Mr. Brendan Lennon:

The Deputy touched on an important point. It is a little complicated but I am happy to go into it. We have been campaigning for a number of years, prior to 2020, for an improvement in the terms and conditions of the hearing aid grant. At that point in time, the hearing aid grant was a maximum of €500 for one hearing aid, or a maximum of €1,000 for two hearing aids. It also had the proviso that the maximum grant payable was 50% of the value of the hearing aid. At that time, for example, some what we call basic or level 1-type hearing aids might have been in the range of €1,400 to €1,600. Somebody would then get a grant of €700 to €800 and have to pay the balance of €200 or €300. We were very much aware that cost was a major barrier for people. At that point, 3.5% of hearing aid claims were for those level 1, basic hearing aids. That 3.5% is an important figure. I will also mention that prior to the financial crash, believe it or not, the hearing aid grant was a maximum of €760 per hearing aid. It is now significantly lower than it was in 2006 or 2007.

In 2020, due to our efforts with the Department of Social Protection, it had to bring forward a report, under the Social Welfare Bill, on the affordability of hearing aids. That report was published in August 2020. The Department's report, in its wisdom, assessed that cost was not a significant factor. It did not want to increase the grant, but it removed the 50% tariff. In other words, everybody could claim €500 for a hearing aid, irrespective of whether it cost below €1,000. What subsequently happened was the hearing aid manufacturers all introduced new level-1 hearing aids at a cost of €1,000. Effectively, somebody who had eligibility for the PRSI hearing aid grant could pop along to get hearing aids "free with PRSI" - that was the catchphrase in some of the advertisements. As a result, when that change came into effect in May 2022, every month since then, an additional 1,000 people, and it has been extremely consistent, have claimed that grant. In addition, of the 28,000 claims last year, since the change, instead of 3.5% of people getting the level-1 basic hearing aid, it is now almost 29%. That is an issue for us as regards the appropriate and quality provision of hearing aids, or the right hearing aid for the person.

We think this has happened for two reasons. A considerable number of people have come forward because they have no spare money in their pockets, if we think about what has been happening with inflation and so on in the past couple of years. People are going in and saying to their provider that they are there to get the free €1,000 hearing aids because they have no money. We also believe a considerable number of people - we do not know how many but, anecdotally, it is significant - who are in their 70s and 80s and on HSE audiology waiting lists, are being told they will wait up to three years for a first appointment, but they also have PRSI eligibility. We think a considerable number of those people are electing to go along to get the free hearing aid until their HSE audiology appointment comes up. This is where we are talking about duplication and inefficiency in the system and the fact we think people are not getting the right hearing aids that are fit for purpose. A national hearing care plan would include recommendations around, perhaps, instead of having just one, single level grant, having a two-tiered grant system so people would get the appropriate hearing aids they need.