Charles on… anything that comes along

This is likely going to fall under the category of “not very interesting to lots of poeple”, but it also falls into “health economics”, and that’s something which in one way or another will affect a lot of us, at some time. (Say, when you’re old and need a care bed..)

Through this blog I’ve come into contact with two fathers of deaf or deafened children (here’s one; the other’s not blogging it) who have had a single cochlear implant. But they’re interested in the possibilities of doubling it - because, some studies suggest, if you have two CIs, you’re better at localising the source of a sound, and distinguishing a sound amidst noise. (The folk at Addenbrookes tell me it’s mixed. But anyway.)

The fathers want to find the answer to the question: how do you persuade your Primary Care Trust (PCT) to OK the extra spending - about £68,000 once you include the cost of the implant and the surgery - involved in a second CI?

I’ve thought about this quite a lot. Here’s one argument you could try: if someone came into Accident & Emergency with two broken legs needing surgery, would you stop at mending one? Would you say “Sorry, it’s too expensive to mend both”?

That’s an OK argument - except it strays into the “mending things” line of argument. Deaf children aren’t broken. No, they’re not; they’re deaf. CIs give them “access to sound” (to use the charming phrase) but don’t stop them being deaf. Take off the CI to play on a slide or have a bath, and you don’t get any access to sound.

So here’s the long and short of it. Deaf children do get care - lots of care from all sorts of people: social workers, teaching assistants, disability living allowance, and so on.

Care is expensive. It costs.

So here’s the argument. You can justify a second CI if you can show the PCT that the cost of putting in the CI - and its associated care - is less than the cost of care for a child with a single CI through its life.

The second part should be fairly well known. Proving the first part is the hard one. There aren’t many studies on bilateral CIs around. But that is how you do it.

So - over to you, guys.

These posts might be related (the database thinks..):
• Two ears better than one, especially for cochlear implant makers (25 September 2006; score: 118.62%)
• I might watch through my fingers: cochlear implants live on the Net! (6 July 2007; score: 111.63%)
• My own call for papers - on cochlear implants (8 May 2006; score: 93.57%)