On March 25th, a D/deaf health debate happened in the House of Lords. Different people spoke – you can see who and what they asked on our website by clicking here.
On behalf of the government, Baroness Jolly answered all the questions.
She started her speech by thanking SignHealth for our Deaf health report Sick Of It, and saying the barriers Deaf people experience are unacceptable. She listed the improvements that have been made for D/deaf people, including screening services for newborns and improving waiting times for patients when they visit their doctor. She then answered and explained each question separately.
In response to Lord Addington’s point about using technology in communication…. Online signing could be a sensible service to use. Maybe using Skype could be helpful? Different commissioning groups working together will be discussed later. Online services would give patients dignity and help make GPs jobs easier.
In response to Lady Howe of Idlicote’s point about Lords checking services in their own GP practices… I think all Lords will check their GP service. My own GP in Bodmin, Cornwall, offers online booking if you want to see a doctor or nurse. When I arrive I do not talk to a receptionist; I press a touch-screen pad that asks for my date of birth and my gender. It then says, “Ah! Are you Mrs Jolly?”, and tells me to sit down and wait. These services would work perfectly for deaf people and could be replicated throughout the country. What happens in the consulting room may not be as good for all of us—I do not know.
There are over 10 million adults in England with hearing loss; the World Health Organisation says in 2030 there will be 14.5 million. To promote good health it is important that health and social care services are ready and prepared to communicate with deaf people and people with hearing loss . All options should be considered.
In response to Lord Hunt’s point about the public sector equality duty…. It’s great that SignHealth’s Sick of It report reminds deaf people about their right to complain when a service provider has not taken their needs into account. However, it is the service provider’s role to anticipate the requirements of disabled people and make reasonable adjustments for them in advance, before any disabled person tries to access their service. It is not acceptable for health services not to be equipped with communication support for those who need it. This may be British Sign Language, basic technology including display screens in GP waiting rooms, or text messaging services.
In response to Lord Borwick’s point about skills possibly being taken over by technology, then his point about cochlear implants, texts and the internet…. The story about Joanne Milne, the woman who heard for the first time this week with her cochlear implant, was emotionally powerful. But it will take a long time before youngsters reach the age of older people who are deaf or have hearing loss. This will not be an instant fix.
As part of the commitment to improve patient experience when using NHS services, and empowering people to take responsibility for their own health, NHS England is developing an Information Standard. The standard will make sure that disabled patients, service users and carers can receive information from NHS organisations and providers in ways they can understand. It will make sure they receive appropriate support to communicate with service providers. It will reduce the number of appointments and screening opportunities missed by patients. Why? Because until now, the information they have received has been inappropriate for them. We hope the standard will be finalised at the end of 2014, and organisations must follow the guidelines by 2015. NHS England will also publish guidance on how to make reasonable adjustments to meet the communication needs of service users with disabilities.
We know there is a need to improve the current commissioning and integration of health and social care services for people with hearing loss, as well as new models of care. This is why we are developing a new action plan on hearing loss. The action plan will identify the key actions that will make a real difference to health and social care outcomes for children, young people and adults with hearing loss. NHS England is currently communicating with the Department of Health, Public Health England, other government departments and agencies and key stakeholders to publish the action plan as soon as possible.
I hope I have been able to reassure the House that the Government have a strong commitment towards promoting the needs of D/deaf people across a range of public services. We want to make sure D/deaf people have equal access to health and social care compared to people who do not have hearing loss. Equality is important.
In response to Lord Hunt’s point about psychological therapy in BSL, and if the responsibility of it should be in specialised commissioning… Following advice from the Prescribed Specialised Services Advisory Group and a consultation with NHS England, Ministers have decided the responsibility for commissioning psychological therapies for Deaf sign language users should continue with Clinical Commissioning Groups.
In response to Lord Hunt’s point about the national champion and how to build on the work done already… I will look into this further and write to Lord Hunt. On health and well-being boards, they should be looking at across-the-board services (health, education, employment). We are hope they are. Health and well-being boards need to make sure that all social care and health services and properly commissioned and co-ordinated. It is a good idea to have regular NHS meetings in local areas for D/deaf people and people with hearing loss. I think people with other disabilities would like this too, maybe the Healthwatch could organise this?
In response to the question, do GPs have to pay for translation services? Each provider of a public service is responsible for making reasonable adjustments to meet the needs of disabled people. It is not funded centrally. It needs to be found within local budgets.
In response to Lord Addington’s point about co-coordinating help for D/deaf people in other areas, such as education and employment… The Minister of State for Disabled People recently wrote to Ministers in other government departments to ask how they’re going to support D/deaf users.
In response to Lord Ponsonby’s point about plans to ensure NHS Choices provide more BSL content… SignHealth were approached, funding was secured and 10 BSL videos were made. They include information on breast cancer, diabetes, heart disease, lung cancer, prostate cancer, back pain, depression, low mood, Chlamydia, high cholesterol and tinnitus.
In response to Lord Ponsonby’s question,’What would the Minister recommend to a D/deaf person who wants to see a doctor but is told there is no interpreter?’ They should make a formal complaint with their GP practice. If the complaint does not resolve the problem, complain to the CCG or NHS England.
In response to Lord Ponsonby’s question, ‘What steps will the government take to encourage NHS England and the Public Health England to promote the health of deaf people?’ NHS England has legal responsibility to make sure there are no health inequalities.
In response to Lord Ponsonby’s question, ‘Can we expect NHS computer systems to tell us how many D/deaf people there are and which services they are accessing?’ No, not yet. But a new system is being commissioned by NHS England to improve Hospital Episode Statistics. This means a new system is being developed to give better hospital data, and data from care services outside of the hospital. It won’t tell us how many D/deaf people there are, but it will tell us the services they are using. In time, I’m sure data will be developed so we will know how many D/deaf people there are.
In response to Lord Ponsonby’s question, ‘Will the Information Standard be supported by a funded programme to help educate and support?’ During the making of the Information Standard, we asked health and care professionals what challenges they experienced when communicating with their patients, carers and service users, and how they want to overcome then. Their responses will be reviewed. We hope their responses will help the making of the Information Standard, and supporting tools.
In response to Lord Borwick’s question, ‘What can be done to encourage more teachers to work in this specialist area?’ Schools and local authorities are responsible for assessing their staff, and having good recruitment and training strategies in place. We expect authorities to work with schools to make sure staff have appropriate skills. The Department for Education is funding scholarships for teachers to develop their knowledge and skills, including postgraduate qualifications. 600 teachers have achieved or are working towards a qualification relating to special education needs, and 500 more have applied for current funding.
In response to information texting…. This is a local decision. I have told Lords how my local GP practice chose to organise it.
Image Credit: RajanPhotos