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LCQ13: Providing hearing aids for hearing impaired students

     Following is a question by the Hon Ip Wai-ming and a written reply by the Secretary for Education, Mr Michael Suen, in the Legislative Council today (December 8):


     Since 2005, the Education Bureau (EDB) has outsourced the service of distributing hearing aids to hearing impaired (HI) students in need and repairing those hearing aids.  In August this year, EDB allocated an additional funding of five million dollars to purchase one more hearing aid for each of the approximately 1,500 HI students in Hong Kong.  Yet, it has been reported earlier that since EDB has outsourced the aforesaid service, some students can only use specified models of hearing aids provided by the contractor of the outsourced service, and the parents of those students who have used such hearing aids complained that not only were the hearing aids ineffective in improving the various problems of hearing impairment of students, the inconsistency in quality (e.g. some hearing aids need to be repaired several times a month because they have broken down) has also affected the learning progress of the students.  In this connection, will the Government inform this Council:

(a) of the total number of students who had applied to EDB for the provision of hearing aids since 2005; the percentage of that number in the total number of HI students in Hong Kong at present; the increase in the number of students receiving such service each year; and of the distribution of classes attended by these students and the male-to-female ratio;

(b) whether EDB has a set of standard for the invitation of tenders for the outsourced service concerned; if so, of the details; if not, the reasons for that; whether the authorities have selected the supplier concerned by way of single tender; whether the condition of "the lowest bidder wins" was the only or major selection criterion in the tendering process;

(c) whether the authorities had conducted detailed examination for individual students when accepting their applications for this support service so as to assist them in getting suitable hearing aids; if so, of the details; if not, the reasons for that;

(d) whether the authorities compulsorily require that students can only choose the specified models of hearing aids under the aforesaid programme; whether the authorities have conducted professional tests on the hearing aids supplied by the supplier of the outsourced service to ensure quality, whether the authorities will provide students with one more hearing aids for substitution when the hearing aids of the students are in need of repair, so that their learning progress will not be affected during the replacement of hearing aids; if not, why the authorities do not provide HI students with a backup hearing aid; and

(e) whether the authorities have considered providing parents of HI students with more choices in purchasing hearing aids through other means, e.g. by ways of voucher or on accountable basis, when implementing this programme in the next few years?


(a) At present, there are 5,866 hearing impaired (HI) students with varying degrees of hearing loss in Hong Kong, of which 1,695 (about 30%) are assessed by audiologists to be in need of hearing aids. The remaining 4,171 HI students whose hearing loss is of mild degree do not need to wear hearing aids.  The Education Bureau (EDB) will arrange for all HI students (including those who do not need to wear hearing aids for the moment) to receive regular audiological reviews and provide audiological reports to schools to facilitate the provision of appropriate learning support for these students.

     The number of new cases provided with hearing aids, by class levels and by gender for each of the 2005/06 to 2009/10 school years, is shown in the Annex.

(b) EDB selects appropriate service providers for hearing aids provision through open tendering in accordance with the Government's guidelines on procurement procedures. Details of our requirements are stipulated in the tender document. For example, the hearing aids should include choices of In-the-ear, Behind-the-ear, Body-worn and Bone-conduction types; the hearing aids should be fully digital with appropriate powers catering for different degrees of hearing loss;  the adjustment of hearing aids should follow the international standard procedures and objective methods such as real ear measurement (measuring the actual acoustic performance of the hearing aid in the ear) and measurement of aided thresholds for evaluating the hearing aid performance should be adopted. As for related services, the service providers are required to provide unlimited number of reassessment and consultation, free maintenance and repair services with labour and parts inclusive, on-loan hearing aid service during repair period, and to provide appropriate service centres and service hours, etc. In addition, the audiologists should possess the qualification of a Master Degree in Audiology and have at least two years' relevant working experience. The service providers are required to procure necessary professional insurance and to accept the monitoring measures set by EDB. In the selection of tenderers, EDB will first ensure that the proposals have fully complied with all the requirements before considering the prices.

(c) Currently the Hospital Authority and the Department of Health provide hearing screening for newborn infants and primary one students. Children diagnosed with persistent hearing impairment are referred to EDB for further assessment and follow-up.  Upon receipt of the referrals, the professional staff of EDB will interview the children and their parents, provide assessment and counseling on the children's hearing and related issues, including the severity and nature of the hearing impairment, communication strategies, suggestions on rehabilitation and related support, etc.  For those who are in need of hearing aids to improve their hearing, upon obtaining parent consent, we will refer them to the outsourced service providers for hearing aid fitting and follow-up services. The audiologists of the service providers should, in accordance with the service contract signed with EDB, explain to the parents the technical features of the hearing aids that would suit their children's hearing conditions, such as the models, power and functions, etc., then fit the hearing aids for their children according to professional procedures, and provide consultation on the usage and effectiveness of the hearing aids.

(d) We have specified in the tender document that the service providers should provide hearing aids with different models and power for students with different degrees of hearing loss. Apart from providing one Body-worn type hearing aids and one Behind-the-ear type hearing aids suitable for students with any degree of hearing loss, the service providers are also required to provide In-the-ear hearing aids for students with mild to moderately severe hearing loss as an alternative. For students with severe to profound hearing loss, high power hearing aids should be provided. EDB's audiologists would evaluate the different models of hearing aids provided by the service providers to ensure that the hearing aids meet the requirements specified in the tender documents, and that the type and the acoustic performance of the hearing aids meet the diverse auditory needs of the HI students. When fitting the hearing aids, the service providers should follow EDB assigned fitting procedures, which include the requirements of real ear measurement and measurement of thresholds before and after hearing aid fitting to ensure that the target standard is achieved.

     The service providers are required to submit to EDB reports for each and every student provided with hearing aid fitting to ensure the service provider has supplied suitable hearing aids and for our monitoring of the effectiveness and quality of the service. EDB also keeps in close contact and have regular meetings with the service providers as well as conducts on-site inspections to monitor and evaluate the progress and quality of the services.  In addition, parents are invited to complete and return service questionnaires to EDB so that we can understand and monitor the quality of the service provided from the users' point of view. Since 2005, we have collected about 830 service questionnaires.  About 90% of the parents were "satisfied" or "very satisfied" with the service while 9.7% have rated "average".  For the very few who indicated "unsatisfied", the reasons were mainly related to the attitude of the service providers and their not being able to provide clear information to parents, etc. We have already taken follow up actions with the service providers and made improvements.

     When arranging HI students to receive outsourced services, we will advise parents that if they find the hearing aids not functioning effectively, they should bring their children back to the service providers for follow-up services. The service providers will re-assess the students' hearing and re-fit the hearing aids, and provide repair and maintenance of the hearing aids with labour and parts inclusive. Furthermore, the service providers are required to provide a hearing aid on-loan to the student concerned if the repair period takes more than one day.

(e) EDB has communicated with parent representatives on various occasions regarding the modes of provision of hearing aids and related services, including the issue of cash coupon to parents. From the professional perspective, we consider the current measure (i.e. procurement through bulk purchase by the Government for providing suitable hearing aids for HI students who have such a need) in the best interest of the HI students. Such practice saves parents' trouble in shopping around for hearing aids as well as enabling EDB to monitor the quality of the hearing aids and its related services more effectively.  In fact, EDB has been reviewing and enhancing from time to time the specifications of the hearing aids and the quality of its related services according to the needs of HI students and the development of hearing aid technology.  Moreover, parents generally do not have the professional knowledge to judge which hearing aids most suit the needs of their children.  They may easily be subject to the influence of other parents and service providers, and buy expensive hearing aids unnecessarily.   

     EDB will continue to keep in view the development and the supply of hearing aids in the market and consider further enhancing the specifications and choices of hearing aids. We will also continue to listen to the views of parents with an open mind.

Ends/Wednesday, December 8, 2010
Issued at HKT 14:22


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