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TX: 13.01.04 – SHOULD THE NHS BE MAKING MORE USE OF THE PRIVATE SECTOR TO PROVIDE DIGITAL HEARING AIDS?

PRESENTER: WINIFRED ROBINSON


THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 91Èȱ¬ CANNOT VOUCH FOR ITS COMPLETE ACCURACY.

ROBINSON
Should the NHS be making greater use of the private sector when it comes to providing people with digital hearing aids? Demand is huge, there's a shortage of NHS audiologists and plenty of private ones willing to do the work. Back in October two of the biggest private companies were brought in to help clear the backlog but according to Dr Michael Blackmoor, a GP in Dorset, who contacted us, this doesn't go far enough. Eight years ago he arranged for a local private company to provide the old analogue hearing aids for his NHS patients, this arrangement could now give the patients digital hearing aids within two months, as opposed to the 17 months they have to wait in his area. Dr Blackmoor is unhappy that his private sector supplier is barred from providing digital aids.

BLACKMOOR
They say they want to make it happen but they just produce objections which are completely unfounded and trivial and not good enough. I mean I'm not prepared to tell an old lady who can't hear properly that because a manager says so she can't have her hearing aid in five or six weeks, which we could provide, and she's got to wait 17 months or even longer. And there's no good reason for this.

ROBINSON
Well the managers in this case are at the primary care trust in Bournemouth. The chief executive, Debbie Fleming, says the rules mean her hands are tied.

FLEMING
We're working as part of a national project that's aimed at improving access to digital aids across the whole of the country and this is a very large scale project, it involves the introduction of new technology, new ways of working and the retraining of large numbers of staff. So having signed up to this project Bournemouth Primary Care Trust is now required to work within its guidelines and these guidelines have been laid down for us by the modernising NHS hearing aid services programme - MHAS as we call it. We just can't act on our own in this matter, we have to work in conjunction with them.

ROBINSON
The private hearing aid companies want a change in the rules. Roger Lewin is from the British Society of Hearing Aid Audiologists.

LEWIN
There are a number of already trained dispensers out there ready and willing to participate in this scheme. If they could be brought in then certainly waiting lists would be reduced and people would be seen in a manner that's very convenient. In existing branches the resources are there and ready and waiting to be used.

ROBINSON
Roger Lewin. Well the entire NHS programme for providing digital hearing aids in the United Kingdom is run by the charity The Royal National Institute for the Deaf. It organised a highly successful campaign to persuade the Government to provide the digital hearing aids in the first place. Their chief executive is Dr John Lowe and he is here. What do you say, Dr Lowe, to the suggestion that more private dispensers should be allowed to get in on this?

LOWE
The most important thing is to get the quality of service, to ensure that digital hearing aids are fitted well and fitted to a national protocol. The - I accept that in Bournemouth the waiting times are very, very long, they're among the highest in the country. The average is around six months at the moment and there is a danger that it will creep up. But it's not acceptable to see people really quickly and not fit the hearing aids well and properly, so that the benefits can come through.

ROBINSON
But surely there must be a way to assess the quality of these private companies who do want to take part, like the hearing aid specialist that Dr Blackmoor has used for eight years?

LOWE
Yes, there's standard training that has to be given. Normally the private company provides its own training and it's validated - the quality's assured - by the Institute of Hearing Research, which is part of the Medical Research Council. This particular dispenser has not gone through that training and has refused to do so.

ROBINSON
Putting this case to one side, if there is a company and that company is good, so good that it satisfied the local GP, who has worked with it for eight years shouldn't that be good enough?

LOWE
The NHS must get good value for money for the NHS.

ROBINSON
But I mean there have to be companies apart from the two great big ones who are able to do this, there just have to be, common sense tells you that.

LOWE
Well there are other companies capable of doing it, without any doubt, but the contract was set so that the quality standard could be maintained and that good value for money, the cost per patient, would be as reasonable as possible. May be one day it will be possible to make it more generally available but as this has been rolled out it has to be done in a controlled way.

ROBINSON
So you think in fact it's going to stay exactly as it is, you're not really listening to the likes of Mr - Dr Blackmoor at all.

LOWE
Dr Blackmoor's work is something that we admire. Two months waiting time is very, very good.

ROBINSON
But he can't offer that though on the digital hearing aid …

LOWE
You can't do that on the NHS at the moment, I accept. But Dr Blackmoor's surgery was seeing about 20 people at year, 20-30 patients per year, 3,000 are being processed by the trust in Bournemouth. What's really important is to get the quality and the standard up for the majority of people, not to divert resources to benefit a small number on the side of the programme. The responsibility for this does actually rest with the PCT in Bournemouth and if they want to commission local services they can do that but they have to make sure the clinical governance is in place.

ROBINSON
Is this a question of the NHS not really being able to work on the micro-scale?

LOWE
I think it is difficult. I can't remember the number of GPs surgeries in the Bournemouth area - it's about 80, and it would be very difficult if they had 80 separate contracts to provide digital hearing aids.

ROBINSON
Dr John Lowe thank you.

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