Public Services: Online Communications
Lord Cashman
To ask His Majesty’s Government what steps they are taking to ensure that adults with learning and communication difficulties are not left isolated or disconnected because of increasing reliance on online communications for access to public services, particularly within the NHS.
Lord in Waiting/Government Whip (Lord Leong) (Lab)
My Lords, digital inclusion is a priority for this Government, which is why we launched the Digital Inclusion Action Plan. It sets out immediate steps to boost inclusion for everyone, including people with disabilities. In the NHS, we recognise that some patients may struggle or prefer not to use digital routes. That is why GP practices are required to maintain traditional methods of access, while digital health services are being designed to be inclusive, accessible and easy to navigate.
Lord Cashman (Non-Afl)
My Lords, I thank the Minister for the reply, but the reality, I am afraid, is very different. The negative effects on vulnerable people and people with learning difficulties accessing services online is deeply problematic. Many do not have access to the internet. Some cannot read or write. Others simply do not have capacity to deal with online programmes and apps. Many are isolated, in poor health and desperately in need of support, yet cannot get it because of these online obstacles. Will the Government improve online access for these people and others, and make it easily and widely available? Will they adopt more voice messaging and voice prompts, as well as simple-to-use spoken menu options and, indeed, dare I say, the option to speak to a human being? These issues of online access must be addressed if we are to tackle the hopelessness that is growing around access to public services, and particularly access to services within the NHS.
Lord Leong (Lab)
My Lords, I thank my noble friend for that. We recognise that not everyone can manage complex digital systems—we acknowledge that—and that some vulnerable people risk becoming cut off as services change. Departments across government are reviewing digital pathways to make them simpler, clearer and supported by voice prompts, as the noble Lord mentioned, and voice-activated tools. We are also expanding easy-to-navigate menus and keeping the option to speak to trained staff. We aim to give people the support they need and to keep every route open, not closed.
Baroness Armstrong of Hill Top (Lab)
My Lords, as chair of the Digital Inclusion Action Committee, I wonder whether I can intervene. I have just spent the last hour talking with two sub-committee chairs, the Minister may want to know, precisely about easier accessibility but also about a recent report about people with learning difficulties. We want to make sure that we start with where the person is and what their service needs are. My goodness, I wish that was how public services had been organised before digital ever came in. We are determined to give the Government options, first on accessibility, to make that much more straightforward, but also to make sure that departments support carers as well as individuals in particular groups so that they are able to get the best from whatever service they need in whatever service is going to suit them as individuals most effectively.
Lord Leong (Lab)
I thank my noble friend for all her work on the Digital Inclusion Action Committee. She is absolutely right. She is bringing all the leaders from government, industry and the voluntary sector to shape our national response to digital inclusion. Her committee is currently setting out its priorities and gathering insights from across the UK to inform recommendations to the Government. The Government have set up the inclusion action plan with a focus on practical actions—I emphasise practical actions—that make a difference to people’s lives.
Baroness Hollins (CB)
My Lords, of the 11 million people who do not have the essential digital skills for life, more than half are disabled people, and the barriers created by digital approaches everywhere increase the barriers that disabled people face. What steps do the Government take specifically to ensure that the NHS app is accessible to people who have learning and communication difficulties and to ensure that NHS services are still available to those who cannot use digital means of communication?
Lord Leong (Lab)
I thank the noble Baroness. As I mentioned earlier, we are not closing off any of the options available, whether that is the voice-activated system or speaking to a human being. The option is still there. We know that millions of people in the UK are still unable to take part in this increasingly digital society and we recognise that digital exclusion falls hardest on disabled people. That is why this Government are committed to improving digital inclusion for everybody. In August, we launched a £9.5 million digital inclusion innovation fund, which supports community projects across the country and helps people build the skills and confidence they need to get online.
Lord Hayward (Con)
My Lords, can I pick up on the comment at the end of the question from the noble Lord, Lord Cashman, in relation to speaking to people voice to voice? Blind spots exist in the web and the web crashes on many occasions, so it is not just those unfortunate people who are disabled or do not have links who lose contact with vital services; on many occasions, it can be far broader, and every service should have access to a human talking to a human.
Lord Leong (Lab)
My Lords, absolutely: digital progress must never mean less choice. The NHS continues to provide face-to-face routes, telephone access and supported appointments for those who need them. We are investing in accessible contact centres, clearer phone menus and trained staff who can guide patients through the next steps. At the same time, we are improving simpler digital options for those who want them. In line with the action plan, we are keeping non-digital routes open and strengthening assisted support.
Lord Scriven (LD)
My Lords, the Minister needs a reality check. For many people, moving to digital is not acceptable. The NHS 10-year plan moves from analogue to digital, with more services moving to the NHS app. For people with a learning disability, issues regarding poor communication come to light at present only at inquests, not through central government monitoring. What new central monitoring will the Government introduce to make sure that existing communication meets vulnerable people’s needs, rather than moving to digital, which will cause further problems?
Lord Leong (Lab)
The noble Lord makes an interesting point. That is why I mentioned earlier that my noble friend Lady Armstrong is working right across government departments to bring everybody together, look at what is available and ensure that nobody is excluded from digital services. As I said, the current situation where someone can speak to a human being is still there, and it will be there. Voice-activated menus will also still exist.
Lord Markham (Con)
I am a big believer in the use of AI and digital communications to improve public services for everyone, in the NHS and elsewhere. At the same time, I am aware that groups with learning difficulties are in danger of being left behind. But the way to square the circle is to make sure that they are involved every step of the way in the design of services, whether analogue or digital, and to use things such as AI to have voice-activated conversations. The Netherlands ministry of health is probably the number one player in involving people with learning difficulties every step of the way. Can we make sure that we do the same with our services?
Lord Leong (Lab)
I thank the noble Lord for that. It is not only in the Netherlands but in other countries in Europe—for example, Estonia as well. Let us not forget that the UK Government are committed to ensuring that our adoption of AI across the public sector is ethical, safe and responsible. The Government Digital Service suite of responsible data and AI tools, such as the data and AI ethics framework, helps teams across government to build and display AI in the right way. Our ambition is really for AI to benefit working people directly by improving their health, care and education, as well as how citizens interact with the Government, while opening up new opportunities, as the noble Lord mentioned, rather than just threatening our traditional patterns of work.
The Lord Bishop of Hereford
My Lords, the passion displayed in this House for digital inclusion is extraordinarily commendable, but these difficulties are compounded in rural areas by very poor connectivity. Many areas endure significant restrictions in broadband and mobile connectivity, which compounds the problems. What steps are the Government taking to ensure that good connectivity is rolled out across the whole country?
Lord Leong (Lab)
The right reverend Prelate makes a very important point. Poor connectivity must not limit access to healthcare. The Government’s rollout of improved broadband and mobile coverage is continuing, with priority given to rural communities. In parallel, the NHS provides telephone access, face-to-face appointments and paper-based communications for those who need them. We are increasing support through community venues such as libraries and outreach centres. No patient should miss care because the digital signal is unreliable or not there.