The additional choices provided by NHS Direct for patients and their carers to obtain health information and advice are welcome.

However, NHS Direct is not directly accessible to the 8. 7 million deaf and hard-ofhearing people in the UK.

Older people are the largest users of the NHS and most affected by hearing loss, with nearly half of those over 60 experiencing it.

Despite the huge financial investment in NHS Direct, a national textphone number has not been established, nor has a date by which it will be operational been set. Interactive e-mail has also been promised, but again, is not yet available.

Brian Lamb Director of communications The Royal National Institute for Deaf People