easier to get used to. My view, which is shared by many others, is that that would be a huge advantage, not least in reducing the levels of dementia. We have discovered that dementia is linked to social isolation, and old people who are and deaf or hard of hearing tend to isolate.

The Department of Health agreed in principle to run a pilot. It took me a long time to get that agreement, because the Department did not want to do it. It knew that I was right and all those extra hearing aids were going to cost a lot more money. Then there was a tragedy, colleagues: I lost the election. I was not there to nag like hell, and it sort of disappeared and was put on the back burner. I am delighted to see that my old colleague is now the Minister. I am sure that, now I have put that on the table, he will move heaven and earth to develop it into a pilot. It will make a huge difference to hundreds of thousands of people—I am deadly serious—so I encourage that.

It is easy to cut hearing aids, because it is mostly old people who use them. They are not organised and are not going to complain like hell; they are isolated, anyway. As I said, they are in their mid-70s by the time they go to audiology departments. I am really pretty angry that a lot of CCGs are getting away with beginning to trim audiology services because there are not enough people fighting their corner. I know that CCGs are independent, but the Minister and I also know that there are protocols. In his response, I ask that he make a commitment that CCGs will be told how important audiology and hearing aids are. They must not use the austerity challenges they face to cut audiology. On that note, I again thank the hon. Member for Poplar and Limehouse for securing this debate.

Photo of Peter Aldous Peter Aldous Conservative, Waveney 2:28 pm, 30th November 2017

It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate my hon. Friend Jim Fitzpatrick on securing the debate. Colleagues have spoken very movingly about their personal experiences.

It is great to see my hon. Friend Steve Brine in his place as the responding Minister. I am sure he will do this ably, but it is an indication of the challenges that the hard-of-hearing and deaf community face that hon. Members have mentioned five Departments that have issues that need to be addressed: the Department of Health, the Department for Education, the Department for Business, Energy and Industrial Strategy, the Department for Culture, Media and Sport and the Department for Work and Pensions. That shows that by working in departmental silos, there is perhaps a danger that some of challenges that we are hearing about today are not being properly addressed.

My hon. Friend the Member for Poplar and Limehouse is a champion for the deaf and hard-of-hearing community. I will briefly highlight the work of another such champion, Ann Jillings, from Lowestoft, who is working with passion and determination to secure the best possible education for her son, Daniel. In doing so, she is campaigning for other parents of deaf children in north Suffolk. Daniel started at Bungay High School in September. He is doing well and there is good package of support in place for him, but Ann had to fight very hard to get that and she continues to campaign for a hearing impaired unit in north Suffolk.

It is clear that not just in Suffolk but across the country, deaf children do not get the right support right from the start, so they cannot always realise their full potential at school. That can put them at a considerable disadvantage for the rest of their lives. We need to break down these barriers and create a properly funded national framework, within which local education authorities such as Suffolk County Council can provide a good education and support service locally. If they do not do that, they must be held to account.

The National Deaf Children’s Society, which does great work campaigning for deaf children to have the same opportunities as everyone else, has highlighted four issues on which Government action is needed to break down the barriers that deaf children face. First, the NHS needs to improve the quality of children’s hearing services. The National Deaf Children’s Society highlighted in its Listen Up! campaign that, across the country, many such services have significant shortcomings and are failing to meet the necessary audiology standards. The quality assurance process that was previously in place has ended, and it has not been replaced by any other mandatory process.

The NDCS has a three-point action plan to address this particular problem. First, NHS England must ensure that the children’s audiology services that it directly commissions, such as for the under-fives, comply with the IQIPs—improving quality in physiological services—accreditation programme. Secondly, it is vital that that programme is more transparent, so that families know whether their services are good quality or whether they need to improve. Thirdly, the accreditation must be compulsory, so that all paediatric audiology services move towards running a good-quality operation.

My second point relates to access to radio waves technology for deaf children. Radio aids play a vital role in helping deaf children to hear speech; they enable them to better understand their teacher, and they have a big impact on improving parent-child communication. Despite the obvious benefits, most local authorities do not currently make radio aids available for use by families in the home. The NDCS is calling on local authorities and the Department for Education to ensure that every child who could benefit from a radio aid is given access to one at the earliest possible opportunity. To do that, the Department for Education should encourage local authorities to make use of their special provision capital fund, to provide radio aids where they are needed.

My third point relates to the need for a GCSE in British Sign Language. The Government really must listen to the right to sign campaign, to make British Sign Language available as a GCSE that can be taught in school. Ann Jillings points out that it is the first language of deaf children, so it is discriminatory that deaf children do not have the opportunity to achieve what is probably the most widely recognised qualification, and that it is given a lower status than other languages. There are other accredited qualifications in British Sign Language, but they are not widely available to children in schools and they are less likely to be recognised by employers. Daniel Jillings achieved his BSL level 1 three years ago, but it was not funded. Ann tutored him and paid for all the assessments herself. There is a compelling case for a GCSE in BSL, based on equality, the denial of choice for deaf children and the unnecessary barrier that it poses to further and higher education, and thereafter, entry to the workplace. That barrier must be removed. A GCSE has already been piloted and is largely ready to go. The Department for Education must make an exception to its blanket policy of not allowing any new GCSEs to be developed.

My fourth and final point relates to the special educational needs and disabilities framework. The Children and Families Act 2014 made significant changes to the SEND framework. One key change was replacing SEND statements with EHC—education, health and care—plans. The deadline for implementing those changes is April next year. There is a concern that many schools and local education authorities are struggling to implement the changes in time. In Suffolk, Ofsted and the CQC identified weaknesses in the county council’s practices in meeting the requirements of the Act.

Authorities such as Suffolk must be provided with sufficient funding so that they can meet their obligations. Although the high needs block, which funds SEND support, has been protected in cash terms, it has not been adjusted to reflect a variety of additional challenges: the rising number of children and young people requiring additional support; the greater local authority responsibility for young children with SEND aged between 16 and 25 and in early years; and a trend towards placing more children in special schools. More money needs to be made available and Ofsted needs to review how it can strengthen the accountability framework around SEND and how it inspects schools.

Ann Jillings has gone that extra mile and works tirelessly to ensure that Daniel gets the opportunity to have the best possible start in life and the best possible education, so that he can realise his full potential. There are many barriers that have been placed in her way in pursuit of that goal. I suggest that it is our duty, the duty of Government and of local authorities to remove those barriers as soon as possible.

Photo of Kerry McCarthy Kerry McCarthy Labour, Bristol East 2:37 pm, 30th November 2017

It is a pleasure, as always, to see you in the chair, Mr McCabe. I thank my hon. Friend Jim Fitzpatrick for securing this important debate. The contributions so far have been fantastic.

There are two issues in particular that affect deaf and hard-of-hearing people that I wish to raise today: the accreditation of children’s hearing services, and the cap on the Access to Work scheme grants, which have already been mentioned. There are more than 50,000 deaf children across the UK and an estimated 794 deaf children in the Bristol area alone. For those children, high-quality audiology services are vital to carry out tests, fit and maintain hearing aids and provide rehabilitative support. Despite that, the Government have stopped mandatory inspections of services, instead replacing them with the improving quality in physiological services accreditation programme. Since the voluntary programme started in 2012, only 15% of children’s audiology services have achieved IQIPs accreditation. That means that 85% cannot guarantee that their service is good quality. That lack of transparency is unacceptable and leaves far too many families in the dark about the quality of their child’s audiology service. Obviously, it is of immense importance to parents that their children have access to good services. Some services have stepped up to the starting blocks by signing up to the scheme, such as St Michael’s Hospital in Bristol which serves my constituents, and a few are nearing the finish line and accreditation, but too many are not taking part at all.

The National Deaf Children’s Society, through its Listen Up! campaign, is calling on the Government and NHS England to make assessments of children’s audiology services mandatory and for information from these assessments to be publicly available. I support that campaign and implore the Government and NHS England to implement changes to help ensure that deaf children get the quality of service they deserve. That could make so much difference to their future life chances.

The second issue is the cap on Access to Work grants. As we heard from my hon. Friend the Member for Poplar and Limehouse, Access to Work enables many disabled people to overcome work-related obstacles by providing practical advice and support, and grants towards extra employment costs that cannot be met by employers as reasonable adjustments. A Government review in 2004—some time ago—suggested that for every £1 spent on Access to Work, £1.48 was generated for the Treasury. I am deeply concerned about the effects of the cap on Access to Work grants that the Department for Work and Pensions imposed for new claimants in 2015 on the career prospects of deaf and hard-of-hearing employees. That cap is due to come into force for existing claimants in April next year. It is currently set at £42,100 per year, which is one and a half times the national average salary. Although that may be enough support for some people, for others it is not.

I was contacted about this debate by a deaf constituent who uses British Sign Language and works as a disability adviser at an education establishment. Access to Work helps him participate fully and equally at work by paying the cost of communication support—namely, British Sign Language interpreters. Such support is inevitably expensive —it is necessary to pay people’s wages—so it is unlikely to be classed as a reasonable adjustment for his employer. At the moment, he can access those interpreters’ support throughout his working week. The cap means that he will be able to book interpreters for three days a week at most, leaving him with two days when he will not be able to communicate with his colleagues and clients. That means he will be unable to do his job effectively.

Access to Work revolutionised deaf people’s career opportunities, shattering the glass ceiling that previously limited them to manual jobs. It is largely due to Access to Work that deaf people have progressed as far as their talent allows. There are now deaf chief executive officers, deaf intermediaries working at the Ministry of Justice, deaf theatre directors and deaf social workers. Yet research conducted earlier this year by DeafATW found that the cap on Access to Work grants is already having a detrimental effect on the deaf community. We heard the figures from my hon. Friend the Member for Poplar and Limehouse. On behalf of my constituent and all those in the deaf community who have benefited or stand to benefit from that scheme, I implore the Minister to listen to what is being said, remove or raise the Access to Work cap, and once again lift the ceiling on the career aspirations of those who are deaf or hard of hearing.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead 2:43 pm, 30th November 2017

It is a pleasure to serve under your chairmanship, Mr McCabe, and a pleasure to speak in a debate secured by my good friend Jim Fitzpatrick. We have been on many campaigns together over the years, not least in our previous careers.

I need to declare an interest at the outset. I have been honorary patron of the Hertfordshire Hearing Advisory Service—a fantastic charity that works not only in Hertfordshire but across many counties—for more than 10 years.

I disagree with hardly anything that has been said in this really positive debate. I think that people watching and others will realise that the House can work together not only for people who are hard of hearing, but for people who are hard of hearing and have other issues. We have not discussed the fact that people who are hard of hearing or deaf often have other ailments, which can be as difficult for them as being hard of hearing.

I can assure hon. Members from experience that Ministers usually do not like former Ministers to stand up and talk about things that they might know something about. For a short time, I was the disability Minister and responsible for Access to Work. Let me be positive about Access to Work and break some of the taboos about it. As we have heard, it is one of the great schemes for people across this great nation who had been left behind, ignored and told that they could not work. Employers told people that they could not employ them because it was not safe to do so. That was complete and utter rubbish. I do not have to take the hon. Gentleman’s word for it, because there is evidence in the Department for Work and Pensions that people with disabilities work harder, are more likely to turn up for work and are more dedicated and more committed than any other employees. That is a fact. We know that.

I went around the country as part of the disability confident scheme trying to encourage employers to take on people with all types of disabilities. That was pretty easy with bigger companies. There are some fantastic large companies out there—particularly Royal Mail. It gets biffed around a little at times in the House, but its commitment to people who either arrive with disabilities or acquire disabilities during their employment is fantastic. However, it is really hard with small and medium-sized enterprises. There is a myth that there is a risk: people say, “Health and safety prevents me.” I was the Minister with responsibility for health and safety, too, and I was happy to go around and dispel that myth. We have to work really hard with SMEs.

Access to Work was fantastic in helping thousands of people to get into work and have the confidence to stay. The cap was brought in just before I became the Minister responsible, and one of the first things I said was, “Where is the Department’s evidence that we need to do this and that the cap will work?” Let me put this on the record: there is evidence in the DWP, the Department knows exactly what it is, and it is continually reviewed. Ministers are taught always to say at the Dispatch Box, “The Government continue to keep under review” this, that or whatever. I assure hon. Members that the Department keeps that evidence under review.

It is a shame that my hon. Friend the Minister, who was my Parliamentary Private Secretary, is responsible for responding to this debate, but the DWP, which will see the record of this debate, knows whether the cap will work, is keeping it under review and needs to be open and honest about how it is working. If it is not working, it needs to be adjusted. As a former Minister, I will not have all that great work and all those people’s aspirations and commitment to work lost because of a cap that does not actually save a huge amount of money in real terms.

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse

The right hon. Gentleman makes the same points that we have all made. Access to Work is a great scheme. It works. As I understand it, the logic for the cap is that there is only so much money in the pot—that is always the case for Governments—and therefore its purpose is to try to spread what is available as widely as possible. But for people with fantastic talent who could be advocates and champions for the deaf community by becoming chief executives and leaders of their professions and so on, the glass ceiling has been reinforced, because they can now get only £43,000. This is not a criticism—well, it is in some respects—but we need to ensure that the evidence is looked at regularly.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

Governments need to be kicked and beaten up when they get things wrong and praised when they get things right. I was proud that a Conservative Government brought in Access to Work, which is massively important. There will always be examples of abuse in the system and so on, but that does not give the Government carte blanche to say, “No, the only way this can work is with a cap,” particularly if the evidence does not show that a cap will work. The Minister will have looked twice when he came into the Chamber and realised what this debate would mostly be about, which is not his responsibility but the DWP’s. I am more than happy to go across to my old Department and sit with my old officials and explain to them exactly where the evidence is in their cupboards.

Let me touch briefly on two other areas, and then on one thing that has not been touched on at all. I do not understand why, in the 21st century, a recognised language is not recognised in the House or across the country. I really do not understand why, all these years after I made a point of order in the main Chamber in 2005 to complain that a hearing loop was not available for my constituents when they were in the House—even when it was installed, it did not work properly—this is the first time a debate has been signed for our constituents. People will always go on about how that must cost more money. The cost is minimal compared with the benefit to our constituents of being part of the democratic process.

Photo of Stephen Lloyd Stephen Lloyd Liberal Democrat, Eastbourne

I thank the right hon. Gentleman for kicking off about the induction loop years ago, because I could not function as an MP in the Chamber without it.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

The things I do for everybody in this House. It was genuinely embarrassing. I remember it vividly. I said to the Speaker, Michael Martin, “My constituents have come to see this world heritage site and their Parliament at work. I took them on a tour, and frankly they got hardly any benefit apart from visuals, because they couldn’t understand or hear a word I was saying.” I seem to remember that there was the comment, from a sedentary position, “Well, they didn’t miss very much,” but I was trying to get across a point. This is the mother of Parliaments, and as we have heard from colleagues, we are way behind the loop again. I am sorry to use that terrible pun, but we are really behind. I hope that we will have a lurch forward. I have noticed all the Clerks coming in, and have heard that the Speaker will be reported to, and all that, and that is great, but it is absolutely useless unless someone actually does something. Then we can move on. I know this is a trial, but signing should be transmitted live.

Secondly, there should be a GCSE. I find it fascinating: we can see all the different courses that our young people do in schools and colleges, yet they are excluded in this way. If people do not want any more GCSEs, we could drop one of the ones that would not get used anywhere near as much as this. It would make people aware. In my constituency, people who are not deaf or hard of hearing have said to me that they want to be able to communicate like this; they want to do these courses as well. They want to have a GCSE, so that they can chat away with their mates in that sort of way. That is a simple thing, and I cannot see huge cost implications, so it should be moved on, as we have heard this afternoon.

Finally, I will touch on people whose hearing has been impaired by industrial injuries. That has not been mentioned at all in the debate, but not because people think it should not be. It is just one of those issues. People cannot see this type of industrial injury. It is not like the industrial injuries that my hon. Friend the Member for Poplar and Limehouse and I saw in our former jobs as firemen. There is something very wrong about how we measure industrial injuries, and hearing impairment industrial injuries in particular. So many people who have a hearing impairment do not admit it to themselves, their wives and their loved ones, even though their wives and loved ones are probably aware that there is an issue. They certainly do not talk about it to their employer or previous employers.

I can talk about this, because my eardrum is perforated. I did not know about that until I started to miss conversations that I thought I should be picking up. You just do not think there is something wrong. However, when I was a Minister at the Ministry of Defence, I had to have a medical before I was allowed to go into operational fields, and it was obvious that I had a perforated eardrum. It was almost certainly from live firing when I was in the armed forces—the specialists told me that—although it was not picked up then. That is not so important to me, but where industrial injuries are common, it is massively important that there be a level playing field on decibel levels. Completely different levels are used for hearing damage in the armed forces and what I call civvy street, and that cannot be right.

We must encourage people to come forward, not so much so that they can get compensation, but because, as we heard earlier, if we can pick this up earlier, it saves the state and everyone a lot of money, and also makes life much better for that person, who can start to accept the disability that they have and continue to live a happy life.

[Ms Karen Buck in the Chair]

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse

When I had the hearing test that identified my audiological loss, as the right hon. Gentleman will know, the printout showed whether it was down to age or genetics, or whether it was industrial. Mine was at least partly industrial. I was told by my clinicians, “Your hearing loss is above the threshold for applying for industrial injury compensation.” I never did, because I had a great job here, so I did not have to, and it was not a matter of money. I have always felt a bit difficult about saying, “Well, I should have gone down as a statistic.” I am sure that, as the right hon. Gentleman says, there are a lot of us out there who have not registered and do not appear in the statistics. The base statistics are only of the people who absolutely needed to make sure that they registered.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

Thank you very much—not Mr McCabe, but Ms Buck; I did a quick double-take. My hon. Friend has hit the nail on the head. It is not just about the money. Getting people in, whether at pensionable age or when they leave an employer or the armed forces, is vital. When I left the armed forces, my hearing was not tested. It was supposed to have been tested, but it was not, and if anyone can find a record of it being tested then, I can take them on about that. I am not raising the issue of whether people are entitled to compensation—that is someone else’s decision—but they are not entitled to compensation unless we get them tested. If we can get them tested, the specialists will know, as my hon. Friend said, the cause of the deafness. There are myriad reasons, but industrial damage is pretty well defined.

I am thrilled that there are so many people here on a Thursday afternoon—the other Chamber probably has half, if not less than half, the amount of people we have here. Perhaps my hon. Friend and I might go back to the Backbench Business Committee to get a proper debate on the Floor of the House on some of the specifics we have discussed. If necessary, that should be on Access to Work, because that is a life-changer and has been for many people. We must not lose that life-changing ability.

Photo of Tommy Sheppard Tommy Sheppard Shadow SNP Spokesperson (Cabinet Office), Shadow SNP Spokesperson (Scotland), Shadow SNP Spokesperson (House of Lords) 2:56 pm, 30th November 2017

I will sign this comment: “Today, I will talk to you about deafness and hearing loss in Scotland.”

I will come back to my poor attempt at signing later. I wanted to speak about a number of things, many of which have already been mentioned. I very much welcome this debate and congratulate my hon. Friend Jim Fitzpatrick on bringing it here. Indeed, I commend him on the work he has done through the all-party parliamentary group on deafness to raise this issue across the House.

There are approximately 1 million people in Scotland who suffer hearing loss, and I am one of them. About 15 years ago, I found that my hearing was deteriorating, and I did not do much about it—I was just very irritating to my friends and family, not hearing things. Eventually, I was persuaded to get treatment. I was diagnosed with degeneration in the inner ear, an inherited trait that means that I cannot hear some frequencies, but I can hear others. I hear some frequencies at full volume, and others at just 30% or 40%, which means I lose a lot of the sense of what people are saying to me.

I am beyond grateful to NHS Lothian and our public health service for what it has been able to do for me. I wear hearing aids, like my hon. Friend, and the degree of technology and sophistication in these little things is quite remarkable. There are mini-computers in here that take in all frequencies and decide to boost the ones that I am weak on, which means that, by and large, I can hear relatively normally. I also want to place on record the efforts of the House authorities. In particular, I find the loop in the Chamber very effective indeed.

Of course, there are still drawbacks; those who, like me, wear hearing aids will be aware of this. For example, when I am in the Chamber taking part in a debate and I have them on the setting for the loop, if a colleague sitting beside me says something, I do not get it; I have to reprogramme the aid and try to find out what they were saying—or quite often I just nod and pretend I got the gist of what they were saying. I also notice that these aids can be irritating to me and others in close proximity, because of the feedback and whistling sound there is sometimes, but it is worth putting up with those minor drawbacks to take advantage of this great technology.

I got these hearing aids on the NHS, and I was very grateful indeed to receive them. These instruments are state-of-the-art technology that match anything available in the private sector. In fact, I have friends who, either through inclination or ignorance, decided to go private, and went to agencies on the high street that retail hearing aids, and their service is far inferior to mine. Eventually, on my advice, they went to the local audiology department and got better treatment.

That is just part of why I have a particular interest in the subject. I am of course also mindful that this is probably one of the most common disabilities that we as a species suffer. More of my constituents probably suffer hearing loss than voted for me on 8 June; that is how prevalent it is.

I want to spend a little time, because others have mentioned it, talking about the situation in Scotland, particularly with regard to BSL. Any BSL users watching what I did at the beginning will understand that I cannot sign, but I tried to learn that opening line because I know that, as time goes on, I will want to learn BSL, as it will be something that I rely on in later years and is therefore important to me, but it is important to me in the here and now because of so many people for whom BSL is a vital means of communication.

It has already been mentioned that in 2015 the Scottish Parliament passed the British Sign Language (Scotland) Act. A Labour MSP decided to bring it to Parliament. The Act was passed unanimously, with all five parties in full agreement. A key thing that the Act did was launch a process to establish a national action plan to promote and develop BSL in Scotland, with the simple objective of making Scotland the best place in the world to be a BSL user and to live, work and play. I say that not to blow Scotland’s trumpet, although it is part of my brief to do that, and not to say that Scotland is better than the rest of the UK, but simply to say that if people took the time and sat down to talk about these things and draw up a plan, they would be surprised at how much can be done. I ask the Minister and the Government to look at the situation as it is developing in Scotland and perhaps see how much of that could be replicated UK-wide.

The national plan was published in September. It is quite detailed and has 70 targets. I will not go into them all; it is available on the Scottish Government website. The process was really important. Once time is provided in a Parliament for a discussion that leads to legislation, because of the statutory force of the discussions taking place, things that people had never thought about begin to go on the agenda and come out of the woodwork. It is a stimulus to all manner of people in civic society and in Government agencies in thinking about how they can improve the situation.

The plan of action has 70 detailed targets set for the next three years. I will give Members a flavour of them. The first is to look at how we can build into the 2021 census a question or series of questions that identify in detail the number of BSL users taking part in the census, so that we have the data on which to plan in future. Target 10 talks about improving access to early years services, so that deaf children can access them. Target 16 is about removing the barriers that prevent BSL users from becoming teachers, so that they can not only teach in the medium of BSL, but teach hearing kids through interpretation. Target 25 is about targets for colleges and universities. Importantly, the next target makes loans available for BSL students. I am pleased to say that just this week the Scottish Government announced that loans will be available for students in Scotland to study throughout the UK if the course is not available in Scotland, so we now have a situation in which we can support BSL users who are students in Scotland, but who are able to go on courses in England and Wales as well.

Target 39 is about making sure that all our health screening and immunisation programmes have the medium of BSL built into them, so that BSL users have full access. Target 48 is about sport, and 53 is about placing obligations on transport and our rail and bus providers to make sure they understand the needs of BSL users and have it available as a means of communication. Target 57 is about access to the arts. Target 63 is about making sure that our emergency services understand the needs of BSL users and have a facility to be able to communicate with them. Finally, the last one I picked out is the target to improve electoral participation and voting in the political process by BSL users.

There is a series of very good targets, but probably the best thing about them is the way in which BSL users themselves have bought into the process and have become part of developing the action plan. A full £1.3 million has been provided to various deaf voluntary organisations to monitor how the targets develop and are implemented. In 2020 the intention is to come back with a full Government review across all agencies to make sure we look at the next stage. Those are practical, achievable steps that can be taken, many of which do not involve a lot of money. They can be done within existing budgets. They require changes in attitudes. We cannot overestimate the importance of having a statutory framework and setting all these things down as targets for Government agencies.

There is always pressure on a legislative programme, but a UK BSL Act that would do some of those things would not take a lot of parliamentary time. It need not be a very complicated Bill. It could be focused. Even if we had to give up three hours of a Back-Bench debate or two to get the measure through, it would be worth doing. I am sure that if the Government were to take the initiative, they would find all parties commending them.

Several people have mentioned Access to Work, but it is important to stress that claimants who had the benefit of the programme and were not limited until now—the cap applied to new claimants—will be subject to the cap as well. That will mean that some people who are in employment will have to reduce or leave their employment. That is the truth of the matter. It might not be a great number of people, but that is what will happen.

I note that the DWP says that only about 267 people will be affected by the cap. That is not a great number, but it really looks like penny-pinching when we compare it to the scale of the DWP budget.

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse

The early statistics said that for every £1 spent on Access to Work, the Treasury got a cost-benefit analysis plus of £1.34 or £1.50. A lot of the people the hon. Gentleman describes are senior professionals, chief executives and so on, who will be on a 40% rate of tax, so it is an investment that will give the Treasury more money back than the basic rate of tax does.

Photo of Tommy Sheppard Tommy Sheppard Shadow SNP Spokesperson (Cabinet Office), Shadow SNP Spokesperson (Scotland), Shadow SNP Spokesperson (House of Lords)

I could not agree more. If somebody is in work and gets support through the scheme, not only are they earning money and paying tax, but the people who support them earn money and pay tax as well. There are all sorts of ways in which this makes sense. My key point is that given the small number of people affected, is the cap really worth it? Would it not be better to not have the cap, and assess the situation later? It is expensive because of the nature of the support that people need in this part of the programme if they are deaf and a BSL user. It is expensive because that support is undertaken by hard-working professional people such as the signers here today, who have trained very hard for the job that they do.

Perhaps in the future developments in audio technology and computer graphics will be such that we will get an app on our smartphone that will turn speech into sign in a way that works, but who knows? That is for the future. For now, we need professional human beings to be able to provide the service. We should accept as a society that for the limited number of people affected, the money is a price worth paying. We could perhaps look at other ways, rather than the cap and restricting the services provided, to reduce costs.

I want to finish by talking about Parliament and some of the things that we might be able to do here. It is wonderful that we have our proceedings signed today. I do not know why we do not have a signer standing beside the Speaker’s Chair and filmed for all the proceedings in our Parliament. When we think of the amount of money we spend in this place, the number of staff that we have, the amount we spend on maintenance and the amount we are going to spend on refurbishment, it is not such a big price to make sure that during the 30 hours a week or whatever when the Chamber is in operation and debating, there is a signer there, signing for the people in the Chamber, and, more importantly, for the people who watch live online or wish to check back on proceedings.

Another thing that we could do has to do with the scheme in Parliament, which Members may be aware of—I have not taken advantage of it yet, but I am sure others have—to get tuition in a foreign language. Why do not we add BSL to that? Why does not each MP have an opportunity to learn that as part of our professional development as Members of Parliament, so that we are better able to communicate with our constituents, and more aware of the technological needs?

My central point, which I will stress as I end, is that it is impossible to overestimate the importance of a legislative framework, because of the sense of purpose it creates for civil society and statutory agencies, and the sense of worth, I suppose, that it gives to people who are looking to us to respond to their needs.

Photo of Teresa Pearce Teresa Pearce Labour, Erith and Thamesmead 3:10 pm, 30th November 2017

It is a pleasure to see you in the Chair, Ms Buck. I too express gratitude to my hon. Friend Jim Fitzpatrick, not just for obtaining the debate, but for the work he has done on deafness and hearing loss for many years; he is a great champion of the cause. I also want to mention Kelly Tolhurst, who shared her personal story. I was struck by what she said about her mother’s isolation, because my late mother-in-law was one of the most sociable people anyone could meet—show her a piano and she would play for two hours—but then she lost her hearing, and with that, she lost her social circle and became incredibly lonely. We hear a lot about elderly people being lonely, and I wonder how much hearing loss has to do with that.

The debate is very broad—as broad as the challenges that people living with deafness face; so I shall confine my remarks to two areas, the first of which is cochlear implants. A constituency case has been brought to me by several constituents, including the grandmother of Jacob, who needs a cochlear implant. He is profoundly deaf in the right ear and severely deaf in the left; he is four years old. He has been tested by St. Thomas’ Hospital cochlear implant team, who supported the case for an implant, but the NHS has turned him down. The family have been told he can have the implant only if they can raise £44,000. My constituents are not the most affluent in the country, but they are truly wonderful, and this will not be the first time they have crowd-funded help for someone. Last year they helped a young mother to get a second stem cell transplant. Their campaign, “Help Jacob Hear”, has run boot sales, raffles and fêtes and raised nearly all the money, which is great news—but it raises the question what the NHS is for if it is not to help children such as Jacob. The spending of taxpayers’ money at this point would potentially be handsomely repaid over the lifetime of that young boy. It might be expensive, but what is the financial and social expense of not funding it?

The second area I wanted to focus on is Access to Work. Quite a number of my constituents are British Sign Language interpreters, and many of them have written to me. One, Joanna, works regularly with people who are helped by Access to Work to participate equally and fully at work. In 2015 the DWP, as has been mentioned, imposed a cap on Access to Work awards, and Joanna is worried that the cap will act as a glass ceiling on deaf colleagues’ and friends’ career aspirations. Those with hearing loss will not be able to apply for promotions or look to develop their career, because the Access to Work support will not be sufficient. That means that they will be able to book interpreters for perhaps only three days a week. What will happen on the other two days? Deaf professionals are left at a disadvantage, experiencing stress and frustration as it leads to their being removed from viable career paths. The consequences can be reduction of their working hours and in some cases complete removal from employment. There are self-employed deaf professionals in the arts who have not been able to develop projects, because of lack of access. Research done by the group DeafATW with people whose awards have been capped already or are due to be capped next year, shows a negative impact on careers and aspiration. Especially affected are deaf people who are in or who aspire to professional, managerial or leadership roles, or those who are self-employed and who run their own business.

Another of my constituents, Andrew, is deaf. He uses British Sign Language and works as a senior team administrator with Surrey County Council. Access to Work pays for the interpreters and note-taking that make it possible for him to communicate with colleagues, customers and others, and help him to participate more fully and equally at work, even though it does not stretch to providing assistance at longer meetings where it is impossible to focus on the interpreter and to take notes at the same time. That said, it is likely that the support that Andrew gets via Access to Work, which we all agree is a fantastic system, is much more than what would be seen as a reasonable adjustment for his employer to make. In cases such as his, Access to Work has revolutionised the career opportunities for people like Andrew, and shattered the glass ceiling that previously often limited people to doing manual jobs. It has ensured progression for deaf people that is based on talent, which is as things should be. There are now deaf chief executives, deaf intermediaries working at the Ministry of Justice, deaf theatre directors, deaf social workers and a deaf senior team administrator at Surrey County Council. I am concerned that a new policy will undo that good work.

In September DeafATW ran a survey among deaf people about Access to Work. Among those who will be subject to the Access to Work cap from 2018, nearly half said they would not apply for promotion in future, because they were worried that in a new job they would not have enough communication support as a result of the cap. For the same reason, a fifth said that they had already had opportunities to apply for promotion, but had not done so. Nearly half said that they would stay with their current employer as long as possible, because they were worried about what a new employer might think about the effect of the cap on their ability to do their job. When talking about growth we hear a lot about the “productivity puzzle”. It is not much of a puzzle really if we are limiting where people’s talent can take them with such a cut.

In about a third of cases, the employer was either taking or thinking about taking action to check whether the individual could still do their job properly. Deaf people fear that having a capped award means that they will not be able to do their job properly, and employers are concerned about it too. As a consequence, deaf people, whether they are already subject to a cap, are expecting to be subject to one in 2018, or are without a cap in their current work, have said that they are already avoiding applying to work in professional, managerial and senior roles.

In 2015, the Government were clear that a key challenge in administering Access to Work was managing a demand-led programme within a defined budget. They said

“We must achieve a balance between meeting customer need and achieving value for money for the taxpayer. It has been a long-standing aspiration of the programme to support more disabled people into work, so we must address the challenge of supporting this growth whilst keeping Access to Work affordable”.

I would say that it is money well spent. I could not find more recent figures, but the Sayce report in 2011 said that for every pound spent £1.48 came back to the Treasury. That is clearly a case of spending to save.

The Minister may be aware that in July 2015 the Government responded to the Work and Pensions Committee report entitled “Improving Access to Work for disabled people”. The report was scathing about the statistics, stating:

“This lack of transparency is unacceptable. We recommend that DWP change its approach to Access to Work statistics and that, as a minimum, it regularly publish the following information: an indicative annual budget;
annual expenditure outturns, broken down by support element and impairment type (including autism spectrum disorders);
the number of service users by size of employer;
and employers’
mandatory and voluntary financial contributions, broken down by size of employer.”

In their response, the Government admitted that there was work to do to meet those requirements. Will the Minister now, or perhaps by writing to me, update us on progress with the Access to Work statistics? The previous Minister said that there were a lot of statistics available, so I should be pleased to know what progress has been made in supplying the information. Will the Minister also provide figures to show the trend in the number of deaf people supported by Access to Work prior to the introduction of the cap, and afterwards?

The Select Committee also highlighted a particularly strong case for the DWP to improve the accessibility of its disability-related services, recommending that it introduce a video relay system to enable deaf BSL users to contact the Department more easily. Has there been any progress on that? By way of a reminder, I noticed when I arrived that there is a signer for the debate, and I recalled that when the Work and Pensions Committee undertook a review of Access to Work in 2015, we had a sitting when deaf people came to give evidence, and there were deaf people in the Public Gallery, and no one had thought to book a signer. Luckily, one of my constituents had come to watch. He was a qualified signer, and he took over and helped us. In this place, sometimes we do things very well and sometimes we overlook things. If a Work and Pensions Committee looking into accessibility for deaf people did not think to have a signer, it goes to show that we must do better on this. Today’s debate is a step forward.

Photo of Liz Twist Liz Twist Labour, Blaydon 3:20 pm, 30th November 2017

It is a pleasure to serve with you in the Chair, Ms Buck.

I am sure most of us know many people who are affected to some degree by hearing loss, and we know the impact it has on their lives. In my own case, both my parents were affected. My dad, who died a couple of years ago, had industrial deafness caused by his work in a factory. The effects of that lasted a long time. I welcome the comments from Sir Mike Penning, recognising the industrial injuries aspect. My mum resisted hearing aids for many years, but the difference they made to her life when she finally gave in was, and continues to be, immense. It is immense to us as well, of course.

That is why I was so concerned to hear from Action on Hearing Loss, which I met recently, that some clinical commissioning groups are proposing restrictions on the prescription of hearing aids to people with mild and moderate hearing loss. Indeed, some have already done so, including North Staffordshire CCG, which was referred to earlier. Not only do hearing aids make a real difference to people with mild and moderate hearing loss, but research shows that they reduce social isolation and depression. New evidence also suggests they can reduce the risk of developing dementia; a study in The Lancet recognised hearing loss as potentially the largest modifiable risk factor for dementia. We can do something about it. I hope the Minister will make clear that hearing aids must be provided where they are needed.

As my hon. Friend Jim Fitzpatrick has clearly set out, the cash limit on the Access to Work scheme has also had a significant impact on many people with hearing loss, limiting their ability to do their job properly, or in some cases meaning that they might not be offered jobs because of the shortfall in financial support. I ask the Government to look again at removing or raising the cap. I also echo my hon. Friend’s call for further work on implementation of the action plan on hearing loss. As he described, some good work has been done already, but I ask the Minister to ensure that the Government step up their work on implementing the plan.

In the summer, I met Erin, a young woman campaigning with the National Deaf Children’s Society to have British Sign Language recognised as a GCSE and made available to all students. I join Erin, and Peter Aldous, in calling for BSL to be a GCSE subject.

Photo of Rosie Cooper Rosie Cooper Labour, West Lancashire 3:22 pm, 30th November 2017

It is a pleasure to serve under your chairmanship today, Ms Buck. I thank my hon. Friend Jim Fitzpatrick for securing this debate. This is one of those occasions when the only suitable ministerial and departmental response to the words spoken in the debate is urgent action to review, reconsider and change course. That means helping deaf people, working across Government instead of in silos, and putting deaf people at the centre of the decision-making process. I include an important area that people have talked about quite a lot today: the Department for Work and Pensions, where Access to Work needs to be promoted, not capped. Unfortunately, that cap will affect so many of our deaf and hard of hearing constituents when we come to the end of the grace period in April 2018.

I am the eldest child of deaf parents, and I was their voice and ears from a very young age. That was invaluable to them, enabling them to be easily heard and understood in a hearing world. My dad was born deaf and my mum became deaf at four years of age. I say that I was kidnapped by the deaf community at birth, because my culture, language and community are theirs. That poses me some difficulties on occasion, because I can be very straightforward in the way I deal with matters. My first language is BSL, not Sign Supported English—most people think that is BSL, but it is not.

I was tempted to sign my whole speech. I was going to do that and have the interpreters voice over my comments for my colleagues, to give everybody a feel for how it is not to be able to communicate directly—not for a minute, not for a sentence, but for five minutes or however long it takes me to finish this speech. Not to be able to communicate directly with the person we are talking to is really, really strange and difficult. Deaf people feel and experience that every single minute of their lives.

My experiences and the communication difficulties I saw led me, when I was Lord Mayor, to provide every deaf person in Liverpool with a minicom. We paid for them by getting children in schools to learn the deaf alphabet. They saw it as a secret language and really enjoyed it, and I got minicoms for everybody who was deaf in Liverpool. Some might ask why that was so important. We talk about isolation, but even though I thought, as a product of that environment, that I understood it, I came home with a minicom for my dad and gave it to him. He looked at it and was so happy, and then he took it and pressed “Nine… nine…” I said, “Whoa!” and he said, “Who else can I call? Nobody else has got one, only the emergency services and the doctor.” I thought, “Right, I get the message: every deaf person in Liverpool needs one.” That made me realise that I needed to get on with it and get everybody a minicom.

Mobile phones have improved the situation, but as Iain Stewart has outlined, we are not progressing with transmission services as we should. I have known Chris Jones for many years, and it is a really important thing, but the agenda is so large that we need Ministers across Government to start tackling it quickly. Being able to communicate is fundamental to someone doing their job and doing a good job. The evidence is clear that Access to Work is a system that enables deaf people, particularly those who use BSL, to use their own voices in the workplace, with the communication support they need.

When I think about it, I am probably one of the first examples. My dad was a plasterer and he was so good—I genuinely mean that—that directors of building companies, since they could not phone him, used to come to my house and sit down around the table. As a child, from the age of eight or nine onwards, I used to sit on a Friday night and instead of all the millions of bits of paper going back and forth, I was drafted in to be the person from Access to Work. My dad did really well. He kept getting more and more money. They wanted him, the prices went up, and I did that every few months.

To me, the evidence is clear: the cap does not simply hinder deaf people’s ability to do their jobs, but will cause them to turn down employment offers and promotions. It might have meant that my dad did not get such a good deal on his next contract. It leaves self-employed people in a precarious position, where the small profits they have worked hard to earn go toward expensive interpretation costs. That is absolutely not a cost-effective way to work. The UK Council on Deafness found that nearly half of those whose income will be capped in April said that they would not even apply for promotion in future because they worried that they would not receive enough communication support. That presents barriers to those aspiring to careers in professional, managerial and senior roles. I have a friend who was the headteacher of a deaf school. Without support, how will that happen in the future?

We need to allow deaf people to progress as far as their talent allows. I have spoken to many other deaf people in lower roles but who aspire to do better. They have stopped looking forward and now live every day in fear that they may lose the job they have. Every day is a challenge, especially if they lose that support for two days a week. We must all be clear that deafness is not a limiting learning disability. There is no reason why deaf people cannot secure employment in senior roles, so long as Government decisions do not dampen down the support that they require.

Central Government just cannot sit back in the hope that employers and the self-employed will simply make up that two-day deficit in support costs that the cap is estimated to impose, especially when employers are already saying that they are not confident about their businesses employing a person with a hearing loss. We simply cannot waste huge swathes of talent. I know that, because my dad, who was born deaf, was probably one of the greatest men I have ever known. He was fantastically clever, and he was deaf, but that did not prevent him from doing anything—and we should not allow it to.

Does the Minister accept that the cap reimposes limits on the ambitions and financial security of deaf people, and leaves the next generation without the belief or ability to succeed in a 21st century workplace? They can. My dad has died now—he was 91—but he did it before; he was a trailblazer. Do not stop the new trailblazers. Help them to forge ahead.

It is also vital that the Minister recognises that, outside this place, the majority of British citizens and employers lack awareness of Access to Work. That really helps to explain why a recent labour force survey found that 30% of working-age people who identify themselves as having a hearing loss are not employed; I actually believe the proportion is higher than that. Does he recognise the need for a single gateway that would provide assistance and advice for employers seeking Access to Work support for their employees who are deaf or have a hearing loss?

I have listened to people refer to deafness as an invisible handicap, and it absolutely is; it is an invisible disability. However, that also means it is an easy target for cuts, especially in the NHS, Education and the DWP. We must guard against taking that easy, quick solution in the hope that deaf people and the hard of hearing will not be able to articulate the anger they feel at their treatment. I have two hearing aids, and I ask the Minister: if my hearing deteriorated to such an extent that I needed communication support to do my job as an MP, would these rules enable me to do the job effectively? If not, how is everybody else supposed to do their jobs under these rules? Do the rules not jeopardise employment, rather than helping to increase it within the deaf and hard of hearing community?

On a slightly different subject, as I said before, my first language was sign language, and I was delighted that the Labour party general election manifesto earlier this year committed to giving BSL full legal recognition. That would improve the structures and the expectation of full language access, through fully qualified interpreters, in all aspects of public life. However, that leads to a question: if the Government do not value interpreters, how will that encourage people to take up those roles?

What will we do if people do not learn BSL and are not there as interpreters? We already have cases of unqualified people interpreting in courts. That is wrong. They have no idea about deaf culture or the nuances and what people really mean. There is a difference between somebody who is just learning sign language and somebody who is really fluent or speaks it as a first language and understands what a deaf person is really saying. We need to value those interpreters.

My final question to the Minister is: does he agree that legal recognition will provide another means of improving awareness of deafness and of the barriers that deaf people and those with hearing loss deal with in the workplace? We need to ensure that Access to Work is extended to many more employers than the current miniscule few who actually use it. I look forward to hearing the Minister’s reply. Ultimately, he will be judged on the ability of the deaf community and those with hearing loss to succeed and to realise their potentials. That means in every part of their lives—particularly in the workplace, education and health, because without those things, what are we to do? Please give them the same chances that we get.

Photo of Martyn Day Martyn Day Scottish National Party, Linlithgow and East Falkirk 3:35 pm, 30th November 2017

It is a pleasure to serve under your chairmanship, Ms Buck, and to take part in this important debate secured by Jim Fitzpatrick. It has been a consensual debate across the Chamber, which is extremely welcome.

This will be the first time that my words have ever been signed, as well as it being the first time in a parliamentary debate; I certainly hope it becomes a regular feature in Parliament. It would be nice if the signing was on the live feed, not only on the re-broadcast. I do not know whose remit that is in—perhaps the parliamentary authorities or the Administration Committee could discuss it further with the broadcasters to see how best we can implement that. Again, I thank the hon. Gentleman for securing the debate; it is a tremendous first. I echo the calls from Iain Stewart that providing sign language interpretation should become a regular feature.

Various Members have discussed the multiplicity of Departments responsible for this sphere. If that is not simplified, there certainly seems to be a need for there to be, at the very least, a clear, identified lead Department. That may be an easier route. We have heard of the many day-to-day difficulties experienced by those who are hard of hearing—one person in six is affected, and they are less likely to be in employment. On the one hand, it is welcome news that technology is making it easier for people suffering from deafness to work, while, on the other, it is worrying that the cap on Access to Work support has disproportionately impacted on those with hearing loss. That point has been well made and I do not need to emphasise it further; the cost-benefit ratio of £1 spent to £1.48 received says it all, in financial terms.

Various Members have given their personal stories and accounts, such as Kelly Tolhurst. I am also grateful to Mr McFadden for the case he identified, which put a very human dimension on to the issue. I cannot imagine what it would be like to not hear family or listen to music; I have no comprehension of how awful that would be. However, there are ways that we can help people, and we should do everything we can to ensure a better quality of life for everyone. Indeed, that is effectively the challenge of today: to ensure that deaf people can be fully involved in daily and public life as active, healthy citizens who can make informed choices about every aspect of their own lives.

My hon. Friend Tommy Sheppard covered much of what happens in Scotland, but I will mention a few of the points again. The Scottish Government have a British Sign Language national plan, which, as has been said, aims to make Scotland the best place in the world for BSL users to live, work and visit. It seems to be a regular feature in debates that I am always telling people to visit my constituency, so I might as well emphasise this again: it is a great place, and if hon. Members have not been, they should come.

The British Sign Language (Scotland) Act 2015 requires public bodies in Scotland to publish plans for how they will promote and support BSL every six years. The first national plan covers the Scottish Government, and other public bodies, including councils, NHS boards, colleges and universities, will publish plans next year. The national plan, which runs from 2017-23, is the first of its kind in the UK and sets out 10 long-term goals for BSL in Scotland, covering early years and education, training and work, health, mental health and wellbeing, transport, culture and the arts, justice and democracy. It describes 70 actions Scottish Ministers will take by 2020, whereafter a progress report shall be published and a further set of actions for delivery by 2023 will be identified. My hon. Friend the Member for Edinburgh East mentioned several of those key actions, so I will not repeat them.

However, I can think of a 71st action that might feed into the next round for the Scottish Government and might be one we should take forward in this Parliament, and that is what we as individual elected Members do to facilitate that. In preparing for the debate, I thought about what we do on home visits and for people visiting our constituency offices. There are a number of issues, and we may need parliamentary guidance on how best to service all our constituents with their inquiries.

In Scotland, a lot of it is about attitude, but our plan is also backed up by money: £1.3 million has been put in to support it. That is not a grand amount, but it is enough to do a fair amount of work. Dr Terry Riley, chair of the British Deaf Association, said that the Scottish Government’s national plan is

“a brilliant example for the rest of the United Kingdom to follow.”

I hope that Ministers will have a look at what we are doing in Scotland. I have a copy of the plan here, if anyone wants it. I am not hard of hearing, but I am poor of vision, and I am pleased to say that the plan is in quite large print, so it suits the likes of myself to a tee.

It is not just through the BSL national plan that the Scottish Government are taking action to help. The disability delivery plan is another way that we can help by removing barriers and promoting independent living, with a key target being a reduction in the employment gap between disabled people and the rest of the population. It has been highlighted today that deaf people are not in as great an employment position as other members of society.

The Scotland Act 2016 devolved a number of powers to set up employment schemes to assist those at risk of becoming long-term unemployed and to help disabled people into work, including schemes that seek to help employers to find suitable employees. As a result, Fair Start Scotland will operate from 2018 for three years, with the aim of helping a minimum of 38,000 people into work. I hope that a number of those will be deaf people and those who are hard of hearing.

At a UK level, more needs to be done to address the gender, race and disability pay gap and tackle pay inequality and occupational segregation. To that end, I support extension of pay gap reporting to cover gender, race and disability. I am keen to hear the Minister’s thoughts on that. Better and more statistics could help us greatly in this cause.

I would also like to hear from the Minister on EU law, which has played a huge role in upholding the rights of disabled people. Those rights must be protected post-Brexit. There are many examples, but of particular importance to the deaf community are the employment equality directive of 2000 and the public sector websites and mobile applications directive of 2016, which requires public sector bodies to ensure that their websites and mobile apps comply with accessibility standards so that they can be used by disabled people.

As well as protecting existing EU measures, it is important to ensure that the UK is not left behind. For example, the European Accessibility Act is being negotiated at an EU level. The Equality and Human Rights Commission has said that the Act will benefit disabled people by providing common rules on accessibility in relation to computers and operating systems, ATMs, ticketing and check-in machines, smartphones, TV equipment related to digital television services, telephony services and related equipment. It would be great to know what the UK proposals are for those areas in the future. It would be tremendous if the Minister looked into that.

There is much we can learn from different countries. My hon. Friend the Member for Edinburgh East and I have mentioned what is happening in Scotland, and the hon. Member for Milton Keynes South mentioned some of the things happening in Australia. There is a lot we can learn, and I look forward to hearing the other winding-up speeches and seeing this go further forward.

Photo of Julie Cooper Julie Cooper Shadow Minister (Health) (Community Health) 3:43 pm, 30th November 2017

It is a pleasure to serve under your chairmanship, Ms Buck. I thank my hon. Friend Jim Fitzpatrick for bringing this important subject to our attention.

I begin by saying how delighted I am to see that we have a signer in the room. It must be really easy for us to extend that service across the business of the House—that would be a really quick win, I think we all agree.

It is a real privilege to respond to the debate on behalf of the Opposition. I have been genuinely moved by some of the powerful and personal speeches we have heard today. They prepared me far better for my contribution than the research I did ahead of the debate. We can look at the statistics, such as the fact that 11 million people in the UK are living with deafness, but we have heard today about the extent of it. Kelly Tolhurst courageously shared a very personal story and enriched the debate. We thank her for that. My right hon. Friend Mr McFadden talked movingly of his constituent. We heard about a family having to raise £44,000 to let a little four-year-old boy have a chance in life.

I think we all agree that we must do more. The best thing about the debate is that it has raised awareness of a massive issue. We are talking about deafness and hearing loss, people who were born deaf and people who become deaf, sometimes through illness and sometimes through the ageing process, and how are we going to support them all, beginning with the children. The fact that only a third of screening processes for newborn babies are up to standard and accredited is of great concern. That needs to be addressed, and soon

Bearing in mind that 50,000 children in the UK are deaf, we must serve them well and make sure they are not isolated. We must make sure that their isolation does not begin with being isolated from their parents. The majority—90%—of children born deaf are born to hearing parents. If their parents are not supported, there are implications for the child’s language development. We know there are ways of providing support, such as radio aids, and we must make that available to parents and support them. We hear a lot in the House about early intervention for all children to address all issues in the early years, and there can be no more important an issue to address than this.

My hon. Friend Rosie Cooper stressed powerfully that deaf children and deaf adults do not have learning disabilities. Our education system must address this. It cannot be right that deaf children are 42% less likely to get five decent GCSEs. We are hindering their progress for life at that early stage. I was alarmed to learn that since 2011, the number of specialist teachers for the deaf has reduced by 12%. That cannot be the right way forward.

Members have rightly stressed the importance of British Sign Language. I have to admit, I never realised until this week—I never thought it through, and I am sure I am not the only one—that British Sign Language is some people’s first language. I thought of it as something separate that helped, but this debate has increased my awareness. The more this is talked about, the better. It is vital that BSL is taken seriously and given recognition. The UK is a signatory to the UN convention on the rights of persons with disabilities, but we must do more and give this language the equal validation it deserves. Why can British Sign Language not be a GCSE subject? I know this is beyond the remit of the Minister and his Department, but I am sure he will pass it on to his colleagues in the Department for Education. If BSL were a GCSE subject, people would take it seriously, more people would learn it and there would be more access to it, and therefore deaf people would be able to participate more fully.

Members have rightly mentioned the human cost as well as the financial cost of isolation not being addressed. The health statistics are quite clear—for example, on the number of people who retire early or suffer from anxiety and depression because they can no longer cope in the world of work. As has been mentioned, many elderly people who lose their hearing lose their social circle and cannot communicate with family. There is the cost of not supporting them with hearing aids and, as Iain Stewart mentioned, with a telecommunications relay service. We should be looking into such systems to maximise inclusion for old people.

The world of work is obviously a massive issue. The Access to Work scheme is absolutely brilliant. It is shocking that it is probably the DWP’s best kept secret. I recently hosted a Disability Confident employers event, and many of the employers admitted that they had not known about the scheme at all. There are two aspects to the world of work when it comes to deafness. The person who is deaf or hard of hearing needs support to cope at work, and the employer—in particular, the small or medium-sized employer—needs support to understand that that need not disadvantage their business. As has rightly been mentioned—I think my right hon. Friend the Member for Wolverhampton South East said this—when a disabled person is employed and supported in their workplace, it reduces workforce churn. The support does not have to be expensive. Sometimes it is about awareness, moving someone’s seat so that they can lip-read, or letting them sit in a quiet corner of the office where background noise is not such an issue for them.

The message from the Government about Disability Confident employers is very strong and very useful, but now, with the capping of Access to Work support, they seem to be sending a contradictory message. Can we afford not to support people in work? What is the cost of not supporting them? What a loss of talent. As we have said, this debate covers many areas and not just one Department, but not least is the Department responsible for economic development, because what is the cost to our economy of not utilising and maximising the potential of all our citizens, including people who are deaf or hard of hearing?

What can we do? What concrete action can we take? The recommendations in the 2015 action plan were very welcome. I think there is agreement on both sides of the House that that is a sensible plan, so let us see it put into action. The “What Works” guides published this year were an excellent piece of work that we need to build on. Concrete action is needed at every stage. We need to ensure that newborn babies are properly screened and that the screening is always of high quality. We need to support parents of deaf children with early intervention. We need to support schools and ensure that there are specialist teachers and that children are not allowed to feel like second-class citizens. We need to promote British Sign Language in schools and allow it to become a GCSE subject. We should look to the Scottish example—an excellent job is obviously being done there. As someone who is half-Scottish, I say, “If the Scots can do it, so can we,” and I am sure we will do it at least as well.

We must ensure that equipment is enhanced and not restricted. I was shocked to hear of clinical commissioning groups that are beginning to restrict the provision of hearing aids. The criteria for cochlear implants must be reviewed. We must look to aid people’s hearing and support them to live full lives, rather than looking for ways to limit them. We have to go back and review those criteria.

Let us invest in unlocking the potential of the deaf and the hard of hearing. Our economy depends on the talents of all our people. The cost of not acting not only causes misery for individuals who are discriminated against and excluded from society and the world of work, but stores up for the future huge costs for our health, support services and, of course, our economy. The failure to support deaf people to fulfil their potential is costing the economy. We cannot afford not to act.

Photo of Steve Brine Steve Brine The Parliamentary Under-Secretary of State for Health 3:55 pm, 30th November 2017

I thank all hon. Members very much for their contributions. There are many ways I could spend a Thursday afternoon, but I have really enjoyed this debate and I have learned a lot. This has been a consensual debate, and I thank the shadow Minister, Julie Cooper, for the excellent tone of her comments. I really enjoyed what she had to say as well.

Like everyone else, I congratulate Jim Fitzpatrick on securing the debate through the Backbench Business Committee, and also our signers. Thank you for doing what is a first and for working so hard. I cannot sign, but I can imagine that it is quite hard work to do it for three hours. There are two signers and they have worked really hard. Thank you for that.

I do not have a hearing problem, but I do have a sight problem, which is why I have a lectern in front of me. The papers are far too far away from me without it, which is why I always put it into play.

I thank the all-party parliamentary group on deafness, a number of whose members have spoken today, for all the work that it does in the House in raising awareness and improving the way we provide support. I cannot remember in my time in the House a debate on this subject, so it was certainly long overdue. All-party groups can do this; the Backbench Business Committee is excellent.

As we have heard, hearing loss is widespread, affecting one in six of the UK population, and it has a massive impact on the lives of our constituents and, indeed, some Members of the House. We have heard today really incredible contributions and—I agree with the hon. Member for Burnley—really moving contributions, especially from Rosie Cooper. There was not a dry eye in the House when she was speaking—thank you for the way you put things. I was going to intervene to give her a chance to have a drink, but she was brilliant in the way she put things. I thank her for that.

I shall highlight the key steps that the Government are taking to support those with hearing loss and deafness and then move on to the other important points raised by hon. Members during the debate. I apologise in advance in case I do not cover them all; I will write to hon. Members about any points that are not covered.

As we heard from the hon. Member for Poplar and Limehouse, in March 2015 the Department of Health and NHS England published “Action Plan on Hearing Loss”. That is a statement of intent for action across the health and care sector. There is an ongoing programme of work that the action plan has initiated. There are 20 separate outcome measures, which the hon. Gentleman touched on.

In September 2017—working with the Department for Work and Pensions, the Department for Education and hearing loss charities—NHS England issued a series of “What Works” guides, providing examples of what we know works in supporting individuals with hearing loss throughout their lives. Those guides, aimed at organisations, providers and commissioners, cover hearing loss and employment, the transition to adulthood for young people with hearing loss, and hearing loss and healthy ageing.

A key point in the plan is the need for clear guidance for commissioners, and in July 2016 NHS England published “Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups”—snappy titles we do not do in the NHS, as I have learned since arriving there as a Minister. As the Minister responsible for public health, I am very pleased that that framework recognises hearing loss as a “major public health challenge”, because that is exactly what it is. The framework is a major step forward in focusing local commissioners on tackling uncorrected hearing loss and on addressing the variation in access to and the quality of services across the country.

The framework has been developed with a range of stakeholders, including voluntary sector groups and professional representative groups, such as Action on Hearing Loss, which has been mentioned today, and the British Tinnitus Association—ditto—which are members of the Hearing Loss and Deafness Alliance. The guidance is crucial in ensuring consistency across CCG commissioning in England and supporting commissioners as they make decisions on what is effective and good value for their local populations. In turn, it will help to reduce inequalities in access to and outcomes from hearing services. I recognise the need for us to maintain momentum and to ensure that the action plan secures positive outcomes for those with hearing loss and deafness.

Let me turn to the points—all of them, I hope—that have been raised. In response to the speech by my right hon. Friend Sir Mike Penning, who I know had to run away—he is my former boss—I say this: not only am I not the Minister for Education, DWP, DCMS or others; I am not even the Minister within the Department of Health covering this area, but never let that stop a happy Minister.

I really enjoyed listening to the debate. The smartest way to respond will be to take the points that have been raised the most. The hon. Member for Poplar and Limehouse, in opening the debate; Kerry McCarthy, who mentioned her constituent; my right hon. Friend the Member for Hemel Hempstead and pretty much all other speakers mentioned the Access to Work scheme. I recognise hon. Members’ concerns about the impact of changes to Access to Work. I understand that the hon. Member for Poplar and Limehouse will meet with the Minister for Disabled People, Health and Work early in the new year to discuss in more detail Access to Work and concerns he has about it.

Members will realise that I am not that Minister, who is my hon. Friend Sarah Newton, but I spoke to her at lunch time ahead of this debate and I was on the Front Bench with her this afternoon for the statement on the new Command Paper. We will speak after this debate to ensure that she is fully up to date with everything raised that comes within her portfolio.

I think it is worth putting it on record that resources for Access to Work were increased in real terms in the 2015 spending review. I appreciate that hon. Members have all spoken positively about Access to Work as a scheme, but resources within a publicly-funded health service are still finite and they need to be allocated to the growing numbers coming to the scheme—8% more people had Access to Work provision approved last year than the previous year, including 13% more deaf people. Last year, we spent £104 million on Access to Work grants, an increase from £97 million the year before. As has been said by a number of hon. Members, Access to Work is a demand-led scheme and therefore the number and level of awards will reflect that. We intend for it to continue to meet demand, and with that the numbers continue to go up.

I do not accept that the maximum level of support is too low. The help an individual may receive from Access to Work depends on their individual needs and their personal circumstances—up to the current maximum of £42,100 per year rising to £43,100 from April 2018. That is 1.5 times the average salary, which is far more than most of my constituents, and those of every hon. Member here, earn.

Transitional arrangements are in place for existing recipients and those who made a claim before October 2015. The changes do not apply until April 2018, provided that needs remain the same. People will receive annual reviews of their progress and support in the transition to the award level. The Government continually monitor the application of the cap and consider whether any further flexibilities might be required. That is another point I discussed with my hon. Friend before the debate; she is acutely aware of the situation.

It is not often that a Minister is able to stand up in a Westminster Hall debate on the day that something new has been announced and touch on something new. This Command Paper “Improving Lives: The Future of Work, Health and Disability” sets out our response to last year’s Green Paper consultation. In this document—a weighty tome that hon. Members and I will want to study—we set out how those users with the greatest needs, such as some British Sign Language users, will be offered new managed personal budgets, as well as workplace assessments involving their employers, to help to meet their needs within their award level. Deaf customers will also be supported by a dedicated team of special advisers.

Stephen Lloyd had to get away, but he has returned. He is indeed a friend from the grand old days of the coalition, as he put it. I have noted his incredibly well-made point about SMEs. My right hon. Friend the Member for Hemel Hempstead made the point that those employing disabled people get a lower churn and a number of hon. Members reflected that message in their comments. I think it is absolutely right. A company based in my constituency called Microlink PC was mentioned in the Chamber during the statement. It works with large and small organisations—big banks in the City and small SMEs across the country—and the focus of its business is to use technology to help disabled people into work. That absolutely includes people with deafness and hearing loss. Many people across the charities sector also work to help that to happen.

I saw the hon. Member for Poplar and Limehouse during the statement earlier, standing on the back row, and I knew exactly what he was going to say, and he did not disappoint when he raised the issue of the cap. All I can say is that I wrote on my notes the comments of the Secretary of State—which I know the hon. Gentleman will have noted, too—and that I know the hon. Gentleman will bring the matter up with my hon. Friend the Minister for Disabled People, Health and Work when he meets her. The Secretary of State said he would continue to review, continue to look at the evidence. I encourage the hon. Gentleman to press on that and to continue to look at the evidence, because he has that there in black and white from the Secretary of State.

The hon. Gentleman also mentioned—as did Liz Twist, who has also gone, and many other hon. Members—the legal recognition of British Sign Language and the case for a BSL GCSE. It is not entirely clear to me which Department would lead on legal recognition of British Sign Language, which is the problem that so many people have referred to today. I am sympathetic to the calls for strengthening the role of British Sign Language. We want to see as many people trained and providing support as possible. At this time, Her Majesty’s Government are not yet convinced that the way to achieve that is through legislation. The Department for Work and Pensions undertook an extensive market review, of which the final report was published in July, which demonstrated that communication requirements should be addressed on an individual basis and that there is no universal approach to addressing these needs.

We have protections of the legal rights of people who are deaf in the Equality Act 2010 and in the duties of the NHS—the mandate that I am responsible for giving to NHS England and publicly funded social care organisations—to conform to what we call the accessible information standard. I am happy to take that point away. It came across clearly from many hon. Members in this debate. All I will say is that the private Members’ ballot is a wonderful thing.

On the subject of the GCSE, any change to the school curriculum, particularly the establishment of new GCSEs, is a matter for the Department for Education and something that the all-party group will have to take up with it. I know from talking to the Department before the debate—I suspected that this would come up—that there are no plans at this time to introduce further GCSEs beyond those to which the Government have already committed, but something tells me that the hon. Member for Poplar and Limehouse, my right hon. Friend the Member for Hemel Hempstead, the hon. Member for Eastbourne and other hon. Members who have spoken today will, with their usual determination, follow this through with Ministers at the Department for Education, who will no doubt note their comments today.

The hon. Member for Poplar and Limehouse and Mr McFadden talked about the assessment criteria for cochlear implants. Those were debated in March when the hon. Member for Poplar and Limehouse had an Adjournment debate in which he highlighted the report of the Ear Foundation and he called for NICE to review its cochlear implants technology appraisal. As the hon. Gentleman will know, NICE is an independent and expert body that advises us at the Department, and it has discretion to review its guidance in the light of any new evidence.

NICE is working on a list review for this particular technology appraisal and will consult with stakeholders in 2018, so I will make sure that he and all other hon. Members who have raised this matter get early sight of that and do not have to go looking for it or hear about it in the media. I am absolutely sure that this will include consideration of thresholds and criteria for getting cochlear implants. I understand that NICE is planning this consultation because of its recognition of how important this is, going beyond the usual review process. Although that does not give the hon. Gentleman the clarity he wants, I hope it is helpful to him in some way.

The hon. Gentleman and my hon. Friend Iain Stewart—who spoke excellently about this—talked about the provision of functionally equivalent telecoms services and video-text relay services. Obviously telecommunications does not sit within the Department of Health—no matter how big our remit, I do not think we have that one—but it is very good to hear that companies such as 3 and deafPLUS are at the forefront of delivering equivalent services for their hard-of-hearing customers. I wish deafPLUS all the best in the Helpline awards, which it has been nominated for. I understand that the Department for Digital, Culture, Media and Sport has previously considered the issue of provision of telecoms services, despite it being a commercial decision for the public-facing companies. This has included the Department engaging with companies and industry, and Ministers writing to the FTSE 100 companies seeking views. I hear that the feedback from that included the view that there were better means of meeting the needs of consumers with less reliance on video relay services. I am happy to raise the issues highlighted by Members with DCMS colleagues and see what further engagement there can be, and will of course recommend that they look at the Australia example that my hon. Friend the Member for Milton Keynes South spoke about in such glowing terms.

The Member leading the debate, the hon. Member for Poplar and Limehouse, raised the Deaflympics. I understand that the Under-Secretary of State for Digital, Culture, Media and Sport, my hon. Friend Tracey Crouch, has instructed officials in her Department to look into how we can ensure greater recognition for the Deaflympics in this country, and she will consider their advice in due course. She is a very accessible Minister, and I know the hon. Gentleman knows her and will no doubt take that matter up with her as well.

A number of people, including the hon. Gentleman, my hon. Friend Peter Aldous and the hon. Member for Bristol East talked about improving paediatric audiology services through the Improving Quality in Physiological Services—IQIPS—scheme. Concerns have indeed been raised in relation to accreditation of paediatric audiology services. The independent process of accreditation—the IQIPS services —is there to ensure all providers meet a common standard. We want all providers to have completed accreditation as quickly as possible. The commissioning framework encourages clinical commissioning groups to require providers to have completed the IQIPS self-assessment tool, and to have applied for and achieved accreditation, within the duration of their contract. Commissioners must be the ones who drive this forward. For us, the accreditation process is an effective means of testing against the standard. If during an assessment mandatory findings are raised that show nonconformity with any part of the standard, the service agrees appropriate improvement actions with the United Kingdom Accreditation Service team to rectify that and prevent it reoccurring.

The hon. Member for Poplar and Limehouse and many others raised the issue, which I even question myself on, of which Government Department leads on British Sign Language. I completely appreciate the frustration. There can only ever be one Minister at the Box, but what we really need is a triumvirate of me merged into my hon. Friends the Members for Truro and Falmouth, and for Chatham and Aylesford—that would be an interesting sight! I totally appreciate the frustration with the fact that no single Government Department leads on British Sign Language. I suppose, although this will probably just make it worse, it would depend on the context; if it is in education, that would be for the Department for Education; if it was how BSL is used in health settings in line with the accessibility standard that I mentioned, that would be for my colleagues in the Department of Health. I get the hon. Gentleman’s point, and will take it away.

The hon. Member for Eastbourne, whom I know well and is welcome back to the House, talked about screening for hearing loss in adults. He made the point very well that we do not focus just on people with complete hearing loss. He said to me the other day that he feared the debate would be about the deaf-deaf, as he put it, and he wants to ensure that people with partial hearing loss get the support they need. He made the point very well that people begin to lose their hearing later in life, as age catches up with us all, but accept it as part of the natural ageing process. They are often reluctant to admit they have a hearing problem, do not seek support as promptly as they might with other conditions and, as we have heard and as he said, often wait years before going for a hearing test. We heard his call for the introduction of a hearing loss screening programme for people at the age of 66, once they reach retirement, and as part of the NHS health check for people aged 40 to 70. I am responsible for the health check programme.

The advice from the UK National Screening Committee, the expert group that advises Ministers on all aspects of screening, is that the evidence does not demonstrate that universal screening would provide any hearing-related improvement in quality of life in comparison to hearing loss identified through other channels. However, the hon. Gentleman makes a persuasive argument that we can do more to identify hearing loss as people reach older age. He said that the general election had intervened, but as he also said, he is back, and I do not doubt that I will be hearing from him again on this subject, probably at Health questions in a couple of weeks’ time. I will be more than happy to do so, to be honest. He also mentioned that CCGs commission the audiology services. NHS England’s commissioning framework captures the importance of audiology, and monthly waiting time data for audiology is collected and can and should be used by Members and the public to hold commissioners to account.

I touched on my hon. Friend the Member for Waveney, who spoke about support for children with hearing loss, and about his constituent’s son, Daniel. I was the vice-chair of the all-party parliamentary group on autism for many years when I was on the Back Benches, and we often used to hear about the so-called middle-class parents with sharp elbows who managed to get their children what they needed. That is, of course, human nature; but it should not be the sharp elbows of the middle classes or of anybody else that gets children what they need—that is what the state is for, in my opinion.

Children with a special educational need as a result of their deafness will benefit from the more integrated approach to meeting their needs. Since 2014, a new framework has required CCGs and local authorities to make joint arrangements for assessing the range of eligible children’s needs, and the development of what my hon. Friend rightly referred to as the education, health and care plans to provide necessary support. Every Member in this debate and in this House has casework on EHCPs. These arrangements are transforming the support available to children and young people by joining up services for zero to 25-year-olds—that is their scope—across education, health and social care and by focusing on positive outcomes. He is right to take up the casework, as I would myself. I think the performance of local authorities is vastly different across the country. I know from speaking to him outside this debate that he is working very closely with his local authority, as I would expect, and that he has been impressed by the improvements it has made. I do not doubt that that is because of the pressure that he has put on it.

In my hon. Friend’s speech he used the term, which I wrote down, “The right support right from the start”. I do not think that was an accident, because as a Member of Parliament I had an invitation today, as we all did, from the National Deaf Children’s Society, which he referred to, requesting the pleasure of my company at an event called: “Technology and deaf children: Getting the right support, right from the start”. Mr Speaker has very kindly allowed that to be in the state rooms in Speaker’s House at lunchtime on 10 January. I think that will be an excellent event, and I hope it is well attended; I suspect it will be by all Members in this room.

My hon. Friend touched on special educational needs funding as well. The implementation of the new SEN system has been supported by significant new investment. That includes £70 million in ’14-15, £113 million in ’14 through to ’17 in the implementation funding, and £45 million in the same period for independent supporters for families. Ofsted and the Care Quality Commission are reviewing how all local authorities—authorities know about this—and their CCG partners work together to meet the needs of children with SEN as the EHCPs come into force. The assessment criteria are there, and are very much on their shoulders.

My hon. Friend Kelly Tolhurst gave a brilliant and very personal speech, if I may say so. It is never easy to do that in this place. It gets lots of retweets, but that is the easy bit; it is really hard to do it. She mentioned her mum’s story, and I thought she spoke brilliantly. She used the term invisible disability, which the hon. Member for Burnley also used. My hon. Friend said that deafness could take many different forms and have impacts physical and mental. I thought she made the case really coherently.

To touch again on my right hon. Friend the Member for Hemel Hempstead, my former boss, for the record, I do not mind at all when former Ministers come to debates that I am responding to, especially when they are former Ministers for a Department that I am not responsible for. I thought he made the point very well about the scale of the issue and the hidden deafness in this country, and he gave his example of industrial causes of deafness.

Tommy Sheppard told us about the BSL Act in Scotland and the ensuing national action plan, which he directed colleagues to look at. I will direct colleagues in the UK Government to look at that. Hats off to him for his attempt at signing the start of his speech. I thought that was a very brave move, and I thank him for his remarks.

Teresa Pearce spoke very well about loneliness. I wonder whether the loneliness commission that our former colleague Jo Cox set up touched on the issue of deafness and its impact on loneliness; I would be interested to learn from those involved whether it did. The hon. Lady spoke about Jacob and the crowdfunding in her constituency for his cochlear implant. I do not know the details of his case, so it would be unfair for me to comment, but it sounds as though her community is showing incredible grace to that little boy. It would be wonderful to see him in the House when he has had his implant. She also raised the issue of the Access to Work cap again. My Department for Work and Pensions colleagues and I will write to her about her specific questions on numbers.

The hon. Member for West Lancashire spoke about her kidnap by the deaf community. Again, hers was a very emotional speech. I so wish she had done what she threatened to do and signed her entire speech, as long as she had given me a copy of it beforehand. I like to think I can cope, but I would not have coped with all of that. I thank her for her well made comments, especially about a single gateway. She is a member of the Health Committee, and I suspect that she is also a member of the all-party group, so perhaps she will make that suggestion to the new Minister for Disabled People, Health and Work and will talk about the cap on Access to Work when the group meets her. The hon. Lady also referred to invisible disability.

Martyn Day made points about the gender gap and EU law post-Brexit. They definitely do not fall within my remit, but I will write to him. We have the European Union (Withdrawal) Bill, or the repeal Bill as it is colloquially known, and in the past week or so, we have had a taste of the issues relating to animal rights. I have to say, as a Government MP and a Government Minister, I take slight umbrage with the suggestion—although not by the hon. Gentleman—that somehow we need the EU to have good rights relating to looking after animals in our country, let alone our citizens. I do not buy that for a minute. We will import that regulation through the Bill and then look at it as a sovereign Parliament and decide how we can improve on it. I am sure there are ways to do that. From what Members have said on the subject in this debate, and given the other Members who are interested, I somehow do not think that the issue will go unheard.

I will leave a few minutes for the hon. Member for Poplar and Limehouse to sum up. In conclusion, we have had a very interesting, honest debate. I hope I have been able to demonstrate to hon. Members that across my now expanding portfolio, we have a strong frame- work for supporting people with hearing loss through a set of quality and commissioning criteria—within a restricted budget, of course; that will always be the case. Setting the expectations for commissioners and providers is what we in the Department of Health are most interested in. The dedicated action plan on hearing loss is being spearheaded by NHS England, for which I am responsible, and the multi-agency approach is enshrined in the action plan.

We are doing a lot, but we can always do more. Some really good points have been made in today’s debate. Whether more people are watching today’s debate than “Pointless”, I do not know, but if more people watched debates such as this, they would have a far better opinion of Parliament than some of them do. We have had a really good debate and have covered a huge amount of ground. I very much thank hon. Members for their contributions, which have all been from the heart and incredibly well informed. I look forward to following up on many of the issues that have been raised.

Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse 4:23 pm, 30th November 2017

I am grateful for the opportunity to sum up, Ms Buck. Invariably, the Member who sums up such debates says, “We have had a good discussion.” Not only is that the case today, but this has been an exceptional debate, and I thank everybody who has contributed. There has been a personal theme, but even those who did not raise a personal experience clearly have a grasp of the importance of the subject to their constituents. If any hon. Members are not on the all-party group mailing list, they are now, but I suspect everybody already is.

Iain Stewart put his finger on the big issue. As others mentioned, this is a cross-departmental matter, so we need a champion. I will return to that in due course. My right hon. Friend Mr McFadden spoke about cochlear implants and NICE. The Minister says that the work is now back in hand; it will be nine months late, but hopefully it is coming.

Kelly Tolhurst, as the Minister said, covered her mum’s story powerfully, bringing a tear to my eye. If she saw me wiping it, it is because it was such a great explanation of an individual’s difficulty, told with clear personal commitment. She made a point about how important it is for organisations such as Auditory Verbal to get to children born deaf within the first three and a half years, when their brains can still learn to speak; after that, it is far too late. That is why the pathway is so important.

Stephen Lloyd also spoke powerfully about his personal experience. I was not sure whether he was making a bid to come back as the chair of the all-party parliamentary group; he will need to wait for the annual general meeting, but he is a great vice-chairman, and I will be pleased to see him there. Peter Aldous and Sir Mike Penning both called me their hon. Friend; that does not do me any favours on this side of the House, but I know what it means. We have done a lot of good work on a number of Committees, especially on fire, and we are friends. That tells people outside the House that although we might not often be in the same Division Lobby, we have friends across the Chamber and we work together when there is a common purpose. That is really important.

My hon. Friend Kerry McCarthy spoke about IQIPS and accreditation. The right hon. Member for Hemel Hempstead, with his experience as Minister of State on Access to Work, is a powerful ally. Tommy Sheppard, who just left to catch his train, talked about money being available for BSL lessons here. That ought to be the case, and I am sure that it is the case; we just need to explore it. He made a point by signing, reminding me that so much of sign language is common sense, such as “book”. He used the sign for “Scotland”, which is bagpipes. That tickles me every time I see it. He made a clear point about the power of legislation.

My hon. Friend Teresa Pearce told a story about Jacob and crowdfunding. It was powerful, as was the personal story told by my hon. Friend Liz Twist. My hon. Friend Rosie Cooper told her stories about having BSL as her first language, and the Access to Work issues. She spoke about Liverpool minicoms, and her dad, of whom she is clearly and rightly very proud. I am sure that it touched everybody in the room.

The politics came from the three Front-Bench speakers; the place went back to normal when they started talking. I mean no disrespect at all; they deal with things from a political point of view. Judging by their speeches, Martyn Day, my hon. Friend Julie Cooper and the Minister clearly understand the issues, and we are grateful for that.

Finally, we need a champion in Government. BSL needs a champion in Government. At some point, a Department or a Secretary of State will have to say to a Minister, “You’re the person for the job.” Then we can all go support that person and get a better hearing in Government. This has been a powerful debate. I am grateful to both signers for being here—[Hon. Members: “Hear, hear!”]—and to the House authorities for facilitating that. I hope that this is the first of many opportunities and becomes the norm. I am grateful for the opportunity to say these few words in closing.

Photo of Karen Buck Karen Buck Labour, Westminster North

On behalf of us all, I thank the two signers, Sally Macreavy and Richard Law. We greatly appreciate their work.

Question put and agreed to.

Resolved,

That this House
has considered deafness and hearing loss.

Sitting adjourned.