I must compliment the hon. Member for Rossendale (Mr. Bray) on his choice of subject tonight, for it is of great interest to many right hon. and hon. Members. I am glad of the opportunity of the debate because—let us face it—in the past, the services for the deaf, not being one of the glamorous areas of health care, have been somewhat neglected in the National Health Service.

My hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), who is tragically, completely but triumphally deaf, had hoped to be here for the debate, but this has proved impossible because of a commitment tomorrow morning to which he was firmly pledged before the date of the debate was announced. I know that the hon. Member for Rossendale and the whole House will agree with me that my honoured and hon. Friend notably personifies not only the courage and fortitude but the determination of the deaf to overcome a grievous disability.

I take personal pleasure—indeed, I rejoice—in my hon. Friend's close association with my Department as Parliamentary Private Secretary to my right hon. Friend the Secretary of State. My right hon. Friend herself is, as the hon. Gentleman will appreciate, deeply and most genuinely concerned with the problems with which deaf people have to contend. My colleague—my hon. Friend the Member for Brent, South (Mr. Pavitt)—is here for the debate. He, too, is much respected for his triumph over severe disability and his abiding concern for the welfare of the deaf and all who are afflicted by hearing difficulties.

The hon. Member has spoken about the new National Health Service behind-the-ear hearing aid for adults which, to their credit, the last Government decided to introduce. I shall speak of this in a moment, but first I must say that we are not concerned simply to issue a new kind of aid it is our aim to improve the whole standard of service provided for those with hearing impairment. This means better ways of identifying them, of treating conditions which may respond, and of assessing each patient's hearing impairment and its implications for his social and economic functioning.

Audiology departments need improvements in the design of buildings, in standards of accommodation and equipment and, not least, in the kind and quality of after-care and rehabilitation that they provide. Of course, we all know that it is not enough just to hand out a hearing aid. The user needs help—in some cases, over a considerable period—so that he can learn not only how to operate his aid, but how to exploit its full potential and make the best use of his residual hearing. He may also need training in lip-reading and, perhaps, speech therapy.

The quality, effectiveness and availability of these follow-up and educational services will make all the difference for hearing aid users in helping them to get continued good service from their aid and adapt successfully to their hearing loss in their daily lives. All this serves only to show what a major programme we are embarking on—and hon. Members will not need me to stress that, with present resource limitations, it will take some years before we can hope to achieve the comprehensive, district based service which is our ultimate objective.

We are anxious that, in spite of their current financial problems, National Health Service authorities should develop these services as a matter of urgency. We have, therefore, just decided that, although it must remain a local decision what priority can be given to them in the light of competing demands on resources, we will exceptionally make available a small amount of finance above the ordinary allocations to health service authorities to supplement the financing of some essential projects which could otherwise not be undertaken.

The Medresco range of hearing aids has served the deaf well, and will continue to do so, but it was only a matter of time before behind-the-ear hearing aids which could be worn unobtrusively were available without charge. It was, therefore, with considerable pleasure that the House heard the announcement in July last year by the previous Secretary of State for Social Services—the right hon. Member for Leeds, North-East (Sir K. Joseph). In order to get the new programme off the ground in the shortest possible time, it was decided to utilise tried and tested aids of commercial design provided that they conformed with an up-to-date technical specification prepared by my Department and its expert advisers. It was envisaged that more than one supplier would be needed for the quantities involved. Invitations to tender were sent to all manufacturers in the United Kingdom, EEC countries and elsewhere who had expressed an interest and who were thought to be in a position to offer suitable aids.

As a result of this competition, one contract has so far been placed with the Danish company—Oticon Limited—which has a world-wide reputation as a designer and manufacturer of hearing aids. Although the company's aid is of Danish design, it is being manufactured at a new factory opened specially for this purpose in the Scottish Development Area. When in full production, 60 new jobs for British work people will have been created. The award of further contracts within the next few weeks is planned, and revised quotations from other tenderers, which include British firms, are in the final stages of examination.

The addition of this new aid will attract many more people to health services, and it is estimated that about a million people in the whole country could benefit. This represents a considerable extra commitment to the National Health Service, not only in terms of money for the aids themselves but in highly-trained staff, accommodation and equipment. To allow time for the services to develop to meet the additional burden it was necessary to adopt a system of priority, and in the first year, starting in November, priority is being given to war pensioners who require aids for their accepted disabilities, mothers with children below 5 years of age, children and young people receiving full-time education or whose aid was replaced by a body worn model on leaving school, and people with exceptional medical need or with an additional severe handicap such as blindness. The priority groups for the second and subsequent years are being considered.

The hon. Gentleman has spoken about the possibility of using the expertise of the private dispensers of hearing aids. Many private dispensers have written to us, and members of the Hearing Aid Council have discussed with the Department the possible effects of a decline in the private sector. The previous Government considered this, and so have we. We are convinced that what hard of hearing people need is not merely a service which dispenses hearing aids but a comprehensive service concerned with medical diagnosis follow-up and rehabilitation as well as fitting the aid, with all of these aspects under consultant surveillance. In the circumstances the decision taken by the previous Government to go for a hospital based service was inescapable and I agree absolutely with their conclusion.

Private dispensers have asked why the provision of hearing aids could not be treated in the same way as spectacles, and at first glance this is not an unreasonable request, but it does not hold up to closer examination. The fitting of a hearing aid is not the same as fitting a pair of spectacles, because hard-of-hearing people need to be educated over sometimes quite considerable periods in the use of their aids. We regard the actual fitting as part of a continuous process and not capable of being divorced from the other parts of the service. There would have to be a separation of diagnosis, prescription and follow-up from dispensing with the result that the hospital dispensing service would not develop and the goal of a comprehensive service would be lost.

There are other important factors—namely, cost and the distribution of services, and I can hold out no hope that the private dispensers will be brought in to the new arrangements. In saying this, I am not casting any doubt on the standards of practice of the private dispensers registered with the Hearing Aid Council. Together they constitute a body of great skill who have provided and, I am sure, will continue to provide a service of value to the deaf population. There will be a place for them, partly because many deaf people will not for the time being be suited by National Health Service aids even when the new headworn aid is introduced—as I have said, it will take a long time to make the National Health Service fully comprehensive—partly because no doubt private industry will pioneer new devices, and partly because many deaf people will in any case prefer to use the private sector.