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The general pattern of how far PCTs are from targets now, and will be by 2011, shows a remarkable achievement. As recently as 2003-04, the most under-target PCT was 22 per cent. below target, and by 2005-06, the furthest was still 16 per cent. below. At the beginning of 2009-11, the most under-target PCT will be 10.6 per cent. below, and by the end of that period it will be 6.2 per cent. below. Some, including hon. Members here today, would like to see a more rapid journey to get the PCTs that are furthest under target closer to their targets. However, to
speed up the pace for below-target PCTs would inevitably result in smaller increases in funding for above-target PCTs.
My hon. Friend the Member for Wigan acknowledged the importance of having a floor, and a debate is to be had about where that floor should be. However, we have considered the matter very hard and examined the demands on the health service throughout the country, and, in our view, moving faster over the next two years would result in painful cuts to the services provided by a number of PCTS, including those of my hon. Friend the Member for Regent's Park and Kensington, North (Ms Buck), my right hon. Friend the Member for Oxford, East (Mr. Smith) and the hon. Members for Hemel Hempstead and for Southport (Dr. Pugh). I am sure that neither my hon. Friend the Member for Wigan nor any other hon. Member here wishes for such an outcome.
My hon. Friend made a point about the impact of local government spending. PCT and local authority grants are decided in different ways and take account of different factors, which should help to avoid PCT allocations and local authority grants being suddenly changed in the same way. The Department for Communities and Local Government is represented on ACRA, and so it is involved from the start. My hon. Friend also asked whether we could have a debate in the main Chamber. I think that we have had a pretty good one this afternoon, although I accept that it was not a debate on the Floor of the House. He raised that point with the Secretary of State, who said that he would think about it, but in the end, of course, that is not a matter for the Government, but for the House. However, the Secretary of State said that he would be happy to consider such a debate.
My hon. Friend also asked whether the allocation could be changed in the final year to take into account falling inflation. He acknowledged that NHS spending is heavily dependent on labour costs. However, those costs are fixed, because, thank goodness, we managed to secure a three-year pay deal with the unions, and, given the current climate, I do not envisage them wanting to reopen those negotiationsthe deal might not go in the direction that they want. The wage bill and drugs are by far the biggest proportion of the NHS bill, so we do not actually make huge savings from the fall in inflation.
To change the formula after just one year would be contrary to the very thing for which my hon. Friend and others have long been campaigning in the Housethe certainty of three-year settlements, which allow PCTs to plan for the future. He also asked whether I would commit to a greater distance of travel. I have explained that, given the impact on other hon. Members constituencies, that would not be a good idea over the next two years. However, we can reconsider that matter during the next review period, beginning in 2011, if, as I hope, we still have a Labour Government committed to tackling health inequalities.
My right hon. Friend the Member for Oxford, East asked what would happen if a PCT in a generally affluent area, but with pockets of deprivation, received a floor increase, which would be 10.6 per cent. in his case. He should be aware of two substantial points. Under the operating frameworkthe instruction to the NHS about its prioritiesa clear obligation is placed on PCTs to tackle inequalities, and they should be held
to account if they fail to do so. Secondly, in the world-class commissioning process, the quality of PCT commissioning will be much more closely scrutinised, and, again, they will be obliged to tackle and address health inequalities. They will need to be held account on that as well.
Alun Michael (Cardiff, South and Penarth) (Lab/Co-op): As Members of Parliament, we occasionally have the opportunity to make a real change for the better. Even more rarely, we have the chance to accelerate change to align parliamentary influence with ministerial aspiration and to exploit technical progress. The switchover to digital television gives us an almost unique opportunity to transform the lives of blind and partially sighted people and many elderly people in general. I am confident that the Minister will give me a positive response to this short debate, because she knows how important this matter is from experience in her own constituency.
Digital switchover will give us all clearer pictures and sound, improved reception and more channels. However, an even greater benefit to people who are blind or who suffer from visual impairment comes from one single fact. People who cannot see miss out on so much that sighted people take for granted. That is vitally important because for many people, television is their main source of information and entertainment. Apart from news, documentary programmes and personal consumption of television programmes, people feel left out if they do not know what is going on on programmes such as Big Brother, Celebrity Love Island and Footballers Wives. I have to say with some pride that I do not have a clue what is happening in those programmes, but that is because I do not want to; it is my choice.
At a recent Royal National Institute of Blind People event in the House of Commons, the Secretary of State for Culture, Media and Sport, explained the difference between choice and being excluded. He told us about his time as Parliamentary Private Secretary to my right hon. Friend the Member for Sheffield, Brightside (Mr. Blunkett). My right hon. Friend is a passionate fan of the Harry Potter novels, but was unable to join in the excitement on publication day, because it would be many months before an audio tape or disc would become available and he would know what everyone was talking about.
Most examples of such social exclusion are closely related to television. Around 365,000 people in the UK are registered as blind or partially sighted. Research by the RNIB has suggested that there could be as many as 2 million people in the UK with some degree of significant sight loss. To put it another way, each constituency has between 560 and 3,000 people, depending on which analysis one uses, with some degree of visual impairment.
The switchover to digital television gives us the opportunity to help people who have been excluded from experiencing things that the rest of us take for granted. Audio description is like a narrator telling a story. It fills in the gaps by describing the images that appear on the screen. For example, it describes the lingering looks of a man as he stares deeply into a womans eyes, and the shots of an undiscovered bomb quietly ticking its way down to zero. Although such things mean so much to the storyline, they are often a mystery to blind people, but now they can come to life through audio description.
Last year, I attended an RNIB event in which I watched some television. Wearing glasses that simulated the vision of someone with a visual impairment, I watched a clip from a television programme. That experience
was confusing and I got very little out of it. I could not work out what was going on. Still wearing the glasses, I was then shown the same clip but with the addition of audio description. It is not too much of an exaggeration to say that I was a convert to audio description from that moment.
The campaign run by the RNIB has been both imaginative and effective. Before Christmas, an invitation to a reception in the House of Commons appeared in Advent Times, which is a spoof of the Radio Times. Instead of giving programme information, it told us all about the programmes that blind people could not understand because the vital action was not audio described.
At the event itself, a corner of the Members Dining Room was turned into the living room of Aunt Megan, who was ready to tell every MP about the virtues of audio description. Having experienced audio description with elderly parents or our own Aunt Megan or Uncle Idris, MPs got the point immediately. I want to pay particular tribute to the key person who got the point. The Secretary of State for Culture, Media and Sport, my right hon. Friend the Member for Leigh (Andy Burnham) agreed to change the core receiver requirements for the Governments help scheme for digital switchover. The digibox that will now be provided to people who qualify for help will include one-button access to audio description.
The speed of the Secretary of States response when we approached him was particularly effective and welcome, because it means that such facilities will be available to people in Cardiff South and Penarthand also the rest of Wales. Constituents will receive set-top boxes as part of the help scheme at the time of digital changeover. Even a slight delay in that decision would have resulted in a massive missed opportunity. Such victories of technology would not have been provided automatically to vulnerable people in my constituency or to the rest of Wales, including your constituency as well, Mr. Jones. To add it in later would have been expensive for individuals and impossible for Government or industry to organise. Therefore, the Secretary of States decision to act quickly last October will lead to actual clear benefit to hundreds of thousands of people.
I am particularly pleased that we are having this debate on the day after the Government agreed to the request made by many Back Benchers, led by my hon. Friend the Member for Glasgow, North-West (John Robertson), to give blind people the higher rate of disabled living allowance. Such things make a difference.
Three years ago, the Government set the percentage of programmes to be audio described at 10 per cent. That requirement was enshrined in the Communications Act 2003. The target was set after consultations with Ofcom. Five years before those consultations, Ofcom was unconvinced that awareness and take-up of audio description warranted a more challenging target. Broadcasters were doubtful, too, and perhaps with some justification. If a company is being required to spend money on a service, it wants to know that that service will be used. However, things have changed.
In 2008, the RNIB commissioned a piece of research into awareness of audio description compared with two years previously. The findings were dramatic, and they were drawn to the attention of Ofcom. The public at large and people with visual impairments were all the
more aware of audio description. there was an increase of 62 per cent. in the numbers of the general public who were aware of the service; there was an increase of 67 per cent. in the numbers of people with a visual impairment. That figure included a massive 150 per cent. increase in the number of mildly visually impaired people who knew about audio description. That figure struck me as dramatically important.
When I was Industry Minister, I worked closely with the Secretary of State for Work and Pensions, my right hon. Friend the Member for Stalybridge and Hyde (James Purnell) on digital switchover. We were deeply concerned about identifying those individuals who might not be registered as blind or visually impaired, or who might not have come to the attention of the social services, and yet were definitely in need of assistance from the Government help scheme. Many elderly people have a degree of visual impairment that they may even hide from friends and relatives, because they do not want to be a burden or a nuisance. How can we be sure that they will receive the help that they need? Those are the people who will benefit significantly from the Government help scheme. Publicising audio description is one way to ensure that we identify and reach as many of those people as possible.
Given the massive shift in awareness and the large increase in audience access that follows from the change in the core receiver requirements, I am confident that when Ofcom completes its television access services review, it will recommend that a minimum of 20 per cent. of programming should be audio described. Broadcasters generally deserve credit and praise for doing more than they are required to do by law. Since that research was commissioned, rates of audio description on the main channels have increased exponentially. BBC1 audio describes 14 per cent. of its output and BBC2 describes 12 per cent. ITV manages 13 per cent., Channel 4 describes 10.8 per cent. and Channel 5 describes 13.5 per cent. Even Channel Pedwar Cymru manages to audio describe more than 10.9 per cent. of its output. Some channels do even better. BBC 3 audio describes a whopping 26 per cent. of its output, and GOLD, Sky Movies, UKTV History, Sky Three and BBC 4 are all above the 20 per cent. mark. Broadcasters have reason to be proud of the efforts that they have made.
Of course we understand that there will be a cost to increasing the amount of audio-described television. Channel 5s chief executive, Dawn Airey, told me that increasing audio description levels to 20 per cent. from the current 13 per cent. would cost the broadcaster £100,000 per year, and the costs may be more for other broadcasters. However, it is not acceptable for services for disabled people to be the first to go in times of economic difficulty. ITV has already discontinued its provision of signed evening news bulletins in five regions, including ITV Wales.
ITV Waless response to Welsh Labour MPs was disappointingly dismissive. That was something that ITVs representatives did not mention when they came to talk to us about ITVs financial problems. They do not seem to understand the reputational damage and loss of sympathy that follows from that decision. In a short debate on ITVs cuts in Wales last week, Ann Jones, the Assembly Member for Vale of Clwyd, made the following point:
With the digital switchover just around the corner, we are already being offered HD Emmerdale and HD The Simpsons
on a daily basis. However, among this milieu theres a big gap, leaving deaf people out in the cold.
I want to see a phased increase towards 20 per cent. audio description, which is the RNIBs modest request. It will help to cushion the blow if we ask bigger broadcasters to lead the way, perhaps with 2 per cent. increases yearly for the next few years. A phased approach would reward broadcasters who have already exceeded their targets and enable them to plan ahead and in turn drive down costs. I stress again that all the channels subject to the 10 per cent. audio description target are meeting it. The BBC is well above the basic requirements, and Sky has promised to meet the 20 per cent. target voluntarily. The broadcasters concerned can be proud of what they have accomplished.
The difference that audio description can make to peoples lives cannot be overstated. That is why I am asking broadcasters not to wait for Ofcoms recommendations, but to make a commitment now to audio describe at least 20 per cent. of their output as soon as possible. The problem is that we have reached a plateau for audio description. We are at a point where the only way to increase awareness of audio description is to have more of it. At the moment, audio description is concentrated on the most popular programmes, soaps and films. Those who do not enjoy soaps or who are not a fan of the films being described are likely to miss out altogether on the benefits of audio description.
I thank the RNIB for alerting me to the issue and for running such an imaginative and powerful campaign. In my mothers later years, I saw the impact of failing sight and how lonely a person can get if they cannot continue to engage with the outside world. Often, television is their last link. Above all, I thank the Secretary of State for getting the point so quickly and acting on the message in respect of the core receiver requirements. That change has created the opportunity for all vulnerable people to receive the service simply and straightforwardly when they gain access through the help scheme.
Seizing the opportunity given to us by the digital switchover is essential. It creates the opportunity for a paradigm shift in the availability of audio description by providing the technology of access to all vulnerable people who qualify for the help scheme. That will massively increase the connectivity of the main audience for audio description and allow broadcasters to make their contribution in a way that will be liberating to people who are blind or visually impaired and to elderly people generally. By the way, it will also be good for the reputation of broadcasters.
The Parliamentary Under-Secretary of State for Culture, Media and Sport (Barbara Follett): I congratulate my right hon. Friend the Member for Cardiff, South and Penarth (Alun Michael) on securing this debate and thank him on behalf of my right hon. Friend the Secretary of State for Culture, Media and Sport for his kind words about the Department and the Secretary of State.
I have known my right hon. Friend the Member for Cardiff, South and Penarth for many years, so I know that he is an enthusiastic advocate of the benefits of audio description. As he explained so well, it is a free service, currently available on some television channels, in which a narrator describes the on-screen actions, body language and facial expressions of the actors or participants in a programme in order to help people with visual impairments to follow the programme or story.
After a campaign led by Ofcom in July last year, awareness of the existence of audio description doubled, as my right hon. Friend has said, from 37 per cent. to 72 per cent. among the United Kingdoms visually impaired community of 2 million. Given the success of the campaign, Ofcom believes that the time is right to reconsider recommending an increase in the minimum target for programmes with audio description from 10 per cent. over a 10-year period to something higher. I know that my right hon. Friend is aware of Ofcoms thinking on the matter, as he spoke with its officials at the RNIBs recent parliamentary reception, which he hosted, in support of its campaign to raise the minimum audio description target from 10 to 20 per cent.
I commend my right hon. Friend for his work to promote the benefits of audio description by hosting receptions such as the one that I have described, tabling early-day motions and securing debates such as this. I am glad that he, like me, welcomes the opportunity offered by the digital switchover to increase the use of that extremely helpful technology. Digital switchover will help, because digital terrestrial television transmission, unlike analogue, allows people direct access to audio description through their sets, which will be a huge boon to the visually impaired. As a result, after the digital switchover programme is completed in 2012, 98.5 per cent. of the population will have access to digital terrestrial television and, if they want or need it, to audio description.
As my right hon. Friend will know, the process of switching from analogue to digital television began in earnest on 6 November last year in the Selkirk and borders region. Over the next four years, the switchover will continue region by region, ending in Ulster in 2012. It is a huge exercise, but, fingers crossednew technology always makes me resort to old superstitionsthings seem to be going well. The latest digital Ofcom tracker, which provides useful snapshots of public opinion, bears that analysis out. Awareness of the digital switchover is now at 90 per cent., and understanding of what it actually means is now at 72 per cent. in the UK as a whole.
In Wales, where my right hon. Friend comes fromas do the Chair and my husbandthere is an interesting difference. Some 92 per cent. of the population are aware of this huge changethat is 2 per cent. more than in the UKbut only 65 per cent. understand what it involves. After having named that collection of people in my life and in this Chamber, I will not speculate on how the difference arose.
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