Seanad debates

Wednesday, 1 March 2023

Nithe i dtosach suíonna - Commencement Matters

Health Services

10:30 am

Photo of Gerard CraughwellGerard Craughwell (Independent)
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I thank the Minister of State, Deputy Burke, for attending. Today, I am following up on a reply from the Minister for Health to a parliamentary question last October, in which he said his Department was considering a proposal to establish a working group to assist in the development of an updated strategy that addresses the hearing needs of the Irish population. I am grateful for the great advocacy work of those in Chime Ireland, who have brought this urgent matter to my attention and who do great work in this area. I hope the Minister of State will be able to provide us with an update on what progress has been made and when the working group will meet. I am aware that the last time there was any strategy on hearing needs was in 2011, so a revised strategy is long overdue.

Hearing loss is a common health condition, especially among older people. Some 300,000 adults in Ireland are affected but most have had no diagnosis or intervention. At an individual level, unmanaged hearing loss can impact significantly on personal relationships and social partnerships, leading to isolation and loneliness. It can also lead to other health difficulties, such as depression and cognitive decline. Based on The Irish Longitudinal Study on Ageing, TILDA, figures, there are 50,000 people in Ireland with depression and-or depressive symptoms due to unmanaged hearing loss, while The Lancetcommission estimated that up to 8% of dementia is preventable through early treatment for hearing loss.

Hearing aids are an effective solution for most people with acquired hearing loss. More than 80% of people who get hearing aids say they improve the quality of their lives and family relationships, while fitting of hearing aids has been shown to remove the risk of cognitive decline associated with hearing loss.

The health burden associated with unmanaged hearing loss is so high that, in 2021, the World Health Organization concluded that for every €1 invested in hearing care, governments could expect a return of almost €16 over the following ten years. In the face of this evidence, it is extraordinary that the Minister for Health and his Department are not acting immediately to provide timely access to hearing care for whole populations. A Department of Social Protection report on the affordability of hearing aids in 2020 acknowledged that we in Ireland were prescribing hearing aids at less than half the rate per head of population than happens in the UK.

Cost is a major factor in the low uptake of hearing aids here in Ireland. Those with a medical card who are entitled to free hearing aids from the HSE are twice as likely to have hearing aids compared with those who do not have a medical card. The hearing aid grant available to people with the required level of PRSI payments is actually less than it was 15 years ago. Meanwhile, those on a medical card can wait up to three years for an initial appointment due to long HSE waiting lists.

I hope the Department of Health will have good news for me today and that it is establishing a working group to help develop a comprehensive and cohesive national hearing plan which will enhance public health and save the Department of Health millions of euro.

Photo of Peter BurkePeter Burke (Longford-Westmeath, Fine Gael)
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On behalf of the Minister for Health, I would like to respond to Senator Craughwell, who I thank for raising this very important matter. At the outset, I wish to state that the Minister acknowledges that the provision of appropriate audiology services to children and adults is an important aspect of the healthcare system. The provision of such can prevent other health problems and promote greater well-being and community participation for both children and adults, as the Senator rightly outlined.

The Health Service Executive community audiology service provides a full range of hearing assessments to children free of charge. This includes screening, assessment, diagnostics and related investigations, treatment, rehabilitation and devices, and referrals to speech and language therapy and children's disability services, if required. The HSE community audiology service also offers assessment and rehabilitation for adult medical card holders. The services offered include advice on the use of assistive listening devices and the provision, fitting and repairs of appropriate hearing aids. In addition, the treatment benefits scheme administered by the Department of Social Protection provides a grant towards the purchase of hearing aids for those who have the necessary PRSI contributions to qualify. A dependent spouse, civil partner or cohabitant of a qualified person may also be entitled to assistance.

The national audiology review group report published by the HSE in 2011 identified shortcomings in audiology services available at that time, including access issues, poor information, inadequate staffing and unacceptable waiting times, and made recommendations to address these additional issues. The following recommendations of the national audiology review group report have been implemented: the appointment of a national and assistant national clinical lead; the roll-out of a national newborn hearing screening programme which checks whether babies have permanent hearing loss in one or both ears; the roll-out of the national bone-anchored hearing aid programme, which is available in six hospital sites nationally; the provision of bilateral cochlear implants at the national hearing implant and research centre at Beaumont Hospital; the introduction of a domestic MSc in audiology training programme at University College Cork; the publication of adult hearing aid best practice guidelines in 2017; and the roll-out of the national audiology clinical management system for community and acute services.

The implementation of the last recommendation is facilitating accurate tracking of patients, including for the purposes of waiting list management. In addition, the HSE now employs 21 more audiologists nationwide than it did in December 2019. It is important to recognise, therefore, that the landscape of the audiology service is in a different and much better space than it was when the report was issued back in 2011.

The World Health Organisation report on hearing, published in 2021, recognises that timely action is needed to prevent and address hearing loss in people across the entire course of their lives. It recommends that governments develop a comprehensive people-centred hearing care plan within their national health care plan.The Department of Health is consulting the HSE on the development of such a hearing care plan for Ireland.

Photo of Victor BoyhanVictor Boyhan (Independent)
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Before I call Senator Craughwell, I welcome the students from Ardee who are in the Gallery. They are very welcome and I hope they have a good day in Leinster House.

Photo of Gerard CraughwellGerard Craughwell (Independent)
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The Acting Chair is very observant. He can figure out where people are from by just looking at them.

Photo of Victor BoyhanVictor Boyhan (Independent)
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It is all subtle intelligence.

Photo of Gerard CraughwellGerard Craughwell (Independent)
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The Minister of State will have noticed that I am wearing headphones. I suffer badly from hearing loss and I can tell him it is the most frustrating disability. In crowded spaces I find I do not quite pick up on what people say and sometimes I get the wrong message. My wife reminded me that one time in a crowded gathering I was answering questions I had not been asked. It was an interesting observation on her part.

For elderly people who are damned with this curse of hearing loss, there is nothing worse. Everything we can do we should do. I thank Chime for coming to Leinster House to brief us. We should get people to be more proactive about seeking help with hearing loss. We should get the working group up and running and get reports out as quickly as possible. We need more help for people with hearing loss. I thank the Minister of State for taking the debate on behalf of the Minister for Health and I ask him to bring my comments back.

Photo of Victor BoyhanVictor Boyhan (Independent)
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I thank Senator Craughwell for sharing his personal experience. It is very valuable.

Photo of Victor BoyhanVictor Boyhan (Independent)
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That illustrates it. Thank you for sharing your own valuable experience.

Photo of Peter BurkePeter Burke (Longford-Westmeath, Fine Gael)
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As the Acting Chair has said, I acknowledge Senator Craughwell discussing his personal experience. It is something I know from my late dad who had great difficulty in hearing. It puts people on the periphery of conversations and puts them out of social discourse with people. This has significant consequences for their ability to fit in and meet people. It has an impact on people's well-being. It is very important.

There is proposal to establish a working group comprising the relevant stakeholders to assist with developing a national hearing plan. I will report back to the Minister on Senator Craughwell's interest in this and the possibility of him feeding into it, as it were. Healthcare priorities have been identified by the HSE in this regard. The Department will be actively working on it in the coming months.

Photo of Gerard CraughwellGerard Craughwell (Independent)
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I thank the Minister of State. I am sure many in here would be delighted if I were on the periphery of conversations.

Photo of Victor BoyhanVictor Boyhan (Independent)
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I thank the Minister of State Deputy Burke and Senator Craughwell.