Southern Cochlear Implant Programme chief executive Neil Heslop says, “We have been campaigning for years for a long-term, sustainable funding increase to meet the growing backlog and demand for adult cochlear implants.
“This hard work led to both major parties pledging at the General Election to increase year-on-year adult cochlear implant funding, to begin at the 2021 Budget. This was even in black in white, stipulated in Labour’s own health manifesto.
“These funds were clearly costed and there is no coalition partner to question this expenditure. Meanwhile, hundreds of profoundly deaf adults are waiting to have their hearing – and their lives – restored. With a cochlear implant, these people could contribute so much to society.
“The Government’s continued inaction doesn’t make any economic sense,” says Neil.
Cochlear implants are not covered by health insurance; either you are one of the 20 percent lucky enough to be funded, or you pay $50,000 to have the procedure privately.
“New Zealanders shouldn’t have to buy their hearing back,” says Northern Cochlear Implant Programme chief executive Lee Schoushkoff.
“Our recipients and those waiting include nurses, engineers, teachers, bankers, farmers, factory workers, business owners and retail workers – all qualified and talented people that were previously part of New Zealand’s productive workforce and some have been able to return and excel further.
“For many still on the waiting list, there is no prospect of ever receiving a cochlear implant, without an increase in funding. Their lives remain on hold,” said Lee.
“Terrible waste of human potential”
Dr Amanda Kvalsvig is an infectious disease epidemiologist working on the country’s Covid-19 response. She is also profoundly deaf and has a cochlear implant – without it, she could not do her job.
“Having people wait for a cochlear implant for years and years is a terrible waste of human potential. There are so many of us who have so much to give,” says Dr Kvalsvig.
Dr Kvalsvig is one of the lucky ones. Today’s Budget marks eight years without movement in the annual allocated funding for adult cochlear implants.
Just 40 adults nationally receive public funding for a cochlear implant every year, despite more than 220 eligible adults on the waiting list. By the end of the year, this number is expected to increase by a further 40 percent.
“I find it very distressing to think about other people now who are still waiting and missing out on all of the things they could be doing,” says Dr Kvalsvig, who is based in Wellington.
“I don’t think many people understand the impact of losing your hearing on your sense of belonging, your sense of purpose, even your sense of identity. It’s not just interactions with strangers of course – it’s your own family. I had no idea what my children’s voices sounded like.”
New Zealand’s current level of adult cochlear implant funding remains one of the lowest in the OECD.
The Word Health Organization is now calling on member states to integrate ear and hearing care interventions into national health plans, as part of its landmark World Report on Hearing, released in March.
Such was the initial concern by Government, in February the Minister of Health Andrew Little announced an immediate investment of $6 million for 70 additional adult cochlear implants this year. This was a one-off reallocation of funds.
In the same announcement, the Minister of Health also committed the Government to fulfill its pre-election pledge this term, which means investing an extra $28 million (over four years) toward adult cochlear implants. If implemented, an additional 80 adults each year would receive access to this life-changing technology.
“As medical professionals, we are well aware of the huge pressure on health funding in the face of so much need,” says Neil.
“However, we must keep asking for a level of annual cochlear implant funding that can at least keep up with the increase in demand. This is not only on behalf of those who personally benefit from restored hearing, but also given the wider social, community and economic return on government investment that these devices provide.”
A Deloitte report estimates the cost of hearing loss to the New Zealand economy in 2016 was $957.3 million – the majority (58 percent) of which was related to loss of productivity. Meanwhile, the World Health Organisation calculates that governments can expect a return of nearly US$16 for every US$1 invested in hearing care interventions.
THE FACTS ON COCHLEAR IMPLANTS
• A cochlear implant is a surgically implanted electronic device that restores hearing for those with profound hearing loss.
• Cochlear implants in New Zealand are not covered by health insurance.
• Five referrals are received for every funded adult cochlear implant, and only 20 percent of patients are in a position to self-fund.
• Most people on the waiting list were not born deaf – they lost their hearing as adults. The onset of total and permanent deafness can happen to anyone at any point.
• Hearing aids become ineffective when the hearing loss is more than severe. Communication through spoken language becomes impossible. A cochlear implant is the last and only viable treatment that will restore hearing.
• Public funding for adult cochlear implants in New Zealand first became available in 2003. However, this consisted of irregular, one-off surgeries (there was no set allocation).
• An initial permanent base level of 20 adult cochlear implants per year was implemented in 2007. This was increased in 2013, to the current allocation of 40 adult cochlear implants per year. There has been no further increase in base-level funding since 2013.
• A one-off increase of $6 million for an extra 70 adult cochlear implants was provided in February 2021.
• Based on current funding levels, New Zealand’s national cochlear implant programme represents just 0.04 percent of the entire health budget. Therefore, it is comparatively a very small spend for a significant impact.
• Government funding for children is currently meeting demand.
About the Southern Cochlear Implant Programme (SCIP) and the Northern Cochlear Implant Programme (NCIP):
• NCIP and SCIP are the only two cochlear implant providers in New Zealand. Both charities are funded by the Ministry of Health to provide public cochlear implant services to children and adults.
• NCIP cares for adult and paediatric patients north of Taupo, while SCIP cares for patients south of Taupo.
• NCIP and SCIP perform all cochlear implant assessments, arrange surgery, activate the cochlear implant, administer adjustments and provide post-implant rehabilitation services.
In Brazil, cochlear implants are guaranteed to people of all ages through the national health system. The UK has an uncapped funding model through the National Health Service and in 2017 more than twice the number of Australian adults who received government-funded cochlear implants than New Zealand (on a per capita basis).