Mr. Mark Byrne:

Good morning. I thank the members of the committee for organising this session on the need for a national hearing care plan and for extending an invitation to Chime to present to the committee on this important subject.

Ireland needs a national hearing care plan. According to the national audiology review of 2011, there are 300,000 adults with significant hearing loss. However, according to The Irish Longitudinal Study on Ageing, TILDA, in 2017, only one in five older people with hearing loss had hearing aids, and they only got them as a last resort. In 2019, our own analysis showed that as a country we prescribe hearing aids at less than half the rate of the UK, and while this has improved slightly in the meantime, we are still more than a third behind. The body of research that demonstrates the considerable increased health risks associated with unaddressed hearing loss is growing, with dementia, depression and social isolation some of the most significant issues. On the other hand, recent research also shows that hearing aids largely eliminate the increased health risks associated with hearing loss. The health burden associated with unaddressed hearing loss is significant. In 2021, the WHO recommended that governments invest in national hearing care plans. It said that for every €1 invested, governments could expect a return of almost €16 over the following ten years. This return on investment is approximately one third of direct health cost savings for the State, and two thirds in improved quality of life for individuals and their families, such as improved productivity and independence.

Why does Ireland need a national hearing care plan? As I have already stated, Ireland prescribes hearing aids at a rate well below that of the UK and consequently, has a high rate of unaddressed hearing loss. In turn this has a negative impact on the quality of life and health status of those with unaddressed hearing loss. However, there are other reasons Ireland needs a national hearing care plan. We have persistently long HSE audiology waiting lists. Over 20,000 people are currently on these waiting lists, and half of them are children. In some areas of the country the wait is up to three years. We are aware that for the past two years the HSE has been developing a framework that would address waiting lists in a substantive way. The framework involves two phases. Phase 1 is a procurement process to develop a panel of approved providers and phase 2 would follow whereby local HSE management could tender for services to address waiting lists locally, using that approved provider list. We understand that this process, which has been delayed many times, has hit another roadblock as the HSE procurement division will not progress the framework model until funding is made available. Meanwhile, we are aware that some people on HSE audiology waiting lists are presenting to private providers and availing of the treatment benefit hearing aid grant while awaiting their HSE audiology appointments. This is leading to a level of duplication that is inefficient and wasteful.

Approximately 70% of provision of hearing aids is through private providers. The sector has little independent oversight or governance in customer care or quality standards, despite the State investing €26 million in 2023 through the provision of hearing aid grants. While we welcome this investment, we believe a national hearing care plan would go some way to providing a level of oversight that would ensure better standards of hearing aid prescription and patient care. Another compelling reason for a national hearing care plan is the improved quality of life that adults experience when they have their hearing loss addressed, be it through hearing aids, cochlear implants or assisted listening devices. More than 80% of hearing aid users report that the aids improve their quality of life and social relationships. As one client of Chime who was fitted with hearing aids stated, “life is so much easier when you can hear”.

Chime has campaigned for a national hearing care plan for a number of years and members of this committee have been helpful in raising the issue with the Department and the Minister, Deputy Stephen Donnelly, on many occasions. Chime met with the Minister in May 2023 and he was positively disposed to the development of a national hearing care plan. In January 2024, Department officials committed to set up a working group in the coming weeks to develop the plan. They said that the working group would be tasked initially with making recommendations to reduce the level of unaddressed hearing loss among the adult population, and we understand that these will go forward for consideration in the Estimates process for Budget 2025.

There is a major health opportunity for the State and the Irish population to reduce the health burden and improve the quality of life of many people through reducing the level of unaddressed hearing loss in the population. A national hearing care plan is required to deliver this. We now need all stakeholders to focus on delivering this in a timely fashion as promised. It is vital that the Minister, Deputy Donnelly, and the Department of Health lead the process with vigour and address some of the current pinch points, such as the availability of funding to address waiting lists, as a matter of urgency. We look forward to working with members in the coming months to ensure that a national hearing care plan is developed and commenced later in 2024. I thank the committee.