The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, we continue to remind health authorities that they are required to meet the cost of cochlear implants in all cases where that is the appropriate treatment.
Lord Ashley of Stoke: My Lords, I am grateful to the Minister for that reply. Does she agree that cochlear implants are medical miracles which are now safe and established procedures which rescue totally deaf people from the world of silence? But is she aware that the Government's efforts to encourage DHAs to fund these implants are being rejected by a minority of health authorities, such as East Sussex, which will agree to fund only two children and no adults; oreven worseWorcester, which refuses to fund any implants? Does she agree that that is unfortunate for the totally deaf people in those areas? Will she see what the Government can do to help?
Baroness Cumberlege: My Lords, perhaps I may say that I think that the noble Lord is a medical miracle, and also a man of tremendous courage who has shown us how one can overcome disabilities and still make a tremendous contribution to our society. The noble Lord will be aware that we have just had an evaluation of this operation carried out by the Medical Research Council's Institute of Hearing Research. We are about to publish that report. The report shows that the treatment is safe and effective for all but a small minority of patients. I suspect that some of the reluctance of health authorities to undertake this treatment has been because they have been waiting for that research. Now that it is about to be published, we expect them to follow our advice and to ensure that all those who need the operation have it.
Baroness Gardner of Parkes: My Lords, why is not the Royal National Throat Nose and Ear Hospital, which is the national hospital for work on ears, one of the centres authorised to carry out this treatment? How many centres have the facilities to offer this treatment?
Baroness Cumberlege: My Lords, with any new operation, it is important that we concentrate the expertise on particular areas where clinicians are anxious to do it and it is sufficiently well funded. In England, the following units carry out the operation: Birmingham; Cambridge; the Middlesex, London;
Lord Rea: My Lords, does the Minister agree with my noble friend that cochlear implants are a remarkable example of team work between electronic wizardry and microsurgery? Will she anticipate some of the findings that will be reported in the research document that is coming out shortly? Can she give us any idea of the number of profoundly deaf people who are likely to benefit from cochlear implants? Will she tell us what is the cost of each implant?
Baroness Cumberlege: My Lords, we suspect that there are over 3,000 people (adults and children) who are likely to benefit from the operation. The cost of the operation for adults for the first year is £21,000 and for subsequent years £1,000. For children, in the first year it is £24,000 and for subsequent years £2,000.
The Earl of Lindsay: My Lords, the Local Government Commission recommendedand we have agreedunitary status for many of the largest non-metropolitan towns and cities in England, including several former county boroughs. However, in other districts with apparently similar characteristics the commission recommended the status quo. We believe it is right to test the case for consistency by asking the commission to carry out further reviews of a small number of those districts, including Warrington. We have not yet decided whether to ask the commission also to carry out a further review of Halton.
Lord Rochester: My Lords, I thank the Minister for that Answer. Will he acknowledge that, when on 30th September 1993 the Secretary of State announced that the review of local government was to be speeded upsince when it seems to have slowed down quite a littlehe said:
Do the Government accept that in a series of polls thereafter the great majority of the people of both Warrington and Halton made it plain that they were opposed to changing the present two-tier structure? Can the noble Earl assure me and, more to the point, those directly involved that, rather than imposing a solution which the Government may want, the new guidance to be given to the reconstituted commission will ensure that the views of local people continue to be regarded as paramount?
The Earl of Lindsay: My Lords, I assure the noble Lord that the Government have not prejudged anything as regards Warrington, or Halton if that district is sent back for review. I can also assure him that the opinion of people who live in those areas will be important in respect of both the guidance which is to be issued, and which will be consulted on in May, and the commission itself. Another important issue must be the way in which a convenient and effective structure of local government is set up in those two places. All those issues can be balanced by the commission.
The Earl of Lindsay: My Lords, it is because we wish to get on with the task of strengthening local government that the Local Government Commission was created. My right honourable friend the Secretary of State has selected only a few districts for possible re-review on the basis of testing for consistency. He has not sought to refer any counties, because that would cause upheaval over wide areas.
Lord Rochester: My Lords, I wonder how many noble Lords know that the district of Halton comprises the towns of Runcorn and Widnes. Do the Government fully appreciate that for centuries the area has been divided physically and culturally? Rather than reinforcing those divisions under a unitary structure, would it not be much better to see them happily contained within the existing two-tier structure, thus averting further uncertainty, delay, disruption and expense?
The Earl of Lindsay: My Lords, it is because of specific issues, such as those outlined by the noble Lord, that the guidance which will be given to the commission in respect of the new review will concentrate on a new set of instructions. It is also as a result of specific issues, such as mentioned by the noble Lord, that the commission will re-address those areas. I stress again that there is no prejudgment on the part of the Government in seeking reconsideration of those districts.
Lord Inglewood: My Lords, the number of working days lost in labour disputes in the five-year periods ending 31st December 1979, 1984, 1989 and 1994 were 58 million, 52 million, 20 million and 4 million respectively.
Lord Elton: My Lords, does not that striking information result entirely from government policies? Is not the result of those policies to make United Kingdom industry increasingly competitive in the international market? Does it not explain why our level of
Lord Inglewood: My Lords, my noble friend's inferences are right. The unemployment rate in this country is below the EU average. Only ourselves, Ireland and Denmark have a level of unemployment lower than that of a year ago. It is for that kind of reason that 40 per cent. of Japanese and US direct investment in the European Community is in our country.
Lord Dean of Beswick: My Lords, will the Minister give the figures for the number of jobs lost in our manufacturing sector during the same period due to the Government's policies? Hundreds of thousands of jobs have been lost forever, which must have a bearing on the figures that he has quoted in respect of industrial disputes. Hundreds of thousands of people have not been in work and have had no opportunity to strike, even if they had wanted to.
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