Piped Music etc. (Hospitals) Bill [HL]

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 a 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-level 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. However, 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 it. 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 from tinnitus suffer from background music in any case. Piped music, 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.