A meeting of ear, nose and throat consultants was held in Ballsbridge, Dublin, in December 1995 to try to agree an approach to the wave of Army hearing compensation cases the consultants could see coming.

No agreement has been arrived at. As a consequence the State - the taxpayer - finds itself facing a bill of up to £330 million and quite possibly much more.

It is potentially the largest compensation bill ever to hit the Exchequer, exceeding in size the amount of money (£315 million) Charlie McCreevy allocated in this week's Budget towards reducing tax rates by 2 per cent.

Already more than 1,000 soldiers and former soldiers have received payments averaging £24,000. Many have received awards for levels of hearing loss which would not be recognised as deserving compensation in most other jurisdictions around the world. A further 9,000 cases are pending and 100 new claims are coming in a week.

A hearing test I had carried out during the week showed I had better-than-average hearing for my age, yet I would be awarded about £3,000 if I took a case for hearing loss and if the court accepted criteria being suggested by lawyers representing the soldiers.

The ENT specialists who met in Ballsbridge in 1995, and again in February 1996, considered whether they should agree on a system for assessing hearing damage. Most were in favour of the system used in the United States, the American Medical Association model. However, not everyone was.

There is a need for an agreed system so judges are not left trying to decide between conflicting interpretations by two medical experts of the same set of facts.

A hearing test, an audiogram, measures two variables, loudness (decibel level or dB) and pitch or tone (frequency in Hertz or Hz). The technique measures at which decibel level the patient first hears a sound of a particular pitch.

That is, at say 1,000 Hz, a person may first hear a sound at 0 dB or 10 dB or 30 dB. Zero dB is not no sound but rather the most quiet end of the range at which normal hearing first begins to detect sound. The normal range of hearing for healthy young people is between 0 dB and 25 dB.

An audiogram measures the decibel level at which sound is first heard for a number of frequency or pitch levels. For instance the AMA system tests the dB level at 500 Hz, 1,000 Hz, 2,000 Hz, and 3,000 Hz. The four scores are then added together and divided by four, giving an average.

Human hearing ranges from 20 Hz to 20,000 Hz. However, for the hearing of human speech the frequency range required is from 500 Hz to 2,000 Hz. Telephone lines, for example, do not carry sounds above 3,000 Hz yet are adequate for carrying human speech.

The soldiers are making claims for hearing damage suffered as a result of being exposed to the noise of guns and artillery. Audio grams produced from tests on many of the soldiers showed hearing loss at 4,000 Hz. In other words, their hearing was damaged in that it was not as good as it should have been when it came to hearing sounds of this frequency.

However, it is the view of many ENT specialists around the world that a hearing loss at 4,000 Hz would have little or no effect on the understanding of speech against a background of noise. That means it is not a disability or handicap.

The AMA system is a measure of the hearing handicap associated with a particular hearing loss. The AMA is used in Canada, Iran, Italy, Brazil, Denmark, Japan and Israel. The UK has its own systems.

IN MOST jurisdictions around the world, compensation is paid for hearing disability and not for simple hearing loss. In Ireland, however, claimants are being compensated for levels of hearing loss which would not be considered a disability when measured by the AMA.

Data have been collected on 649 of the claims made against the State. The age of this claimant population ranges from 26 to 84 years. Fifteen of the claimants are over 70. Analysis of the data shows that 80 per cent of the 649 claimants have no hearing disability or handicap (as against no hearing loss). Employing the test used by the British army, only 10 per cent of the claimants would qualify for compensation.

George Fennell is a retired ENT consultant who represents soldiers who have taken claims against the State. He was at the December 1995 meeting and is against the agreed use of the AMA system in Irish courts. He says it is not the job of medical consultants to make what he calls "legal assessments". A consultant should treat a claimant as a patient and make an assessment as to his condition.

"It is reasonable to say of the patient he has almost normal hearing or has hearing that is a little affected when in groups or listening to television." Mr Fennell says he is in favour of using "normal English" when describing the conditions of the soldiers, rather than definitions as laid out by systems such as the ASA.

The courts can then make an assessment of the evidence. Mr Fennell regards the Irish courts as among the best in the world. "The current system is just and reasonable." However, judges have found themselves confronted by two medical views and without recourse to any system which would help them decide which view is correct.

They are told that audiograms show a specific "hearing loss" but then hear argument from two consultants giving different interpretations of the audiogram results. It is their responsibility to treat each case on its own merits. Perhaps understandably, they tend to find on behalf of the soldiers.

Last week the Minister for Defence, Mr Smith, told the Dail that "as a matter of urgency", the Department of Health was preparing an Irish hearing handicap assessment system. A specialist group was being convened and "it is hoped that their report will be available early in the new year".

"I am advised that if it is accepted by the courts it may have a marked effect on the level of damages currently payable," he said.

Mr Smith did not explain why such a move was not thought of two years ago, about the time the consultants were meeting in Balls bridge. It could have saved his Department a lot of trouble, not to mention the Exchequer a lot of expense.

There is an Irish assessment system. It is used by the Department of Social Welfare for assessing hearing disability for the purposes of granting disability benefit. The threshold used is considered particularly harsh. A person has to score 50 dB (0 to 25 is normal) before they qualify.

If the test was used on the 649 cases held in above-mentioned data-base, only 27 of the soldiers would pass.