Stephen Kinnock

It is a pleasure to serve under your chairship, Mr Vickers. I start by thanking my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) and congratulating him on securing this important debate. Having now been in the same room as a specialist in ear, nose and throat, a former GP and a vet, I am not sure that I am entirely qualified, and I approach this debate with some trepidation. I certainly enjoyed the debate and, as the Father of the House rightly said, it was a privilege to be able to hear some of the insights, direct experience and expertise of hon. Friends and Members. My hon. Friend the Member for Uxbridge and South Ruislip has also been doing a huge amount of good work in promoting the flu vaccine ahead of winter, in his constituency and more widely, and I pay tribute to him for that. It was a pleasure to visit his constituency a few weeks ago, where I met the incredible team at the Pembroke centre in Ruislip Manor to hear about how they are delivering, designing and developing their thoughts about neighbourhood health hubs and the neighbourhood health service, which will be a pivotal part of our 10-year plan. The Royal National Institute for Deaf People estimates that one in five people in the UK—almost 12 million adults—are deaf, have hearing loss or experience tinnitus, and by 2035 that figure is projected to rise to over 14 million. For people with cognitive disabilities, hearing loss can have a real impact on their quality of life, causing confusion for people with dementia, making communication and social interaction more difficult and increasing loneliness and isolation. That is why our community audiology services are so important. They represent a comprehensive range of hearing care delivered in local, accessible settings, such as GP surgeries, community clinics and community diagnostic centres. They help people of all ages, offering assessments, hearing aid fittings and support for those with tinnitus and balance issues. They advise on equipment such as amplified telephones and alerting devices, while working alongside occupational therapists to support people to stay independent. They form part of a wider team with speech, language and other community services, acute care, and the ear, nose and throat department for issues that cannot be managed in the community. Community audiology services face challenges, particularly on waiting lists and inequality of provision. Members across the Chamber raised some of those points. The Father of the House rightly pointed out that there are 6.7 million people who should use a hearing aid but do not. We must overcome the stigma associated with hearing loss. The hon. Member for Honiton and Sidmouth (Richard Foord) was right to talk about the connection between hearing loss and the propensity for falls. My hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) shared his tremendous expertise as an ear, nose and throat surgeon, and I thank him for his insights about the Hear for Norfolk project, which is a very interesting model indeed. Perhaps we can follow up on it in the new year. The hon. Member for Winchester (Dr Chambers) gave a remarkable exposition on hearing loss in dogs—I have to say that I did not have that on my bingo card for this afternoon—from which we all learned a tremendous amount. He also made a number of important points about hearing loss in humans, and we absolutely take them on board. The hon. Member for Hinckley and Bosworth (Dr Evans) rattled off a number of questions for me, and I desperately tried keep track of them. I got some of them and did not get others, so I will happily write to him on the points that I am unable to address now. He raised an important point about self-referral, which of course depends on local commissioning arrangements. There is inequality and unwarranted variation in the ability to self-refer. We want more self-referral. We think there are opportunities in upgrading the functionality of the NHS app. Our objective is absolutely to be able to do this without having to go through a GP. There are some technology-related solutions, but I want to assure him that there is no conscious decision from the Government to deprioritise self-referral; I just think that there are some variations. The old chestnut that we are constantly trying to crack is around devolving to ICBs the power and agency that they should have because they are closest to the health needs of their population, while ensuring that they are clear about the outcomes, frameworks and standards that we expect. We honestly hold our hands up and say that we have not got that right in all cases, but we are committed to self-referral as a principle and as a really important part of the shift from hospital to community. On ICB budgets, we have secured £6 billion through the spending review process for capital upgrades. A lot of that will help us to ramp up what we are doing on community diagnostics. That is one way to square the circle around the investment that we need on the ground for ICBs to be able to do more in terms of the services they provide by improving the equipment, the kit and the technology they have. Part of the answer to the hon. Member for Hinckley and Bosworth’s question relates to capital investment really helping to boost the services provided. The workforce plan is coming in the spring of 2026. I absolutely hear what the hon. Member says about the need to move forward on that. It has been a complex process. Obviously some of the changes and restructuring around what we are doing on NHS England have also had an impact on the process of putting the workforce plan together, but I am reliably informed that that will be in the spring of 2026. Timely access and effective support to services can make all the difference to someone’s quality of life, wellbeing and independence. As part of our effort to shift care from hospital to home, this Government want to support people to live independently in the community, and community audiology will play an essential part in making that happen. Community audiology is commissioned locally by integrated care boards. Funding is allocated to ICBs by NHS England. Each ICB commissions the services it needs for its local area, taking into account its annual budget, planning guidance and the wider needs of the people that it serves. This year, my right hon. Friend the Chancellor confirmed the Government’s commitment to getting our NHS back on its feet and fit for the future, with day-to-day spending increasing by £29 billion in real terms over the next five years. By the end of this Parliament, the NHS resource budget will reach £226 billion. That funding will support the growing demand for community health services, including audiology. It will help integrated care boards to expand diagnostic capacity, invest in local estates and equipment, and sustain the workforce needed to deliver high quality hearing care for patients of all ages. For the first time, we have published an overview of the core community health services, which include audiology, for ICBs to consider when planning for their local populations and commissioning processes. Our medium-term planning framework for the next financial years sets out our ambition to bring waiting times over 18 weeks down, develop plans to bring waits over 52 weeks to zero, and to increase capacity to meet growth in demand, which is expected to be around 3% nationally every year. We are asking systems to seek every opportunity to improve productivity and get care closer to home, from getting teams the latest digital tools and equipment they need so they can connect remotely to health systems and patients, to expanding point-of-care testing in the community. Systems are also asked to ensure that all providers in acute, community and mental health sectors are onboarded to the NHS federated data platform and use its core products. Our 10-year health plan sets out how we would make the shift from analogue to digital by making the NHS app the digital front door to services. We will make it easier for patients to access audiology services through self-referral. This will transform the working lives of GPs, letting them focus on care where they provide the highest value-add. This is how we will make sure everyone can self-refer—not just the most confident and health-literate. Patients can access NIH-funded audiology services directly without having to wait for a referral from their GP. That means improved access to care and shorter waiting times. My hon. Friend the Member for Uxbridge and South Ruislip and other hon. Friends stood, as I did, on a manifesto to halve health inequality between the richest and poorest areas of our country. I know he will agree that access should not be based on where we live. A key part of our elective reform plan, published at the start of the year, is transforming and expanding diagnostic services so we can reduce waiting times for tests and bring down overall waits. NHS England is working closely with services to improve access to self-referral options, aiming for a more consistent offer right across the country.