We'll move now to the shorts debates, and I call on Joel James to speak to the topic he has chosen.

And if Members are leaving, please do so quietly. Joel.

Thank you, Dirprwy Llywydd, and I'd like to confirm that I've agreed to give my colleagues Altaf Hussain and Russell George a minute each. As many here will know, the subject of deafness and the issues facing the deaf community are very close to my heart, and I wanted to take the opportunity of—

Joel, just before you continue, just confirm: Altaf Hussain and Russell George.

Yes, a minute each.

Thank you.

As many here will know, the subject of deafness and the issues facing the deaf community are very close to my heart. I wanted to take the opportunity of my first short debate to highlight some of these issues. I will cover three main points, namely the effect that hearing loss has within employment, the British Sign Language Act 2022, and the inability of private audiology practitioners to carry out NHS work and the implication this has for waiting lists and the subsequent impact on people's health and well-being. I want to focus on these points because I believe there needs to be a better, more intuitive understanding by the Government of the wider deaf community, particularly of the hidden aspects of hearing loss and how this has a profound effect on people's lives.

In terms of employment, we know that at least 4.4 million working-age people in the UK have hearing loss. We also know that the employment rate for those with hearing loss is much lower compared to people with no long-term health issues or disability, typically 65 per cent and 79 per cent respectively. On average, people with hearing loss are paid at least £2,000 less per year than the general population, meaning that those with hearing loss can expect to earn considerably less over their lifetime, which has a knock-on effect in terms of providing for their families and enjoying the same lifestyle as people with no long-term health issues. A recent survey of those suffering hearing loss by the Royal Association for Deaf People found that those with hearing loss face a tougher working environment, and the majority felt that they had not been given equal opportunities, that they did not feel supported, that they felt excluded from conversations with colleagues, that they were lonely at work, that they had been left out of social events, and that they had experienced bullying or acts of unkindness at work because of their condition. These issues of exclusion and a lack of support play out detrimentally in the long term.

When it came to career progression, the majority—60 per cent—of respondents said they had not been given progression opportunities during their career, with several people citing a lack of deaf role models within work as a key barrier. Unfortunately, there is a sense in the deaf community that despite numerous Government programmes created to remove the effect of disability from the job market, there were still many examples of difficulty accessing the correct type of support, and sometimes accessing any support at all. The most glaring evidence that Government programmes were ineffective was that those who are deaf or have severe hearing loss are still regarded as expensive employees because of the limitation to the roles they can carry out and the additional support that they require.

All of this tells a sad story for people within work who suffer hearing loss, more so because a lot of this is hidden. There are clearly many people who do not feel able to integrate into working life fully, which as we know can be a major factor in people's identity and life fulfilment. The lack of support, provision of reasonable adjustments and, at times, almost total absence of flexibility was a problem for all participants, particularly in manual or skilled jobs, which leaves many feeling that, despite their best efforts, they could not do their job to the best of their ability.

We also have to be aware of another hidden aspect, in that, for those with hearing loss in work, there's a feeling as though the ability for them to stay in work and keep their job is beyond their control, regardless of work performance, and it's ultimately up to those who supervise them in their role. Moreover, there is a feeling that employers regard people who are deaf or have hearing loss as a health and safety burden. For those who had worked for over 10 to 15 years, current health and safety regulations were limiting their work, which is in stark contrast to past working conditions. Quite worryingly, there was a feeling that because of their hearing loss it would be extremely difficult to find employment elsewhere, and they had to accept their current working conditions or face unemployment. Sadly, the plight of unemployed deaf people is even worse. Being unable to use the phone, almost all contact with prospective employers is via written correspondence. Very often, finding a British Sign Language interpreter for interviews can prove challenging.

This brings me to my second point, the BSL Act. I, like many others, were very pleased to see that, at the end of April this year, the UK Government's BSL Bill received Royal Assent, passing into law as the British Sign Language Act 2022. For those unfamiliar with the Act, there will now be recognition of British Sign Language as an official language of England, Wales and Scotland. Whilst this is a huge milestone for deaf people, we are not out of the woods in the devolved nations. In England, the law requires the Secretary of State to report on the promotion and facilitation of the use of BSL by ministerial Government departments, and guidance must be issued in relation to BSL, setting out how Government departments and public bodies must meet the needs of deaf people in the UK. Based on those aims, the Act should improve access to interpreters, as well as enhance general awareness, and help develop BSL education. It should also help improve access to employment for deaf people. Because of the devolution settlement, Welsh Government Ministers are not subject to the reporting duty of the Act, and therefore it is entirely on the shoulders of Welsh Government Ministers here whether or not we see this benefit in Wales. I believe, in this instance, the Welsh Government needs to recognise the Act in its entirety, and take on its full reporting duties, and I would hope that all Members here in this Chamber would encourage the Welsh Government to adopt this approach.

In my final point, I want to discuss audiology services in Wales, and the potential role and impact that private audiology practitioners can make. We have an unprecedented need to clear audiology backlogs in Wales. Cardiff and Vale health board has almost 1,500 people waiting for treatment, with over 800 having waited 14 months or more for NHS audiology services. There are a further 5,000 more waiting across Wales for much-needed treatment to hear well again, and these figures have only increased since the pandemic. This particular waiting list is significant. Whilst it can be said that hearing loss is not immediately life threatening, it has a massive impact on the lives of those who are suffering, especially since age-related hearing loss is very common in Wales, with 1 per cent of the population per year of age suffering from it—that means 70 per cent of 70-year-olds and 80 per cent of 80-year olds et cetera.

The impact of age-related hearing loss goes far beyond just not being able to hear well. It leads, tragically, to social isolation, loneliness, mental ill health, dementia, and these conditions then give further rise to other health issues. Waiting more than 14 months for an assessment and hearing aids is no trivial matter if you are 80 years old with increasing cognitive decline. It places you in a highly vulnerable situation, which I have no doubt is truly terrifying for them. There is strong evidence to show that mild hearing loss doubles the risk of developing dementia, moderate hearing loss leads to three times the risk, and severe hearing loss increases the risk five times. Hearing loss is estimated to account for 8 per cent of dementia cases, as well as other long-term health problems. People with hearing loss have, over a 10-year period, a 47 per cent increased rate of hospitalisation because of increased risk for falls and depression. What stands out even further is that, if there is a timely diagnosis, then declining cognitive function can be stopped, so the 14-month waiting list to access audiology services, without a doubt, is harming people.

I questioned the First Minister on this point recently, and though I welcome his response that there needs to a building up of primary care capacity, I believe that this sole approach is short-sighted, not least because it is going to take a considerable amount of time to build up primary care capacity in an NHS that is already overstretched, but also because we have available to us well-established community audiologists that have been proven to be safe, clinically effective, liked by patients, and have been found to deliver good value for money in Ireland, England and elsewhere, and they're available on nearly every high street in Wales. We have to be mindful that we have many patients over the age of 70 who are desperate to access services. They simply cannot wait for the lengthy process of each health board undertaking pilots and recruiting directly into the service, and then having to clear the waiting lists that keep getting longer, which is a situation that I recently experienced as I had just been removed from the out-patient list that I was on because it had grown too long.

What is more absurd with this Government's approach is the fact that they already use private optometrists, pharmacists, dentists and GP practitioners in Wales to help deliver NHS primary care services. So, this Government, without any supporting evidence, is singling out audiology services and denying patients in Wales fast access to this service. Members here may not be aware, but in the most recent audit of audiology services in Wales, which, I might add, was pre COVID-19, all health boards in Wales failed to meet compliance to contact all hearing aid patients every three years to offer a reassessment appointment. All health boards also failed this criteria in 2017. Only five out of nine services met or exceeded the compliance target for each individual standard. So, we already saw, before COVID, patients not getting the audiology services that they deserve, and this situation is only getting worse.

The number of people with hearing loss is increasing. Estimates suggest that, by 2035, about 15.6 million people in the UK will have hearing loss—that's one in five of the population, compared to one in six people presently. By 2030, adult onset hearing loss will be in the top 10 of disease burdens in the UK, above cataracts and diabetes, as measured by disability-adjusted life years. Frustratingly, this Government's attitude to problems with audiology services is bizarre at best and wilfully inflicting harm at worse, especially since there is a ready-made solution in high-street community audiologists. NHS Wales already commissions primary care optometry and health boards commission community eye health services, so why is this Government singling out audiology and not applying the same approach? This, I hope, is a position that the Minister will address. Thank you, Llywydd, and thank you to everyone for taking the time to listen. 

Thank you, Joel, for this debate and for giving me a minute—I may take more. In many cases, people with hearing loss are forced to wait significantly longer for an appointment with their GP. Many GP surgeries can't offer same-day appointments because they lack staff who are trained interpreters or can use sign language. Patients could wait two weeks or more as they wait for an interpreter to be arranged. This is a significant time for a vulnerable person who needs to see their doctor. At a cross-party group, a person with hearing loss described how they were cut off during a 111 call, as it took so long to find someone who could communicate with them over the phone. If this was a 999 call, this could have been catastrophic. Regulations need to be tightened by the Welsh Government for over-the-counter hearing aids, as users could experience further isolation and hearing loss due to overamplification. The Welsh Government needs to invest in hearing loss services so that all people receive equal treatment. Ultimately, this could save lives. Thank you.

Can I thank my colleague Joel James for his contribution and for giving me a moment of his time as well? In Wales, hearing loss services are exclusively provided by NHS hospital-based services. We also know that there is a huge unacceptable level of waiting times for some patients, forcing patients to either go private, or if they can't afford it, to suffer or not know where to turn to. When I go for my appointment for an eyesight test, I also get offered a hearing test, as well, at Specsavers in Newtown. They offer a hearing test and also—[Interruption.] A two-for-one—absolutely. But my colleague Joel James has pointed this out and I would put to you, Minister, that there's an opportunity here to save the NHS money, to improve access to services and also to take the pressure off the NHS, and that is by commissioning existing providers of community services in Wales to provide NHS services using a model based on existing primary care optometry in Wales. Optometrists play a huge role, of course, in reducing the burden upon GP primary care services and the NHS as a whole in Wales, so I would ask the Minister to consider this as a similar model for NHS hearing loss services in Wales.

I call on the Minister for Health and Social Services to reply to the debate—Eluned Morgan.

Diolch yn fawr. I would like to pay tribute to Joel for bringing this matter to the attention of the Senedd. I also want to pay tribute to the Tory group, because it's so lovely the way you all support each other in these short debates. It's a real example to the rest of us, so well done, you. You'll be pleased to hear that my 15-page speech has now been cut down to five. [Laughter.]

The Welsh Government's programme for government set out the actions we'll pursue over this Senedd term to ensure that nobody's left behind through a shared commitment to ensure that everyone reaches their potential. And that includes, of course, people who are deaf or living with hearing impairments. The Welsh Government recognises being deaf or having a hearing impairment can sometimes negatively impact levels of communications, as has been set out by Joel. This may leave people feeling isolated, detached from the world around them and feeling depressed. Everyday barriers in respect of public services, transport, health, social care, entertainment and leisure may hold them back. Early intervention and diagnosis is absolutely paramount for health and the well-being of these individuals.

Wales is actually a leader in the development and provision of hearing healthcare, through our hearing plan, 'Framework of Action for Wales, 2017-2020: integrated framework of care and support for people who are D/deaf or living with hearing loss'. It is a first for the UK, and our framework for action outlines the service redesign required to meet the needs of the current and future Welsh population. The framework for action has been extended to 2023, in recognition of the remaining challenges of the work still to do, to ensure that we do everything we can to prevent ear problems. This includes ensuring people are diagnosed and treated in a timely manner and receive the ongoing care and communication support that they need.

People who are deaf or are living with unmanaged hearing impairment or diagnosed with hearing loss and dementia, or mental health problems, are more likely to need care and support if they are to reach their full employment, education and social potential. The framework for action aims to follow the life course from newborn screening and children to adults and older people, to ensure that appropriate services are developed and individuals are signposted to those services when they're needed.

In the time I have today, I can't do justice to the range of policies under way to address hidden issues affecting deaf people and those living with hearing impairment, but I will just highlight a few little areas of activity. I would like to say that I will look into the opportunities to see if there is any opportunity for us to work with the private sector to expand and to speed up the process. Hearing loss can't be cured, but its negative effects can be mitigated through hearing aids and equipment and support from multi-agency professionals. In April, I published our programme for transforming and modernising planned hospital care and reducing waiting lists. Importantly, the plan signals the transformation of community-based services to offer different options designed to support individuals. This will remain our key way of addressing the issue.

It's really great that the UK has recognised BSL. Of course, that's following the example that we set back in 2004, when we formally recognised BSL as a language in its own right. The Welsh Government recognises the importance of accessible communications, and we were the first Government in the UK to ensure our COVID-19 press conferences included the presence of a BSL interpreter.

All-Wales standards give guidance to health service staff on how to ensure that patients' needs for support and communications are met, and that includes BSL. Every health board and every trust is expected to put arrangements in place to deliver the standards in order to ensure that all services are available and are accessible, including for those experiencing hearing loss.

If you remember in December of last year, when we marked International Day of Persons with Disabilities, Jane Hutt, the Minister for Social Justice, had made a statement in the Senedd, highlighting the way the COVID pandemic has had a very negative impact on disabled people. The lack of equality, which already existed, had contributed to that, and that lack of equality was intensified during the pandemic. The 'Locked Out' report focused on the clear unfairness faced by disabled people and highlighted the barriers for those experiencing hearing loss, and this has encouraged the Welsh Government to establish a disability rights task force.

To conclude, I think we can be agreed that a broad range of activities are in place in order to tackle the hidden issues impacting those experiencing hearing loss. However, there is more to come, and I will continue to welcome innovative solutions to support these citizens in Wales. Thank you.

Thank you, Minister, and thank you, all. That brings today's proceedings to a close.

The meeting ended at 19:50.