Seanad debates

Thursday, 14 February 2013

Adjournment Matters

Hospital Services

1:20 pm

Photo of Martin ConwayMartin Conway (Fine Gael)
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I welcome the Minister of State to the House. I raise this issue on foot of a news report from last week or the week before concerning a young person who had a cochlear implant inserted and who had to wait four years to have a second implant put in. The report indicated that Beaumont Hospital made a submission to the Department of Health for funding in order to do both ears at one time when treating a young person.

It seems highly unusual and unacceptable to me that a hospital would carry out an operation to implant one device into a child's ear yet wait four years to do the second ear. By then the child will have developed and his or her hearing will have developed in certain ways. The time between both procedures is not best practice. On making inquiries it turned out that such delays happen but that is unacceptable. It makes sense to treat both ears at the same time. I am sure that there is a waiting list to get the first treatment done. It makes medical and economic sense to implant a device in both ears at the one time thus leading to a greater improvement in the child's hearing. This is a no-brainer. No one should have to wait years to have a second device implanted and I hope that the Minister of State will have a positive response.

1:30 pm

Photo of John PerryJohn Perry (Sligo-North Leitrim, Fine Gael)
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Yesterday the Taoiseach comprehensively dealt with the matter in the Dáil and I thank the Senator for raising this important matter in the Seanad.

Beaumont Hospital is the centre for delivering Ireland's national cochlear implant programme with surgical provision for patients under six years of age carried out in the Children's University Hospital, Temple Street. Beaumont Hospital's annual budget for provision of the service, inclusive of implants, is ¤4 million. Since the programme commenced 17 years ago over 700 patients have received cochlear implants. I am advised that Beaumont Hospital carried out 90 cochlear implants in 2012 so 48 adults and 42 children received implants.

In addition to providing the surgical services, the programme provides a comprehensive assessment service to potential candidates and a rehabilitative service to those actually implanted. There are three target groups that could benefit from cochlear implantation: prelingually severely or profoundly deaf children from one year to five years of age; post-lingually severely or profoundly deaf children from six to 17 years of age; and post-lingually deafened adults.

There is good evidence on the benefits of cochlear implantation and on the added benefit of bilateral implantation for children. In 2009 the UK's National Institute for Health and Clinical Excellence, NICE, recommended simultaneous bilateral cochlear implantation as best practice for children. The HSE undertook a national review of audiology services. The group was tasked with examining the services provided to children and adults nationwide and with formulating a national plan for the service. The report was published by the HSE in 2011. It provides the blueprint for the planning, development and delivery of HSE audiology services from newborn screening to assessment and management of adults and children with hearing problems, including cochlear implantation. Two of the main recommendations include the national roll-out of a universal newborn hearing screening programme and the establishment of a bone anchored hearing aid programme. The report included a recommendation that continued ring-fenced financial support be provided for the cochlear implant programme but at levels which allow for simultaneous bilateral implantation for children.

Since then, the HSE's audiology clinical care programme was formed to oversee the implementation of the recommendations detailed by the report. Progress is being made on the modernisation of audiology services in Ireland, with the introduction of a universal national programme of newborn hearing screening a key priority. It will ensure that all babies have their hearing screened shortly after birth.

While no dedicated programme for simultaneous or sequential implantation is being carried out here at this time, some bilateral implantation has already occurred for patients, mainly very young children with certain medical conditions such as a history of meningitis or blindness. It is estimated that there are approximately 200 children in Ireland today who may be suitable for a second implant. Not all suitable patients proceed with the second implant when appraised of the all the issues involved.

The HSE is working closely with Beaumont Hospital to progress plans for both simultaneous and sequential bilateral implantation. The hospital, HSE management and the HSE's audiology clinical care programme have met recently to discuss a joint process to identify the options for developing and resourcing a programme of simultaneous and sequential cochlear implantation. An important element of this will be the development of clear clinical criteria to prioritise clients for assessment and follow on implantation. These plans will be progressed through the HSE 2014 Estimates process.

Photo of Paddy BurkePaddy Burke (Fine Gael)
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I thank the Minister of State.

The Seanad adjourned at 1.55 p.m. until 2.30 p.m. on Tuesday, 19 February 2013.