Professor Malcolm MacLachlan:

It is a great question. The competence would certainly be around access to the system, but perhaps multiple access points. To take a commercial example, companies like Specsavers that do spectacles and now do hearing aids could conceivably offer a whole range of services. You would not necessarily need to have an audiologist on the staff, but you could have people trained very specifically to do that sort of assessment. That is certainly one of the visions within the WHO. It involves a specific cadre who are trained more specifically with competence around assessments of different sorts of difficulties, including communication difficulties, rather than necessarily investing them in one type of profession. Clearly, where the presenting problem is more difficult, you need a more highly specialised person. However, it is possible to have a lower-level cadre who are more specifically trained. It is a more cost-effective way of doing it.