With 10 per cent of the population suffering from hearing loss, the hwaring aid market may be growing but buyer beware, there is a lot of money at stake, writes JOHN CRADDEN.
EVER SINCE glasses lost their label/image as medical aids or devices, and with it the stigma once strongly associated with wearing them, some have hopefully predicted that hearing aids will go the same way.
It’s even mooted that just as some fashionistas with perfect sight will wear designer label specs with plain glass, a trendy design of fake hearing aid could someday become a must-have accessory. According to a biography of 1980s English rock band The Smiths, frontman Morrissey once wore a fake hearing aid to support a hearing-impaired female fan who was ashamed of using one.
All the same, there has been a huge growth in the private hearing aid market. Over the past five years the number of private hearing aid shops or clinics in Ireland has almost doubled, according to the Irish Society of Hearing Aid Audiologists (ISHAA), which represents most of the private hearing audiologists in the Republic of Ireland.
The large optician chain Specsavers entered the hearing aid market in late 2006 with its first “hearing centre” in Limerick. It now has hearing aid shops in 12 other locations around the State – though not in Dublin. Hidden Hearing, another UK firm, has 50 clinics throughout the island of Ireland and has plans for more.
It’s almost impossible to say accurately how many deaf and hard of hearing people there are in Ireland, but it’s generally agreed that at least 10 per cent of the population have some form of hearing loss, according to Deafhear (formerly the National Association for Deaf People), which means more than 400,000.
This figure is widely expected to rise in the future because of our rapidly ageing population as well as ear damage caused by constant exposure to high levels of noise at work or music at rock concerts or nightclubs.
What this means is a potentially huge market for hearing aids, limited only by the continuing stigma associated with them, or by large numbers of people who don’t know (or don’t believe) they have a hearing loss.
But if you suspect you have a hearing loss and might benefit from a hearing aid, your first port of call should still be your GP and not a hearing aid shop, says Jean Hegarty, chairwoman of the Irish Society of Audiology (ISA), which represents audiologists working for the HSE and other professionals in the field of audiology.
The GP can at least rule out some temporary causes of hearing loss, such as excessive earwax, any infections, discharge, etc. If your GP suspects you have a hearing loss, they can refer you to a reputable private hearing aid clinic, she says.
Only those with a medical card can be referred by the HSE to a public audiology service in their local health board area, and avail of free hearing aids if required.
Unfortunately, there is widespread evidence of people being sold hearing aids from private shops staffed by unqualified dispensers who sell hearing aids worth thousands of euro that may turn out to be totally unsuitable. “People are being stung every day of the week,” says Hegarty.
“Unfortunately, what can happen is that having been attracted to a fancy media advertisement promising ‘miracle hearing’, an individual can be exposed to high pressure selling from someone with minimum training and end up committing themselves to a purchase of a very expensive hearing aid without any proper medical examination at all,” says Jim Sharkey, former president of the ISHAA and senior audiologist with Advance Hearing in Dublin.
“Trying to return a hearing aid, if unsatisfactory, can be made quite difficult, as the dispenser would lose out on a hefty commission.”
The ISHAA also strongly recommends consulting a GP first, and if a hearing aid is suggested, then it recommends that the audiological assessment should be carried out only by a properly qualified hearing aid audiologist.
The association, which has 84 members, estimates that there are currently up to 40 private hearing aid dispensers working in Ireland who are not properly qualified or have done “questionable” internet courses.
The profession of private hearing aid dispensing is still not regulated in Ireland, despite EU rules that came into force here in 1998. In the UK, hearing aid dispensers have been regulated by the Hearing Aid Council (HAC) since 1968. It is an offence to sell a hearing aid without being registered with the HAC, including in Northern Ireland.
Sharkey says he and former ISHAA secretary Peter Ferguson wrote several letters to the Minister for Health, Mary Harney, and had a meeting with the then Minister of State Brian Lenihan in 2005, putting the case for an official register of qualified hearing aid practitioners. But they have yet to receive a “definite answer’’ from the Department of Health.
On the positive side, work is ongoing on the development of an EU voluntary standard for hearing aid professionals in private practice, involving experts from throughout the EU.
The National Standards Authority of Ireland has been co-ordinating the input from the Irish professional associations, including the ISHAA, the ISA, as well as the Department of Family and Social Affairs (DSFA).
In the meantime, the closest thing to regulation is the DSFA’s official register (of sorts) of private hearing aid clinics. The department administers a treatment benefit scheme (TBS), which provides for 50 per cent of the cost of hearing aids up to a maximum of €830 for each aid. This is a significant grant and helps to offset the high cost of digital hearing aids.
Anyone with enough PRSI contributions under their belt can qualify for this grant. The one condition is that you purchase your hearing aid from any one of the department’s list of registered hearing aid dispensers.
To qualify for inclusion on this list, the DFSA says that under the relevant social welfare legislation, an audiologist must be a member of any one of the following: the ISHAA, the BSHAA (British Society of Hearing Aid Audiologists), BSA (British Society of Audiology) or BAA (British Academy of Audiology) or a US organisation called the International Hearing Society (but only with a National Board for Certification in Hearing Instrument Sciences qualification obtained from the US).
This means that if you decide to shop around different private hearing aid clinics, you should check if they are registered with the DSFA. You can find the list on its website. If you go to a shop that is not, the chances are it is staffed by unqualified dispensers and, therefore, not recommended.
It may also be worthwhile to cross-check the dispensers on this list with those of the ISHAA, which is available from www.ishaa.ie. Unlike the DSFA list, which lists the firms only, each member on the ISHAA is listed individually, irrespective of whether they work for a large retail company, family practice, small partnership or one-person business.
“It must be stressed that because a firm employs one of our members it does not necessarily follow that all the persons employed by that firm are ISHAA members or hold a qualification,” the ISHAA’s website states.
However, the ISHAA does not recognise the International Hearing Society’s qualification.
Why the high price tag?
It is almost universally acknowledged, both in Ireland and elsewhere, that hearing aids are not cheap. Prices for a modern, digital hearing aid range from about €700-€3,000 each, as there are many different types and levels of sophistication.
“It really is a case of ‘buyer beware’, but if a person is sensible and shops around, they will find that the majority of dispensers offer a good choice,” says Jim Sharkey, former president of the ISHAA (Irish Society of Hearing Aid Audiologists).
“It is generally advised to talk to two or three hearing aid users regarding which supplier to choose.”
While digital hearing aid technology has come a long way in the past few years and has filtered down even into the cheapest hearing aids available today, dispensers say that the cost of providing the service itself adds considerably to the cost of buying a hearing aid, regardless of how cheap or expensive the hearing aid is.
A good audiologist, it is argued, needs to take time with the selection and fitting process, which includes testing, ear impressions, programming the aid, follow-up appointments and dealing with drop-ins when problems occur. There are more potential issues that they may have to deal with than for an optometrist dispensing a new set of glasses, in other words.