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The Minister of State, Department of Health (Ms Rosie Winterton): I congratulate my hon. Friend the Member for Dartford (Dr. Stoate). The topic is clearly important nationally and to his constituents, and as usual he set out his arguments eloquently. Like him, I believe that people who need hearing aids should have access not only to the latest technology, but to a high quality service. I thank him for his recognition of the dramatic national progress of the past five years in audiology, particularly the move from the old-fashioned analogue aids towards offering modern digital hearing aids.

My hon. Friend referred to the situation in his area. I pay tribute to the national health service staff in his constituency who have worked hard locally and done much to bring down waiting lists. I shall come to some of the problems that he has outlined and set out some of the ways in which we are addressing them. I should, however, put it on the record that the average waiting time for first fitting of digital hearing aids in all areas served by Medway Maritime Hospital Trust is 40 weeks. That sounds a long time, but it has come down from approximately 100 weeks—nearly two years—in early 2005. The trust plans to bring that below 10 weeks. The trust also plans to see 70 patients per month who are waiting for conversion from analogue to digital hearing aids. As part of that, there have been a number of local initiatives. One in Dartford, involving Gravesham primary care trust, is providing services to something like 600 extra patients, some of whom require analogue to digital conversions, by using private sector providers.

The team at the Medway trust is also carrying out group-fit sessions that enable more patients to be seen, and that is giving valuable peer support. Audiology facilities at Darent Valley hospital are to be extended, and recruitment of additional staff is under way. Audiology services at Gravesend hospital is to be moved to the new Gravesend community hospital later this year, and service links at the new facility will enable more sessions to be carried out at Gravesend to complement the sessions at Darent Valley hospital. In addition, £606,000 from the modernising hearing aid services initiative is being used this financial year across Kent to bring down waiting times. Finally, Kent and Medway strategic health authority is establishing an audiology group to look with PCTs and trusts at the impact of some of those current initiatives and to set further targets and trajectories for waiting lists in 2006.

My hon. Friend mentioned the initial £125 million investment in modernising NHS audiology services. He asked what that covered, and I can confirm that it covered staffing and training in the new modernising hearing aids services procedures as well as equipment and information systems.
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All NHS audiology services are now able to fit digital hearing aids routinely and I reassure my hon. Friend that the Department would neither advocate nor promote treating only those without analogue aids. I am pleased to see that my hon. Friend's trust is now working to fit analogue aid wearers with digital hearing aids. However, I agree that we still have a long way to go. As my hon. Friend said, demand has grown enormously, and that has led to long waits in some areas.

Mr. Brooks Newmark (Braintree) (Con): I, too, wish to congratulate the hon. Member for Dartford (Dr.   Stoate) on raising this important issue. I also congratulate the Minister on her willingness to try to achieve the goals that the hon. Gentleman seeks. The challenge, however, arises from the funding crisis that many PCTs are suffering. How does the Minister intend to bridge the gap between the important objectives that she seeks to achieve and the funding crisis?

Ms Winterton: It is important to be clear that the NHS has received enormous investment, and all PCTs have benefited from that. We need to ensure that PCTs manage their finances properly, and if that is not sorted out the finances will not be on the even keel necessary to fund some of the new services that are coming on line. Financial management is vital to enable some of the PCTs that have difficulties to get on an even keel so that those services are provided by all PCTs.

We are taking several measures to tackle the problems, including 350 additional audiology posts and a new four-year BSc degree in audiology with a total of 348 students in training. The national framework contract public-private partnership will allow NHS trusts to use private hearing aid dispensers, which is just the sort of initiative that is being used in my hon.   Friend's constituency. As my hon. Friend the Member for North-West Leicestershire (David Taylor) mentioned, we are also introducing Hearing Direct, an optional telephone-based service that offers follow-up care and advice for selected hearing aid users. It will not suit everybody, and I wish to emphasise that if face-to-face contact is still necessary after the telephone contact, it will still be on offer. However, Hearing Direct is an exciting initiative that has achieved a high degree of satisfaction among users, not least because it can reduce the time that they spend travelling to out-patient appointments.

In the time remaining, I wish to address a few more of the points that my hon. Friend mentioned, such as the availability of in-the-ear aids compared with behind-the-ear aids. The MHAS procurement group, chaired by the RNID, agreed that the default position would be the provision of a range of behind-the-ear devices. However, if a specific clinical need for an in-the-ear device was indicated, one would be provided.

My hon. Friend also mentioned accommodation provision, which should be part of local service planning arrangements. The Medway NHS trust is considering using some of its capital to fund the creation of an additional audiology room. Even one room can cost something like £100,000, but I must emphasise that it is a matter for local PCTs to decide how they wish to address some of the accommodation issues.

We are also looking at further action on waiting times through the national physiological measurement programme. One of the development sites for this work
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is at the East Kent Hospitals NHS Trust and the outcome of that will be shared across the strategic health authority.

My hon. Friend asked particularly about the 18-week target, and we are looking at the principles and definitions for that target. We started consultation that closed on 8 December. Audiology, as a whole, is one of the disciplines that we are considering at the moment and, following ministerial approval to the final principles and definitions, we will be publishing guidance within the next two months.
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My hon. Friend also referred to the NICE guidance. NICE withdrew that guidance in May 2003 in the light of the proven success of the MHAS pilots and the wider availability of digital hearing aids. There is no central audit of practice by the Department—

The motion being made after Ten o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.

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