11. Discussion Forum
Does more need to be done to meet the needs of disabled and elderly people?
Discussion leader - Mike Martin, Chairman PhoneAbility
MIKE MARTIN: This last session is very much a discussion, question and answer session, and we gave it the title "Does more need to be done to meet the needs of disabled and elderly people?" I am sure the answer is "yes", but the thing is how we go about it. At the same time, we have most of the speakers up here. We can therefore take questions for individual speakers.
TONY SHIPLEY: I think it was Meg Galley, in particular, who made the point about the importance of companies designing products and services involving disabled people in the process. I am sure we can all agree with that, but there is the obvious snag. It is no use going out and grabbing your statutory disabled person off the street and saying, "Right, now my product is accessible." I am sure manufacturers and service providers need some guidance on how to assemble what we might call the representative cross-section of disabled people for whom that product might be targeted.
MIKE MARTIN: Yes. I quite agree. I think a lot of us have probably seen it. There is some sort of idea of what a particular disabled person looks like and what they do, completely forgetting that they have a spectrum of opinions, views, and so on, as does the rest of the population. Certainly, I have seen where trials have been run on what are supposed to be representative groups of people who, in other people's opinion, are very far from representative. Would anybody like to comment on that?
JAN-INGVAR LINDSTROM: Just a comment which might be exactly in line with what you expected, but from my years as a manufacturer of devices, I know that the company were very reluctant to include any user in the design process. The reason was that, if you came across something interesting, something that really would be a good application, you could not be sure that there would not be a leak, so we had very little success in convincing the company that disabled people should come in, even in designing a text telephone. Even at that stage, they said, "No,this is a company secret. We don`t want anybody coming in. We have our own designers." Perhaps it is a good suggestion for designers, so they may have connections with end users, disabled users. They do not tell anybody else about their needs.
MAGDALEN GALLEY: I think it is fair to say that this lack of inclusion of users is not confined to disabled people. It can be extended to other consumers who are for various reasons often not involved in the design process.
We have heard about a number of organisations that do have panels of disabled people. Scott Milne talked about having a panel. When I was in Loughborough, we did that. I think Ricability have their panel.They are available if manufacturers choose to go to organisations. Probably the bodies representing groups of disabled people, it would be beneficial if they had their panels to offer up to work with the designers, to make it as easy as possible for manufacturers to identify their stakeholders and make it easy.
SCOTT MILNE: I would like to add to Meg Galley`s point. For a company to start from scratch on a process of consulting disabled people would be quite difficult, because it takes time to develop knowledge and experience of the needs that people have. For example, when you turn up at a building to take part in particular studies and they do not have a lift, which is a problem. It does take time to build up knowledge and experience.
It is one of the reasons why the facility that we provide, of doing that usability evaluation process with various disabled and other users, has been popular with commercial companies. It is seen as something which we and others have had the time to build up a knowledge and experience of, and means that companies themselves can tap into this.
In terms of web design, in particular, yes, it is important and necessary to involve users in the process of designing those services. I pointed out a couple of examples such as a lack of alternative descriptions for images. It is necessary to consult with users, but for many things it does not take a rocket scientist to look at something and say, "Hold on, here is a picture but there is no description. It is inaccessible. Let us think of a description." There are still a lot of things which companies could be doing which they are not doing when they develop websites. They can do things without involving users which are just common-sense aspects to building a website.
MIKE MARTIN: The other point I would make is that, of course, the organisations for disabled people very often also have their own agendas. Therefore, I think it is very important to set up, as far as one can, independent groups, who do not necessarily reflect the views of organisations.
It may be there is room for some sort of guidance - and I look to Patrick Roe on COST 219 - into how you set up such groups. COST 219 has set up a user group, have they not, Patrick?
PATRICK ROE: No. We have not, actually. We talked about maybe doing it, but we actually have not got a group at the moment.
MAGGIE ELLIS: I mentioned earlier this morning, I have done quite a lot of work about evaluation of using equipment, working with consumer groups. Jan-Ingvar very clearly used words earlier on today about the difference between research and evaluation. Those words may not be important to a lot of people in this room, but they are very important in academia. In this field we are talking about of market research, there are a lot of people who do what is actually evaluation; it`s very rarely true research.
I think that there will be less and less true research because of the pressures on academic researchers and the power of ethical committees. It`s becoming quite tricky to do true research with consumers because of the demands of ethical committees. I was only talking to somebody two days ago, who said that their research, which was with six people, was being so changed by the local ethical committee that it almost destroyed the research they wanted to do.
I think it would be a very sound suggestion from you, Mike, that PhoneAbility might come up with some good practice guidelines. If manufacturers are interested in getting an ordinary cross-section of users - and especially we are talking about elderly people - they could do a lot worse than approaching their local day centre, where there may be one or two or three hundred users of facilities on their doorstep, who would be very happy to be part of a community project. It would be evaluation, it wouldn`t be research, but it would be good consumer facts which they would find out at the end of it. There would be a lot to be said for that.
CAROLINE JACOBS: Ricability as an organisation do a lot of usability research with manufacturers. They often do come to us and they want to try out their products. They hope that it is going to be of help, or just finding out. When you explain the proper research and the numbers involved, that is often where they say, "Oh, no. I am not prepared to commit that much money to it."
We would, as an organisation, be very interested to work to develop materials so people can understand the difference between research and evaluation. A lot of that information is already prepared and out there. A lot of it has gone to the design world, where designers are learning about research and the different methods that there are, and what you can get out of different ways of designing things. I can maybe talk afterwards about how that information can be circulated.
MIKE MARTIN: Ricability and others beforehand have had many years of experience with these topics. COST 219, over 18 years, has produced endless information. I do sometimes wonder, where has all this information gone? We seem to keep reinventing the wheel. Is it because all the new designers never look back more than three years or something, because there is so much information out there. Anyway, perhaps Caroline or others will look further into this.
PATRICK ROE: I will pick up on two or three points. Where has the information gone? I can say that it does not come back, and it is often referred to in publications. In European Commission publications, I have seen COST 219 quoted on several occasions. It has fed a lot of this information. I think that is quite a positive thing.
MIKE MARTIN: Could I interject. It may have filtered through to some levels of say the European Commission, but where has it got to in the companies? It is very unfortunate that we only have BT here, and I think we should be very grateful to them for sticking their heads above the parapets. As we have said, there are probably several hundred others out there. OK, BT can lead by example, and other people will use other services, regrettably for BT, but all this information just has not got to the people who actually really need to have it.
PATRICK ROE: I think there is still a method, if companies are looking for ways to have users to test for that. When you said we did not have a user group, I thought you meant like having a panel of 150-200 users. In that sense, we do have an advisory group for the disabled, but it does not have, like I think was mentioned by one of the speakers, up to 200 users. Certainly, COST 219 ter would be interested in helping to produce guidelines. I am not volunteering some people, but I think this is something we could look into.
JAN-INGVAR LINDSTROM: Can I just add a little bit about evaluation. I think the word "research" is a bit overemphasised, in a way. Research is always better with a big R. Serious evaluation is, to me, research. If you do it in such a way that you can say, "This is the fact", it is OK and you should do it. In all applications we have, there should be evaluations afterwards, and serious evaluations, including cost-benefit analysis. We have not talked much about that today, but I am pretty sure that we could all gain from cost-gain analysis.
For example, my presentation here today, with the consultancy people, all that has a cost across the country to find an expert who is able to help. The technology that we are talking about and the investment has to be put up there. Also, sometimes the competitors that we have, even if we hesitate to confess, perhaps sometimes it is difficult to express different points of view.
VIVIENNE POZO: I just wanted to make the point that the users we are talking about here are elderly people. I think it is very important to remember there is a role for young disabled people. Apart from anything, they like the technology, they like developing ideas, and I think they have a lot of input. They are also the future generation of disabled people, so I think we should not be forgetting them as well. I am not quite sure how PhoneAbility deals with that.
MIKE MARTIN: I think most organisations would want to encompass the full range of ages. We have not addressed or talked at all, other than in passing perhaps, about children, the very young generation coming up, and the use of these systems.
Again, it has been referred to, but we have not seen the assistive devices that may be required to actually link on to broadband and all its services. Where are these coming from? Obviously the service providers - and BT, I know, has done a great deal in this area - but one of the major problems we have seen, certainly within PhoneAbility and COST 219, is the actual problem of access, the terminal access and getting into it. Who is doing what, and where is that coming from?
GRETAL JONES: Cost has come up quite a lot in the presentations today. I was really asking what ideas do people think is the way to help disabled people to access this, and the cost of using it? It Is always a tricky one, but it has come up.
MIKE MARTIN: I quite agree. You do not get something for nothing. Somebody somewhere has got to put in funds to actually generate a service or implement a design, and whether you are starting right from the research or evaluation, somebody has to pay for it. This is a very big issue. We have not raised it in this meeting because this discussion was intended to bring up other issues.
There is the question of whether there should be some form of regulation which provides a Universal Service Fund. In Sweden, the money has come initially from the state. We do not have that system here. My personal experience is that we have the Typetalk facility, which only got off the ground when BT provided substantial funding. Only then, after it was in place, was it actually regulated for.
I am sorry, but in terms of what regulation in this country has brought, it has actually brought nothing new, in my opinion. We have established what was already established. How do we get these new things going? This is a major issue. It is not really one for this meeting, but I think it is something which seriously has to be looked at. It took us something like 15 years to get Typetalk into place.
Are we all going to sit here and wait 15 years before any of these other things get into place? I am looking at the facilities or things they are trialing in Sweden, which have come out of state funding. What is going to happen here? I would suggest nothing, unless something is done to address the issue, both on the setting up of the services, the evaluation of them, the provision of the equipment and then the running costs, both to whoever is going to run it and also for the users. We heard that certain users will actually use things more than others, and therefore that will provide them with greater costs, so who is going to bear these costs? This is indeed a big issue that has to be faced up to.
BOB TWITCHIN: Very much following on from what you have just said, Mike, as I think most people will know, Ofcom has just started phase 2 of its consultation on the Telecommunications Review, and in the very near future they are going to be starting consultation on the current Universal Service Obligation. Next year, the EU are going to be talking about the scope of universal service.
It will be very helpful if panel members could perhaps give us some ideas of what arguments should be used to make the case for broadband access, and the kind of services we have been talking about, being covered by this obligation.
SCOTT MILNE: Coming back to the point I made in the presentation earlier, whereas the web is something which empowers all of us, to the extent that there are things available on there and new forms of communication which were not accessible to us and did not exist before, sure, it is an empowering tool for everyone, but, particularly in the case of people with disabilities, the value of the web is it is there to provide things which we simply could not access in the real world before, which were accessible to the rest of us.
It reduces the need for dependence on other people because of the nature of digital information, which enables it to be rendered and customised in different ways. To be able to increase or change the size of text or change the colour combinations for people with dyslexia. The actual cases of where it is useful, and why, are endless, but the overarching point is that not only is the web something new and exciting for all of us, but it has particular potential as an enabling technology for people with disabilities.
MAGDALEN GALLEY: Taking up what Jan-Ingvar Lindstrom said about cost-benefit analysis, I think we need to call on our government to look at the cost of providing it versus the cost of not providing it. We did a Smart homes study before I finished that employment, and that seems to be an issue throughout the world. You manage to keep people independent in their own homes, so they are saving money to the medical services, but the money does not flow out of that into the social side of it to help support them in their homes.
Somehow or other, we need to get governments looking at how much they are saving by spending this money on supporting people via broadband, and therefore spending less elsewhere. Although I do not know how you do that, it seems to be a fundamental need to get to government the cost-benefit argument, and the fact they can save money.
JOHN WORSOLD: I can only speak for the visually impaired market. Just because people are visually impaired does not mean they expect the information to be free or cheaper. They are quite prepared to pay for the information at the same price as any other bit of information. Once publishers realise this, and that they can produce content that is inherently accessible, there is a new market for them. There is a new customer base. People are prepared to pay for the same content, and they use it in the way they want to.
MIKE MARTIN: Would you like to comment as a user on the question of cost, Pete. Have you, firstly, found that your costs have gone up?
PETE GARDINER: My costs have gone up in terms of the time I spent on dial-up in comparison to broadband. For someone on benefit, the cost of paying £20 a month can stop you doing it. They may only check their e-mails once a week because of the cost of going on e-mail with dial-up. There has to be a cost issue of paying for things in a certain way. Why should people have something for nothing? If you give people something for nothing, it will get abused and then others will get upset. It is just how to regulate it.
MIKE MARTIN: I understand the difficulties but, from a BT perspective, obviously the company is putting very considerable sums of money into the whole disability area, and presumably you see this as "promotional", but it also extends your customer base. What is the company policy here, in terms of cost, and what it costs the company versus the services that it could provide?
KEITH LAWTON: For us at the moment, clearly, this is an investment. As I was saying this morning, to enable a telephone exchange is about £250,000, and there are 5,500 to enable. We are enabling at about the rate of 35 a week. At the moment, the take-up, in terms of the number of customers per telephone exchange, is certainly increasing this year compared with last year.
I would also say we are on the cusp of broadband in terms of the content and the applications.
If you go back to what I said about electricity in homes replacing gas lighting, we did not really appreciate the benefits of electricity then. It is the same with broadband. We have seen a very good example from John with Dolphin, and we have seen from Jan-Ingvar what is going on in Sweden, and the research that Scott has done for us.
So, for us, yes, it is a risk, but it is where we see our future, and we are investing in it. In terms of a universal service obligation, that is an issue we would want to debate with the regulator. I would say at the moment that we are battling against the laws of physics with broadband, in that we can only get a half-megabit service, or a 512kb service, to a customer's phone line that is no longer than 8km as it is routed from the telephone exchange to their home. Beyond that, we cannot deliver broadband service, and neither can anybody else. It is one of the laws of physics.
We are looking at alternative solutions with our competitors in the broadband industry. This is being led by Ofcom through a DSL working group. I apologise if you have done this already, but it seems to me that what you really need is a lobby plan, or a hit list of the key people in the consumer sector, for white goods, for example.
In the other sectors, you can go and talk to these people and say, "Look, this is the size of the market that you could look to in terms of increasing your revenue, hence profit, and these are the people who can help you with your evaluation." You have to be clear about who are the opinion formers in each of those sectors that can help you get there. If you have done that already, I apologise. You are obviously ahead of the game, but I think that is absolutely key to this.
SEAN JENKINS: I would just like to go back to the cost benefit and the references to people taking advantage or abusing what is provided free. Pensioners in this country are on pension credit, which means that they have no more disposable income, either through the state or a person on £105 a week. There are several million persons who could be eligible for a free service, if they applied for it. The same applies to people on disability benefits.
It costs approximately £2,000 a week to take somebody in to a hospital service, so if you are able to enable people to remain at home, efficiently monitored by the PCTs and the GPs, you would have a cost-benefit analysis becoming quite clear. You will also have your income level base, so the scope for abuse is really quite small.
PETE GARDINER: I agree with what you are saying. It is just that there is a tiny minority who will spoil these situations for the majority. I actually know someone who gets disability benefits and there is nothing wrong with him, and he openly admits that he wants to get what he can out of society. If you have someone doing that, you will never win.
MIKE MARTIN: The danger is that we over regulate, make too many rules in order to get rid of the minority who actually cause the trouble, and that goes to the detriment of the majority.
RUTH MYERS: I wanted to come back to the point of cost. Obviously there will always be some who cannot afford it, and there will always be some who can. Surely, where broadband is concerned, once it is rolled out more widely, I would hope the price will come down a little bit. It should do. I might be an optimist, but, once it is up and running smoothly, it should. Even so, we do not pay for the phone call on top of the broadband charge, do we, so if you are paying a fee to a broadband service provider, you are not also paying for that phone call, because you are online all the time.
KEITH LAWTON: It is an interesting point that you have raised. First of all, you are absolutely right, if you make your phone call or your voice over IP phone call over a broadband connection, then you are not paying for the phone call as you would do in the traditional sense. In terms of costs coming down, I would suggest, from the research we have done, that the cost of broadband service in this country is actually one of the cheapest in the world now. You have 150 different companies to choose your broadband service from. If you go back probably 18 months, you were having to pay £50 to £80 for your broadband modem, plus an installation fee, and now they are free. In fact, in some companies, broadband service providers are giving free modems and broadband routers.
In terms of the reason why the price is so low at the moment, it is because there is a market share war going on, as I am sure you will all realise and know. Everybody is trying to grab more and more of the market by lowering their prices, but there will come a point where the price cannot go any lower because there is a cost of providing it. I would suggest to you that the industry is very near that now. The circuit grinders are getting near to that, so what you will see are offers of broadband service that will include additional things they want you to buy.
I think Chris Aver mentioned some of that this morning. Some of it is free, like the anti-spyware software, and other things you will see next year will be extras on top of your broadband basic cost. Being blunt about it, as a company, we have shareholders, and we have to make money. We are not able to give our services away at below-cost. At the same time, we have been associated with the elderly and disabled community for 20 years, through our Age & Disability team, and we do understand our social responsibility. Where we are in the product life cycle of broadband, it is market share, grab at any cost, but we will come out of that because it is unsustainable for some of the companies.
NEW SPEAKER: I am a member of the BT Age & Disability team. I think what is important is to support people who are going to be using these devices. Particularly when we hear about computers and other Smart tools, lots of elderly people are totally afraid of these devices. It is great what is going to come through, but we even find at the present time there are some people who have difficulty getting beyond a dialed telephone even. That is real and that is out there.
Jim Kyle talked about the video phone, which is great. I have seen this in operation. Lots of older people are isolated, they live alone or do not have any relatives, so that will bring them together with other people. Jim did not say much about this, but behind that there is a huge amount of support required to show people how to use this. Part of this is that anybody who develops anything at all has to have some way of making it easily understood. Also, within Social Services, perhaps there has to be a bit more than the element of taking the box along, dropping it off, leaving it and saying, "I will see you in two weeks."
PATRICK ROE: In answer to the question about Ofcom, it is worth flagging up the INCOM group, a sub-committee of COCOM.
COCOM is the communications committee within the European Commission and INCOM is a sub-committee with member states present. They have been looking into the different directives, but also widening the scope of the Universal Service Obligation. That is why I am mentioning it because it could be a good platform to feed in any examples of why the scope should be broadened for broadband.
There is a question for Jim Kyle. He is not here but someone might know it. He gave figures for the video relay service, which I think referred to April to November 2003. Do I understand from that that it is not running now. Does anyone know whether it is still running?
NEW SPEAKER: It is still running.
KARL FARRELL: I want to raise a bit of a different issue, in the hope of perhaps affecting costs. In my efforts to get on the Internet in the not too distant past, I encountered a lot of problems, and I was quite a few times ringing up the helpline for my ISP. They did a grand job to try and help, but they were not 100%. The point is, yes, I was paying for that help, but then they said I was taking too long, so they gave me a reference number, so then I did incur costs on them.
For specialist applications, to a standard service provider, there are a lot of problems in the support. We would like the standard service supplier or provider to be able to understand our specialist needs, but then, if we have a lot of palava and a lot of problems in getting the help, it leads me to wonder whether perhaps there should not be specialist helplines provided by the standard service providers to help people such as myself to use screen readers.
It might also provide an opportunity for employment for visually impaired people, for example, who have computer expertise, and of whom there are quite a number who are not working. That might be a side issue, but it is a matter of providing information, support and help to the best effect, rather than incurring a lot of costs on the main help providers.
We only have one service provider here today, but we have got a lot of the rest of us who at one time or another need help. I wonder what other people think about this? Could we have better help if we had experts or people within our own area of understanding?
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