Mr. Brendan Lennon:

I thank Deputy Brady for his questions and all his help to date. Mr. Mark Byrne mentioned some of the reasons people might delay in getting hearing aids. They include stigma, embarrassment and historical issues such as the old analogue hearing aids that some people might remember which used to whistle in people's ears, which bear no relation to modern digital hearing aids which are now available. Those are some of the reasons. Unaddressed hearing loss is typically something that comes on gradually over a number of years. The person with hearing loss is often the last person in the family to realise what is going on. People compensate by turning up the television volume, etc., and gradually withdrawing from engagement with family and family members. They do not wake up some day and realise that they have hearing loss. People's confidence and self-esteem go down and they start to withdraw. That is another reason people do not come forward and state that they need to do something about it.

The UK's National Institute for Health and Care Excellence, NICE, is introducing a draft standard for hearing loss which is out for consultation. The draft standard states that some people in the UK wait for up to ten years to have their hearing loss addressed. That is the evidence in the UK, which is prescribing hearing aids at twice the rate at which they are prescribed here. Some 71% of people in the UK who get hearing aids say that they wish they got them sooner. That figure must be higher in Ireland. Some 85% of people say that hearing aids improve their quality of life. Those who are of working age say that it supports them in the workplace. Those figures for satisfaction when people get hearing aids might be lower in Ireland, because the longer that one delays, the more difficult it is to adjust to getting and wearing hearing aids.

It is not the same as putting on a pair of glasses. As I stated, during those years of unaddressed hearing loss, people probably experience emotional anxiety, frustration and so on, which leads to issues such as clinical depression in some instances - there is twice to three times the rate of clinical depression as among the general population. Although only 10% or 11% people who get hearing loss develop full-blown dementia, many experience a gradual decline which means they are not as alert and engaged as would be the case if they had hearing aids. The value of providing people with hearing aids is that it allows them to continue to function as confident and independent adults rather than withdrawing. As members know, one may see people sitting in the corner or similar at family events, etc.

The Deputy mentioned that the Minister stated in correspondence that she regularly reviews the scheme. There has been no change to the scheme for many years in terms of the level of the grant. In 2017 the Minister extended the treatment benefit scheme to self employed people. There was a 25% increase in the number of claimants that year which the Department probably rightly attributed to the scheme being extended to self employed people. However, the self employed people who availed of the scheme are likely to have a reasonably good standard of income, rather than be self employed people who might earn €30,000 or €40,000 per year because that additional cost is not doable at such levels of income.

I hope I have answered most of the Deputy's questions.