Peter Fitzpatrick (Louth, Fine Gael) | Oireachtas source

A cochlear implant is a highly sophisticated device which provides access to sound for people with severe to profound hearing loss. The surgical implant device, when coupled with an external processor, can provide access to speech and everyday sound to aid or improve communication ability. Beaumont Hospital is the centre for the delivery of Ireland's national cochlear implant programme, but surgical procedures for patients under six are carried out at the Children's University Hospital at Temple Street. Since the programme commenced 17 years ago, more than 700 patients have received cochlear implants.

There are two aspects to the introduction of a bilateral cochlear implant programme. Simultaneous cochlear implantation is the provision of clinically appropriate bilateral cochlear implants at the same time as a single surgical procedure. Sequential cochlear implantation is the provision of bilateral implants separately, over a period of time. With the introduction of a bilateral cochlear implantation programme, children who have already received one implant under the national cochlear implant programme will need to be assessed for candidacy for a potential second implant, and be provided with information about the advantages and disadvantages of a second implant. The full-year cost of introducing simultaneous bilateral cochlear implantation for children has been estimated at €2.38 million. This estimate encompasses estimated additional staffing needs and additional non-pay costs. In addition, there would be some capital costs associated with the expansion or enhancement of infrastructure, initially estimated at €1 million.

There are a number of possible options with regard to the implementation of sequential bilateral cochlear implants for the cohort of children who already have one implant. The cost of providing a second implant in this cohort is estimated to vary from €3.5 million to €10.2 million over the period of implantation, depending on the option chosen. It is also important to note that it is not possible to be definitive about the level of uptake of a second sequential implant among this cohort.

A national clinical care programme for audiology has been put in place under the clinical strategy and programmes directorate. A new national clinical head commenced in March 2013 and a panel of successful candidates was created to fill four new assistant head posts.

Permanent childhood hearing loss occurs at a rate of two to four per 1,000. Children are entitled to HSE audiology services free of charge, including screening, investigation, treatment, rehabilitation and devices, speech and language therapy and referral of children with a hearing loss to a visiting teacher of the deaf services under the Department of Education and Skills. In April 2011 the HSE national audiology review group published a report that identified some inconsistencies and shortcomings in audiology services throughout the country, including access issues, poor information, inadequate staffing levels, poor infrastructure and unacceptable waiting times. It made recommendations for addressing these issues. Audiology services require restructuring to place audiologists into fewer teams with larger clinical mass in order to deliver better clinical governance and efficient care pathways. Some work has been initiated in this area, with €3.7 million being made available in 2011 to begin implementation of the recommendations of the review group. An additional €1.9 million was made available in 2013.

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