Piped Music etc. (Hospitals) Bill [HL]

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.