Tuesday 28th July
The number of adults waiting for a cochlear implant is at a crisis level, with people dying without ever getting this life-changing technology, according to New Zealand’s two cochlear implant providers.
Southern Cochlear Implant Programme General Manager Neil Heslop says, “Demand exceeds capacity five-fold and has done so for years. There are hundreds waiting, with no prospect of ever receiving a cochlear implant unless government funding is increased.
“As they have lost their hearing through accident or illness, many do not consider themselves part of the Deaf community and rely on spoken language. Our patients are clinically depressed or suicidal, have high rates of anxiety, isolated in their homes, and unable to work or look after their children because they can’t hear or communicate.
“Your life has to completely fall apart before you are deemed eligible and then you still must wait. The technology is there but out of reach due to a lack of allocated funding.
“We play God, forced to choose between people with equally high needs. Do we fund the person depressed and suicidal, or the person blind as well as deaf? Do we fund the parent looking after a dependent child who they can’t hear, or the main income earner facing redundancy or lay-off?”
Just 40 adults nationally receive government funding for a cochlear implant every year. This base figure hasn’t changed for more than six years and is no longer meeting demand. Since 2003, 17 adults eligible for a cochlear implant have died while still on the waiting list.
Today, there are 230 eligible adults on the waiting list and by the end of the year, this number is expected to increase by 20 percent. Without an increase in government funding, the majority will never hear again unless they have $50,000 to pay for the procedure privately.
After several years of correspondence with Ministers and officials, SCIP and the Northern Cochlear Implant Programme (NCIP) were hopeful that funding would finally be increased in the 2019 and 2020 Wellbeing Budgets. Despite both allocating record levels of new funding for the disability sector, adult cochlear implants were not included.
“In late 2019 Associate Minister of Health Jenny Salesa met with patients, a surgeon and representatives from both programmes to discuss the funding crisis. Minister Salesa was very supportive and flagged a follow-up meeting in February 2020. This never eventuated,” Neil Heslop says.
Northern Cochlear Implant Trust Chairman, Andrew Nicoll says the Government’s inaction and continued underfunding is cruel and will continue to have a huge impact on the lives of vulnerable patients, often isolated by the nature of their disability.
“In the midst of the COVID-19 lockdown we heard messages from the Government about how to look after your mental health, due to the known negative impact isolation and loneliness can have on our wellbeing.
“For adults who live with a severe to profound hearing loss, this is their life every day. Hearing loss cuts them off from family, friends and work. It is no exaggeration to say that it can destroy lives. It’s isolating, frustrating and lonely,” says Andrew.
SCIP General Manager Neil Heslop says, “We appreciate that the COVID-19 crisis has resulted in unprecedented circumstances and additional pressures on the health system.
“However, how long do our patients – who are already at rock bottom – have to wait? The Government spends hundreds of millions of dollars on other elective services, but only $8 million a year on cochlear implant surgery.”
NCIP and SCIP are calling on the Government to provide an immediate and sustainable funding increase from 40 to 120 adult implants per annum, to address the most urgent cases. This equates to an additional $6.4 million per year.
New Zealand lags behind other OECD countries in terms of adult cochlear implant funding – including Brazil, Australia, the UK and Germany. In 2017, 547 Australian adults received cochlear implants. On a per-capita basis, this is more than twice the numbers funded in New Zealand. Furthermore, cochlear implants are guaranteed to Brazilians of all ages through the national health system.
The Pindrop Foundation, NCIP and SCIP have launched a petition calling on the Government to adopt a sustainable funding model that reflects demand. It currently has 3289 signatures.
THE FACTS ON COCHLEAR IMPLANTS
• A cochlear implant is a surgically-implanted electronic device that restores hearing for those with profound hearing loss.
• Just 40 adults nationally receive government funding for a cochlear implant every year. Today, there are 230 eligible adults on the waitlist, and with 200 new referrals each year, this number will increase significantly.
• The current lack of access means New Zealand is now in breach of its obligations under the UN Convention on the Rights of Persons with Disabilities (Article 25) .
• 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 increases in base-level funding since 2013.
• The previous government provided only a one-off increase of $6.5 million for an extra 60 adult cochlear implants in 2017/18 after a 26,000 signature petition was presented to Parliament.
• SCIP and NCIP are calling on the Government to provide an immediate funding increase from 40 to 120 implants for adults per annum, to address the most urgent cases. This equates to just $6.4 million per year.
• 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 Pindrop Foundation, Nothern Cochlear Implant Programme (NCIP) and the Southern Cochlear Implant Programme (SCIP)
• The Pindrop Foundation is a New Zealand charity supporting severely hearing-impaired adults into a hearing world through cochlear implant technology and services.
• 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.