Apparatus for enabling speech while a tracheostomy tube is in place includes a tracheostomy tube 1 with a vocalisation gas lumen 15 extending along its length and opening at one end externally of the tube above the sealing cuff 10 in the trachea T. A ventilator 2 is connected to the main bore 3 of the tube 1 to supply ventilation gas cyclically to the patient. The ventilator 2 also has an auxiliary outlet 29 connected to the vocalisation gas lumen 15. The auxiliary outlet 29 supplies vocalisation gas to the vocalisation gas lumen 15 only during the expiratory phases of ventilation. Alternatively, the apparatus includes a separate supply 50 of vocalisation gas connected with the vocalisation gas lumen 15′ via a valve 52. The valve 52 is controlled by pressure in the main gas supply tubing 31′ so that the valve is opened to enable the supply of vocalisation gas only during the expiratory phases of ventilation.
