2nd reading in the Lords
- Speaker
Lord Beaumont of WhitleyGreen Party- Quote
- My Lords, I beg to move that this Bill be now read a second time. It will not have escaped the attention of those of your Lordships who are doomed to be here for last business on a Friday that we have been here before. I have initiated a debate on piped music in general and I moved the Second Reading of a Bill which covered piped music in public transport and health establishments, which I then abandoned because, apart from some intelligent and mildly sympathetic comments from the Conservative Front Bench, it received very little support from your Lordships' House. I now return with a Bill covering hospitals alone which, I give notice, I hope to pilot through your Lordships’ House, thus bringing to four the number of Bills that I have piloted through your Lordships' House, one of which reached the statute book as part of the wild animals and wild plants protection Act. I have hopes for this Bill, with such key advocates for my cause as Mr Robert Key in another place. The reason that I have narrowed the field affected so much at the same time as everyone, without exception, who has spoken to me on the subject has urged me to widen it, is that I believe that the case for hospitals is irrefutable. Clause 1 directs the Secretary of State to draw up within two years, after consultation, a plan to prohibit piped music or the showing of television programmes in the public areas of hospitals and to require the wearing of headphones by persons listening to music in those areas and, when he has done so, to lay the plan before both Houses of Parliament. Clause 2 lays down exceptions to be included in the plan for television broadcasts which are in the public interest, including those which are for the purpose of safeguarding the welfare of hospital users. Clause 3 defines piped music in public areas of hospitals, and Clause 4 contains a citation of the Act as it extends to Northern Ireland. There should be no doubt about the need for the Bill. Many hospitals, including outpatients’ departments, are filled with music and television. The reasons for this are, of course, well meant. It is thought that music is calming and television distracting. Some music is very calming; the kind that you happen to like. By definition, however, the proportion of any given involuntary audience that likes the kind of music being played at any particular time is small, while, for the rest, it is actively unpleasant, even painful, or just noise. All unwanted noise raises the blood pressure and depresses the immune system. For some medical conditions, such as tinnitus, noise is actually very painful. A famous survey of blood donors at University of Nottingham Medical School in 1995 found that playing piped music made donors more stressed before giving blood and more depressed afterwards. Surely hospitals should be places of restful calm, whereas too often they are the reverse. I would like to acknowledge the help that I received in preparing the Bill from the UK Noise Association, Pipedown and the Royal National Institute for Deaf People. I urge your Lordships to accept it at Second Reading. Moved, That the Bill be now read a second time.—(Lord Beaumont of Whitley.)
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- 15:32
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- Speaker
Lord AddingtonLiberal Democrat- Quote
- My Lords, I am one of those who did not give the original Bill a tremendously good welcome. This Bill is in a slightly more workable form of words, although I am still not 100 per cent convinced that background music, piped music, canned music—call it what you will—is that bad. In my experience, based admittedly on a limited number of times sitting in accident and emergency departments, waiting to be treated for small injuries and so on, one can wait for long periods without being prepared. Things go wrong in hospitals, and TV screens or a little music allow you to switch off, not because the music is to your taste but often because it cuts down the amount of background noise. You may be waiting to have two stitches in your knee, as I said before, when someone comes in after a big road accident. You are then quite rightly at the back of the queue, but you see people running around, especially in accident and emergency departments, and stress levels go up. Some form of distraction is needed. The one most easily available to you is probably television, and it should be available in these circumstances. That is what makes me slightly more cautious about this. I commend the noble Lord for making the Bill short enough to read quickly. It says that exemptions could be made where it was felt to be in the patient’s interests. I suggest that a balance will always have to be struck. It might be interesting to have guidance from the Minister, now or at another point, on where the Government think it is appropriate not to have music and in which circumstances. I believe that, in our previous debate on the subject, the noble Lord talked about someone who had died in a hospital with friends and relatives around the bedside, with music blaring out from somewhere else. This might be better addressed by a little common sense and guidance to ward administrators on the appropriate level of background music. Other than that, I have no active objection to the Bill, although I certainly could not bring myself to support it actively.
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- 15:36
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- Speaker
Earl HoweConservative- Quote
- My Lords, in presenting his Bill to the House today, the noble Lord, Lord Beaumont of Whitley, has shown himself to be an eloquent advocate for that precious and most elusive commodity, silence. I say to him immediately that my sympathies lie with his cause. Over the years, the poets have written about the joys of silence. Oliver Wendell Holmes put it rather aptly: “And silence, like a poultice, comes To heal the blows of sound”. Christina Rossetti spoke of, “Silence, more musical than any song”. Gerard Manley Hopkins, that most original of poets, wrote: “Elected silence, sing to me Pipe me to pastures still and be The music that I care to hear”. We may struggle to express ourselves in words so lyrical but we surely know what the poets are saying to us. Our days can sometimes consist of wall-to-wall noise. Opinion polls have proved how large a percentage of the public abhor piped music. A survey for the Sunday Times a few years ago asked people what single thing they detested about modern life. Third in the list of most-hated things was piped music. The first two were other forms of noise. The noble Lord, Lord Beaumont, has invited us to put ourselves in the position of the captive hospital patient who has to endure the sound of non-stop music blaring out from televisions and speakers. At Christmas it is an endless loop of Bing Crosby. At other times it is Mantovani, Dean Martin or that evergreen crooner, Perry Como, whose immortality is assured courtesy of National Health Service management. Speaking for myself, this is one piece of NHS care we can do without, but I do speak only for myself. Strange as it may seem there are many people who like piped music very much. The website of Kidney Research UK says: “Some patients find that hospitals depress them. At dialysis centres you will find that the staff have created an environment that is as welcoming, cheerful and friendly as possible. Attractive décor, televisions, piped music and an efficient but relaxed atmosphere help to make you feel comfortable during your treatment”. Not so long ago there was an announcement from Norwich, which stated: “The Norfolk and Norwich University Hospital is to receive a generous gift of artwork and a music system which will brighten up the outpatients department in Rheumatology”. I know someone who recently had to attend hospital for a PET scan, which, as noble Lords may know, can be a daunting and claustrophobic experience. He reported that while being scanned he derived great comfort from being able to hear music from Classic FM being piped through some nearby speakers. So, while some may find therapy in silence, there are others who most certainly do not. We can agree that the noise of a power drill or a kango hammer can be detrimental to the health of anyone if it is prolonged. But I am less sure that we can say with even a small degree of confidence that piped music is anything more than an irritant, and then again only to some people. If we turn to the detail of the Bill, we find perhaps some unexpected features. I began my remarks by suggesting that this Bill makes an eloquent plea for silence in preference to noise, but perhaps I was somewhat overstating the noble Lord's case. In Clause 2, provision is made for a range of exceptions to the plan which the Secretary of State is being asked to draw up. It strikes me therefore that we are dealing here not with a principled objection to noise, but an objection to certain types of noise. That seems rather odd. Nor would the prohibition extend as far as some people might wish. Many of the objections one hears about muzak relate to piped sound blaring out on hospital wards, yet in-patient wards are expressly excluded from the scope of the Bill. What in any case is an in-patient ward? Does it, for example, include a ward where patients are treated as day cases or a ward where kidney patients receive dialysis for a few hours? Nor is it clear to me whether the television programmes for which exception is made in Clause 2 would require listeners to wear headphones if they happen to include music. The workability of the provision about headphones is perhaps a matter on which the noble Lord would like to comment. The Bill needs to be more specific, too, about what kind of hospitals we are dealing with. NHS hospitals are presumably included, but what about foundation trusts? Does the Bill really mean to override the devolved responsibilities of the Scottish Parliament so as to extend to hospitals north of the Border? This is something about which perhaps the Scottish Executive would have views. Most important, is the prohibition intended to cover hospitals outside the NHS? Would it apply to independent sector treatment centres? If it is indeed the noble Lord’s intention to cover all types of hospital, can he say what consultation has been carried out with independent sector providers or their representatives on the measures contained in the Bill? It is quite a major step for the Secretary of State to tell private businesses how they should order their affairs other than in the area of clinical standards and patient safety. It is also, I suggest, quite a major step for the Secretary of State to tell NHS managers how to run their hospitals or, to be precise, their hospital waiting areas. On the one hand, a plan that was merely advisory would not have much point to it. On the other hand, if the plan were to acquire legal force, it is not clear to me from the Bill what mechanism the Secretary of State would employ in order to bring that about. Almost any means of her doing so would, I am bound to say, be seen as disproportionate and heavy-handed. To use her power of direction on a matter of this sort is not something that many of us would regard as justifiable. We are not dealing here with an issue of public health. It is an issue, if anything, of public nuisance, and even then something which is not by any means regarded as a nuisance by everybody. I have to say to the noble Lord that, much as I am personally an advocate of peace and quiet, I cannot in all conscience give my backing to the proposals he has put before us. Were the Bill to be enacted, it would run completely counter to the direction of health policy set in recent years, which enables decision-making in the NHS to be devolved to the local level. I believe that that direction of travel is the right one, and equally we should not forget that there are mechanisms at the local level to enable the voice of the patient and members of the public to be heard if the decisions of NHS management of whatever nature do not prove popular. Hospitals increasingly compete for business as providers of healthcare and it is therefore in their interests to listen to what patients are telling them. That surely is the way forward in a matter of this kind. To end on a positive note, I hope very much that even if the noble Lord’s Bill does not find its way on to the statute book, and I make no prediction about that, he will at least be able to take some public credit for having raised an issue on which every hospital chief executive in the land would be wise to reflect.
- Time
- 15:39
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- Speaker
Baroness Royall of BlaisdonLabour- Quote
- My Lords, I congratulate the noble Lord, Lord Beaumont, on once again bringing forward his Bill so far. He certainly shows tenacity and strength, and I know that that reflects a deep belief in this subject. This has been a short but interesting and, indeed, poetic debate. I am grateful to the noble Earl, Lord Howe, for his soothing quotations. I have real sympathy with those who find piped music a trial and wish to see it regulated. I personally detest piped music, but I do not believe that it is a matter for regulation. We are all committed to reducing red tape, and regulatory activity should be proportionate to the risk involved. Our focus must be on the health and safety risks that cause greatest injury or ill health. Extending regulation into low-risk areas would almost certainly attract much criticism and be suggestive of a nanny state. It would also add to the burdens on the NHS. I do not wish to underestimate the irritation that piped music obviously causes the noble Lord and many others, but irritation is not the same as harm, and there is no convincing evidence to show that exposure to piped music causes significant harm to health in the great majority of people. When I talk about harm I think first of damage to hearing. Prolonged exposure to noise at 85 decibels over an average of eight hours can cause damage. The Control of Noise at Work Regulations cover just such instances. They contain a general requirement to control work noise to as low a level as is reasonably practicable, but at levels below 80 decibels there should not be a health and safety issue. It is highly unlikely that music or TV would reach those levels. Hospitals are noisy places. Research shows that a hospital ward can reach average noise levels of as much as 50 to 70 decibels, with peaks of up to 90 decibels. That is higher than the WHO recommendations, but it is not because of TVs or piped music; rather, it is due to medical equipment, telephones and people talking. The noble Lord has quoted research showing that blood pressure is raised in people who on two occasions have listened to piped music while giving blood. However, that very same study showed the opposite in patients who gave blood three times. Other studies have shown reductions in stress and even reduced pain from listening to soothing music. The research is conflicting. Search as one might, there is scant evidence of harm. In the absence of such evidence, it would be improper to seek to ban piped music. Can piped music or TV do any good in common areas in hospitals? Common sense alone would tell us that, in some circumstances, background entertainment can be beneficial, as the noble Lord, Lord Addington, suggested. We have seen a revolution in waiting times in A&E, with over 98 per cent of patients now seen and treated within four hours, but there are still times when a short wait is inevitable. During those periods, watching TV may be a useful distraction, and we should not prevent hospitals from using it. The noble Lord, Lord Addington, asked about guidance. We do not put out central guidance; however, as noble Lords will be aware, ward sisters and modern matrons have responsibility for ensuring that their departments offer a quality environment, which includes paying attention to unwanted noise. We should leave this to modern matrons and nurses themselves. Finally, the noble Lord proposed the compulsory wearing of headphones. Only a few years ago, it was commonplace to see groups of young people listening to music on their ghetto blasters. Today, the status symbol of choice is the ubiquitous iPod—with headphones. iPods have transformed the journey to and from work, and I have no doubt that they have helped many a patient in hospital while away the time as they move along their care journey. In fact, headphones are now the norm. Bedside TVs are usually equipped with them, hospital radios invariably so. Frankly, we do not need legislation to encourage people to use headphones. They are doing so already of their own free will. We should also remember that some people cannot wear headphones, perhaps because they suffer from tinnitus—although I note that the noble Lord suggested that people with tinnitus suffer from background music in any case. Piped music, and acoustic wallpaper they may well be an irritant for many people, and they may well be intrusive, but they are not a major problem that needs to be addressed by legislation. Do not take my word alone, though: in the past few weeks we have asked a representative sample of trust chief executives and senior managers for their views. Noble Lords will be relieved to learn that well over half the respondents— 60 per cent, from a sample of 92 people—said they did not use piped music or general TV in the public areas of their hospitals. The remaining 40 per cent reported that it had not led to complaints. With regard to the compulsory wearing of headphones, 40 per cent felt that enforcement would cause problems, while 40 per cent felt that powers were already sufficient to deal with the issue. That suggests that it is, as the noble Earl, Lord Howe, indicated, a problem best resolved at local level, and that it is better for hospitals to listen to their patients and decide how to act accordingly. If enacted, the Bill would bind the NHS yet add nothing practical to our current powers. It would impose the views of one group upon another without, as now, giving us the freedom of a flexible response. While I understand the motivation behind the noble Lord’s Bill, and I acknowledge that piped music can be extremely annoying, this regulation would be a disproportionate response. It is perhaps a sledgehammer to crack a nut.
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- 15:47
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- Speaker
- Lord Beaumont of WhitleyGreen Party
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- My Lords, I thank the noble Lords who have taken part in this debate. The standard has been raised by the literary contribution of the noble Earl, Lord Howe. I also thank the noble Lord, Lord Addington, for his measured reply. He and the noble Earl said that it was a question for local decision and common sense—indeed, everyone said that. I quite agree that where that is in place, it is the way to approach the matter. But despite the survey which the Minister told us about, it remains true that in many hospitals—by “hospitals” I mean all hospitals—there is an immense amount of noise and distraction, not necessarily good distraction, from piped music and uncontrolled television broadcasts. It is right that we should tackle what has in this debate been under-rated as an evil, because it is an evil. When I was about to come into the Chamber, I met a noble Lord in the Corridor who said, “I wish you well with your Bill. It is much needed”. Almost everyone who has spoken to me on this matter has said that the Bill is much needed. I therefore hope to take it through your Lordships' House. On Question, Bill read a second time, and committed to a Committee of the Whole House, House adjourned at 3.57 pm.
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- 15:54
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