The Daily Telegraph is carrying an article suggesting that hard of hearing people should pay for hearing aids, stating that its no special case as being short sighted. You pay for your glasses why not hearing aids?
The article quotes the cost of hearing aid provision:
According to evidence given in May to the Health Select Committee, the NHS tariff puts the per capita cost of hearing aid provision - from appointment and clinic time to use of equipment - at about £270.Add on the cost of the cheapest aid, bought with an NHS bulk discount at approximately £75, and the outlay per patient comes to about £350. And as hearing aids are issued on loan by the NHS, they need to be updated.
So could older people afford £350 for the fitting of one hearing aid?
Due to the waiting list problem, it seems that audiology is excluded from NHS targets:
The queue is so long that the Government has excluded the hard of hearing from the 18-week target times for treatment on the NHS; and some hospitals won't include the figures in their reports for fear of distorting their otherwise creditable results.
The article does home in on the 9 million figure, a case of the rnid's numbers game backfiring?
We did it with eyes, why not with ears?Last Updated: 12:01am BST 06/08/2007
In a provocative and personal view, Victoria Lambert suggests that it's time we helped out the over-burdened NHS and paid for hearing aids ourselves
When 108-year-old Olive Beal was told she must wait 18 months for a new NHS hearing aid, it provoked a wave of righteous indignation across the country.
Her family pointed out that - given her age - realistically, she was unlikely to receive one. If ever a case seemed to beg for the application of a little common sense and stretching of rules, Olive's would seem to be it.Instead, this former suffragette from Deal, Kent, has joined the half a million people waiting for hearing aids languishing on lists that are on average two years long, but can be as long as six years in some areas, including Edinburgh. The immediate crisis has been caused by a switch-over from supplying analogue devices to more reliable digital versions.
And it can only get worse: the Royal National Institute for the Deaf (RNID) suggests that another four million people would benefit from more aural assistance.
The queue is so long that the Government has excluded the hard of hearing from the 18-week target times for treatment on the NHS; and some hospitals won't include the figures in their reports for fear of distorting their otherwise creditable results.
Dr John Low, chairman of the RNID, has been leading a vigorous campaign to have audiology included in the 18-week target, a view recently endorsed by a cross-party Health Select Committee. And last month, the Government announced that up to 100,000 war veterans with moderate hearing loss will be able to jump the queue for digital hearing aids.
Yet is this initiative really so vital? In fact, why do we still offer hearing aids on the NHS at all?
According to evidence given in May to the Health Select Committee, the NHS tariff puts the per capita cost of hearing aid provision - from appointment and clinic time to use of equipment - at about £270.
Add on the cost of the cheapest aid, bought with an NHS bulk discount at approximately £75, and the outlay per patient comes to about £350. And as hearing aids are issued on loan by the NHS, they need to be updated.
So to clear a waiting list of 500,000 using the simplest and cheapest equipment possible would cost £175 million.
To offer that service to the further four million people whom the RNID believes need aural assistance would cost £1.4 billion - and that's if the problem is confined to just one ear. Throw in an ageing population, and the cost is prohibitive.
Currently there are nearly nine million people in Britain with some level of deafness, ranging through mild to moderate, severe and profound. The majority of these - 8.3 million - are hard of hearing to a mild or moderate degree.
Mild means the quietest sounds you can hear will be 25-39 decibels and you may have difficulty following speech in a noisy situation. With moderate deafness the quietest sound you can hear is 40-69 decibels and you may have difficulty following speech without a hearing aid.
Deafness is heavily age-dependent: more than 70 per cent of the over-seventies have some degree of hearing impairment.
The severely deaf, who rely on lip-reading as well as a hearing aid, and the profoundly deaf surely deserve fast and efficient treatment on the NHS.
But what of these eight million mild or moderately hard of hearing? Should they be catapulted up the waiting lists too, forcing hard-pressed primary care trust cash to be diverted away from meeting targets on breast cancer and stroke? After all, no one has ever died from mild hearing loss.
Yes, living with a hearing problem can be frustrating, for both sufferer and family, and isolating and depressing. But this is not unique.
Those of us with short sight (myopia), or long sight, or presbyopia, the weakening of the eye muscles brought on in old age, know how sensory impairment can be frustrating.
We can hear music and chat to grandchildren without help, but we can't read books, watch television, use a computer, drive a car, identify friends in the street or at a party. Some people can no longer practise their professions. For others, crossing a road could be fatal.
Yet unlike the hard of hearing, most of the 18 million Britons estimated to have myopia (three million of whom suffer it severely) have to pay for treatment themselves.
Since 1989, when free eye tests for all were abandoned (the practice of free frames was ended in 1983), you're on your own unless you are on a low income or have a serious related health condition.
Sight tests are still free for the young and old but the rest of us must pay. Moreover, myopia is not principally a disease connected with old age; all those who develop the condition, even as children, (and the number is increasing) must foot the bill for regular check-ups and new lenses.
So why do we accept that we must pay for our visual aids, but refuse to shell out for audio aids? Perhaps it comes down to the stigma that still attaches itself to hearing loss.
There are many who know they have a problem but find the thought of wearing an old-fashioned ''NHS banana'' behind the ear embarrassing and ageing. They are too proud to get help, and certainly won't be aware of the range of discreet aids, ranging in price from £200 to nearer £2,000.
Compare this to the collapse of taboos attached to short-sightedness and those heavy NHS specs with the arrival of the fashion frame on the high street, promptly followed by lenses and now surgery.
None of this is cheap - and the end of free eye care certainly wasn't one of the most popular policies of the last Conservative government.
But putting general optometry on the high street has seen prices fall and choice increase for everyone. Meanwhile, those who genuinely need the NHS to cover their costs are not waiting behind those who do not.
So what if we changed the rules for the mild to moderate hard of hearing, too - keeping safeguards in place for those on state pensions or income support, or with complicated conditions, and with hearing tests free for children and the elderly?
Professor Chris Ham, professor of health policy and management at the University of Birmingham, and a governor of independent charity the Health Foundation, thinks the idea has merit.
"We would have to ensure that those of limited means or with complex needs had access to them," he says.
"We might have to offer a voucher scheme where the cost would be equivalent to the basic hearing aid, but could be topped up with cash, if so required. But, subject to the proper safeguards, it is worth exploring."
And what would life be like if mild to moderate hearing problems were devolved from the NHS?
No doubt there would be an immediate chorus of dismay but the public would adjust. Perhaps chains of shops called ''Ear Savers'' would spring up in the high street, digital aids would be standard, styles would be more discreet and attractive - or in some cases brighter and heavily logo-ed.
Without the threat of long waits or irritating trips to the local hospital, those with mild hearing loss would be more likely to opt for assessment. The more widely hearing aids became seen, the faster the stigma would disappear. And we would all find it easier and less embarrassing to get help.
Prof Ham points out that there would be lots of advantages to opening up the market - not least that "it would drive down costs". But this policy would not be principally about saving money as many of the elderly would qualify for financial help.
In 1948, eye tests, frames, and lenses were all offered free on the NHS - but with demand ahead of supply, a two-year waiting list quickly developed. It is impossible to imagine that now; a maturity in public mood has meant more choice, lower costs, faster access and, even for those in financial difficulty, no delay.
It is time we applied the same rules to hearing aids and slashed those six-year waiting lists to nought.
Comments (14)
Becasue hearing aids cost 10 times as much as glasses. And people shouldn't have to pay for glasses
Posted by David Pearson | August 6, 2007 3:10 AM
Stupid hearing people! Notice there is no capitalisation of the H to reflect the very low levels of intellignece and insight into Deaf issues!
Posted by Tony Nicholas | August 6, 2007 7:06 AM
So soon you'll have to pay for hearing aids and you'll be cornered into buying them from the RNID?
Posted by Howard | August 6, 2007 8:26 AM
If the article's suggestion ever get realised, I can envisage businesses jostling for position in this uptapped market and provide competition for RNId if the size of the potential customer pool anything to go by. Its a big market, valued at £2.68 billion if the 8.4 million punters were buy an hearing aid each @ £270. Of course, it could be less if safeguards are in place for the people on low income and benefits but still, the market potential will be hard to ignore.
Posted by Tony B | August 6, 2007 9:05 AM
The actual manufacturing cost of the basic BE aid used to be about £30-50 I don't know where they used to get £350 from... the cost is ENT TIME and labour not the aids. They want to charge for the test ? There should be no charges at all, since without testing and provision the individual becomes non-employable and then a drain in the benefits system as well, it's false economy to deter people by charging them £3-500 then they have to pay £1,000s to support them after.
ATW would cover the cost wouldn't it ? I'd prefer the NHS retain the testing, as private testing leaves a lot to be desired and they rip off people. The provision of aids is up for grabs with the RNID one area who could do this, if it's them or the corner shop.... would you trust private enterprise ? I would have thought the technology of basic hearing aids is cheap, far less than a £100, but digital aids cost a lot more, I don't think many older people could afford it, and we know a lot of older people are already being denied the provision because too many need them.
Something stinks as usual...
Posted by MM | August 6, 2007 11:57 AM
I'm against hearing aids being provided by AtW as a matter of course. Current AtW rules say that if you finish employment / move onto another job, the equipment belongs to your employer. This in effect your employer gets to own your hearing aids, even if they are no use to them. They could always flog them on eBay.
The problem with the above approach, it creates bureaucracy. When I finished one job the organisation insisted on keeping equip etc. This just created problems, in that I needed to go through the whole AtW process again to get the same equipment when I started my new job literally 3 days later. No smooth transition, instead pissing around with forms and whatever. In fact the same equipment didn't ever materialise in my next job (even though it was recommended for me), 2 years later it still was not in place.
Now what if in theory you worked for a deaf org and they wanted to keep a person's hearing aids issued by AtW at the end of their employment, so e.g. they could use for their equipment room? As the law stands, in theory it could be done, and there's very little or no redress you could have over it. That highlights one of the major problems with AtW as it currently stands.
The second problem is around continuity. If you stopped working for a while, say to do some travelling. For 6 months you would have to give your hearing aids back to the Employment Services, because you aren't technically in work. Thus you have to go through bureaucracy to find some alternative provision, or pay for something else? Since this suggestion has been targeted at hoh, different outputs from different hearing aids will matter and wouldn't it be a case of getting used to different sounds?
I think Australia has a model where you get free hearing aids only if you are in employment. Tony N might be able to chip in here.
All the above, I strongly believe that any hearing aid provision should be kept within the health sector.
The second point, I think that 9 million figure is so grossly over inflated that at least half that number, they would not be issued with hearing aids anyway ... audiogram reads too much like a hearing persons, with small a decibel dip on a few frequencies. Subjectively, this is probably a big deal to them, however on a larger scale says a lot about the politics surrounding this ... which ties into Tim's point nicely. The reason its being brought up here, is flinging around huge inflated numbers gives an opportunity for Joe Public to see: millions = expensive, thus don't give, deflecting from ____________ [fill in blank].
Posted by Alison | August 6, 2007 2:14 PM
I'm surprised actually the employers pay for any equipment, in my time the job centre did via the state. It was my experience the employers would not pay for anything at all. As soon as they knew expensive equipment was needed (Or discovered you were deaf), they would hire someone else ! It's probably a rare occurrence someone with a hearing loss would ever turn up for an interview without an aid anyway,it was just a thought...
Unlike moi who turned up profoundly deaf and without any support whatever, you lived or worked solely on the strength of what you could lip-read nothing else. Obviously I was turned down flat 9 times out of 10, "Where have you worked before ?", "Half past two..", etc ! I eventually proved that as I could use a broom, deafness was no barrier, 30 years as a skilled fitter, worthless.... What education and proven skills I had, counted for nothing at all. As I recanted elsewhere, one employer kicked me out of the interview, phoned the Job centre and berated them for "Sending deaf idiots" to him for work, he ended "I am not a bloody social service,stop wasting my time...". The DRO (Pre DEA !), then had the nerve to endorse that and told me off too, I told him where to stick it... and was asked to leave the job centre, I did, and never went back there, doing about 8 jobs a year, none required any thought... none paid a decent wage either ! I cleared toilets, everything, bugger the Job centres, bloody useless... I'd have made a million had I the laws you have now, by suing their asses off.... and I'd be posting here from the Seychilles...
Posted by MM | August 6, 2007 5:47 PM
Too right - tell them where to stick it, MM. I wouldn't stand for that and I wouldn't want to work for that bigot.
AtW used to pay for the equipment for your use and you can take it with you but now they are bucking the trends especially if you work for large company or organisation where they think they are big enough to absorb the costs of equipment. I think they have a point there but my fear is that this is a backward step where employers won't employ us due to extra costs to make "reasonable adjustment". This goes against the grain of what Access to Work is all about - taking away any reason why they should not employ us.
Why is the Government treating our rights to access like a hot potato and passing it onto the private sector. Last year, when I was living up in Bradford, Social Services refused to install fire alarm for deaf people, citing DDA and responsibility befalls on the landlord. I am against that principle because the landlord might not have any use for it for the next tenants and possbily will never have another Deaf tenant. It makes sense for the equipment to be own by Social Services, which they can install and take away again after it is not required anymore and install again at different rented house where it is required. The same concept ought to apply to Access to Work where equipment to follow where access is required. Otherwise we will have a mountain of obsolete equipment. Seemed wasteful to me.
I was lucky to find out that West Yorkshire Fire Bridgage was able to install fire alarm for deaf people for free of charge and they took it away again when we vacate the property. We only found about this via Derby Social Services (via my mother in law) - not Bradford Social Services - huh! WYFB were very professional and used text messages co-ordinate their access to property.
Posted by Tony B | August 7, 2007 10:28 AM
Next up...people may start queuing up at your local butcher for cochlear implants - this have the double advantage that if they mess it up...well price of meat goes down for some reason...
Posted by JGJones | August 7, 2007 11:58 PM
If you think I am walking around with a pair of sausages stuck in my ears.... I think that's offal....
Posted by MM | August 8, 2007 11:05 AM
So is pork pies.....
Posted by Tony B | August 8, 2007 12:22 PM
Paying that much for hearing aid will leave me out...
Just think how many people stopped going to dentist since we have to pay so imagine how many deaf people without hearing aids...
I expect an increase of BSL classes and I rather pay £250 for whole family to learn BSL to which is a life time lanuage than paying £500 (both ears) to which they only last about 3 years!
Posted by Fintan | August 8, 2007 4:10 PM
To all you tossers on this who think they should pay i hope you all go deaf because you don`t know how lucky you are to be able to hear properly just take a moment and think before you engage that thing you call a mouth
Posted by DD | February 7, 2008 9:05 PM
i want to buy hearing aid but i dont have money pls can u help me to get it
Posted by jaiyesimi-segun | March 28, 2008 1:29 PM