Mr. Mark Byrne:

I thank the joint committee for giving me the opportunity to be with its members. By way of introduction, Chime is the national charity for those suffering from deafness and hearing loss. It has been in existence for more than 50 years, championing the issues of deaf and hard-of-hearing people. We have 12 resource centres nationally providing specialist services to help to improve the quality of life of those who are deaf or hard of hearing.

We are here to highlight for the committee a significant ongoing health inequality that has a major impact on the health and well-being of many of the 300,000 individuals in Ireland who have significant hearing loss. The source of the inequality lies in the parameters of the Department's treatment benefit scheme in respect of the hearing aid grant which is set at a maximum of €500 per hearing aid. This typically equates to approximately 30% of the overall cost of a hearing aid. The individuals who have hearing loss and medical cards can access free hearing aids from the HSE, while those who do not have medical cards must pay substantial sums of money to purchase their own hearing aids. This health inequality was starkly highlighted in the Irish Longitudinal Study on Ageing, TILDA, in 2017. It reported that medical card holders were twice as likely to have hearing aids than those without medical cards.

This evidence demonstrates that cost is a significant barrier for many people in accessing the treatment for their hearing loss.

This health inequality is fundamentally unjust. Those most disadvantaged are the people on low and middle incomes just above the income threshold to qualify for a medical card. These people must pay their taxes just like other citizens, but if they acquire a hearing loss, they are faced with trying to source several thousand euros to purchase hearing aids. This is clearly beyond the means of many people. We have tried unsuccessfully to engage with the Minister for Employment Affairs and Social Protection on this matter over the past couple of years and that is why we wanted to bring this issue to the committee today.

In this context, we see hearing loss as a health issue with two significant elements, the first of which is the number of Irish people with a hearing loss. This condition is often dismissed or ignored. According to the HSE audiology review report of 2011, 8% of all adults are in need of audiological intervention and have a significant hearing loss. This equates to almost 300,000 adults in Ireland, with approximately 80,000 of working age. Hearing loss increases in prevalence significantly after 50 years of age, and is one of the most prevalent conditions in older age.

Currently Ireland prescribes hearing aids at approximately 50% of the rate per head of population compared to the UK. As a result we have a high level of unaddressed hearing loss as only 21%, or approximately one in five, of those with hearing loss had hearing aids according to the Irish longitudinal study on aging, TILDA, 2017. Of the 300,000 Irish adults with a significant hearing loss who require audiological intervention, only 60,000 have received any treatment. Non-medical card holders are less likely to have hearing aids, and it is likely that those on low and middle incomes are most disadvantaged.

The second issue to highlight is the increased risks associated with untreated hearing loss. Untreated hearing has myriad increased health risks. They include stress and anxiety and people with hearing loss are two to three times more likely to suffer from depression. Increased cognitive decline is another risk. People with mild to severe hearing loss have two to five times the rate of dementia compared to hearing peers and significantly faster rates of cognitive decline. Research has shown that the fitting of hearing aids eliminates or reduces this risk. There can also be lower social participation and increased loneliness.Irish people with hearing loss have significantly increased levels of loneliness and social isolation, according to the 2017 TILDA study.

There are actions we hope we will see. The World Health Organization, WHO, states that interventions to identify and address hearing loss are cost effective and can bring great benefit to individuals. There is a high level of satisfaction with modern hearing aids, with 85% of users reporting that their hearing aids worked as well or better than expected.

Chime, as the national charity for deafness and hearing loss, is requesting that the Department considers two main changes to the hearing aid grant that would help address this inequality. First, we request that the Department double the hearing aid grant for those purchasing hearing aids for the first time. This would make hearing aids more affordable for many thousands of people and encourage and assist to address their hearing loss as early as possible. Earlier intervention results in improved outcomes for individuals and their families and this in turn benefits the Exchequer in reducing the overall health burden associated with hearing loss.

Second, we request an increase in the hearing aid grant of 50% for all other claimants, to provide increased assistance to those who need to upgrade their hearing aids periodically and in recognition that the grant has not been increased for quite a number of years.

In conclusion, Chime believes that this is a significant health matter requiring immediate attention. Hearing loss is a prevalent condition that is impacting on 300,000 individuals and on population health generally. We have a very low treatment rate especially compared to the UK. Those on low to middle incomes are most disadvantaged in the current system. We call on the Minister to take concrete action to make the hearing aids more affordable and accessible for these people, and we welcome any assistance from the committee in that regard.