In May 2019, Health Central NZ featured the following news story about the state of cochlear implant funding for adults affected by a severe to profound hearing loss in New Zealand.
Nearly 200 New Zealand adults will never hear again unless Government funding for cochlear implants is increased, according to new figures released today by the Southern Cochlear Implant Programme (SCIP).
One of these people is Ricky McLeod (pictured in banner), who has been on the waiting list for a cochlear implant since 2015.
Ricky lives by himself in the small North Island community of Raetihi. His profound hearing loss makes it extremely difficult for him to communicate with others, impacting on his ability to find employment. This has led to a lack of confidence, which means Ricky spends most of his days in the safety of a secluded warehouse stripping cars for scrap metal; a place where he knows he won’t have to socialise.
He has limited contact with anyone, except one friend who helps him to communicate when needed. The resulting isolation has left Ricky feeling uncertain about what will happen to him in the future.
SCIP General Manager Neil Heslop says the Government currently funds cochlear implants for 40 adults nationally every year, but this base figure hasn’t changed for more than five years and is now inadequate.
“The Government needs to heed the fact that nearly 200 adults currently meet Ministry of Health criteria for surgery that will restore their hearing and change their lives.
“Without an increase in Government support the majority will never hear again – unless they have $50,000 to fund the procedure privately. What’s more, based on current referral rates there could be 500 adults waiting for a cochlear implant in as little as four years.
“It is soul-destroying for clinical staff, every day, to have to tell people who previously led full and productive lives that a small increased investment from government is the only barrier to regaining their hearing and previous quality of life.”
Cochlear implants for adults is often confused as an aged-care issue, adds Neil.
“It is actually a disability issue. Our adult patients have had severe to profound hearing loss for many years, and it is not the result of the normal ageing process. Sometimes there is a genetic cause, there may be a disease process, or it may happen suddenly for no known reason. It could happen to anyone at any point.”
A cochlear implant is a surgically-implanted electronic device that restores hearing for those with profound hearing loss.
Starting with this year’s Budget, SCIP is calling on Ministers to increase the annual number of adult surgeries from 40 to 120 to address the most urgent cases. The previous government provided 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.
“However, the increase was not rolled over in 2018/19 and this level of funding needed to be sustained in order to address increasing numbers and wait times,” says Neil.
“Today there are nearly 200 adults nationally who meet the Ministry of Health’s own guidelines for a cochlear implant. There is no prospect they will receive one without more, and sustainable, funding.
“Behind the numbers there are real people. Parents who can no longer hear their children’s voices, talented professionals who are now unemployed, and people who are isolated because they can’t communicate. Often they will present with clinical depression or anxiety, which leads to downstream social and economic effects on them and their family.
“We appreciate that there will always be unmet need in a public health system but for adults, as well as children, cochlear implants restore hearing and completely change lives. As health providers, we and our surgeons have an expectation that an increase in Disability Support Services funding can be delivered in the 2019 Budget.”
Neil is currently liaising with Minister of Health David Clark and Associate Minister of Health Julie Anne Genter on the issue.
Christchurch woman Nikki Cleine received a publicly-funded cochlear implant in 2011, after being profoundly deaf for nearly 10 years. She can now hear her children, work, socialise and participate in society.
“You take your damaged ears with you wherever you go,” says Nikki, who has three children.
“The day my cochlear implant was switched on was one of the best days of my life. I could hear my kids. I had never heard anything my three-year-old said, ever. I just felt so full of hope.”
A year after receiving her cochlear implant Nikki started working at SCIP as an adult rehabilitationist, supporting patients from initial assessment through to switch-on and subsequent follow-up.
“The most heart-breaking thing about working at SCIP is the waiting list,” says Nikki.
“It’s the fact that I know and have benefitted first hand from this surgery. I know what an impact it has had on my life, and what my life was like before and after.
“The waiting list is so long that more than 80 percent of people I meet at SCIP will not receive a government-funded implant. They leave here knowing there is something that can help them, but they can’t afford it.
“I was so lucky. But they won’t ever get it. And it happens every day, all the time. It’s heart-breaking.”
SCIP is one of two cochlear implant providers in New Zealand, caring for adult and paediatric patients south of Taupo. The Northern Cochlear Implant Programme (NCIP) cares for patients north of Taupo. NCIP’s Board and Chief Executive Lee Schoushkoff support the call for increased government funding.
SCIP receives five referrals for every funded adult cochlear implant. Unlike other surgical procedures, cochlear implants are not covered by health insurance. Only 20 percent of patients are in a position to self-fund.
Government funding for children is currently meeting demand.
Says Neil: “The adult waitlist is prioritised and not a queue. If people don’t achieve enough priority at the initial assessment then, in all likelihood, they won’t receive funding at all.”
The majority of SCIP’s adult patients were born with useful hearing. They started to lose their hearing in childhood or early adulthood – mostly slowly over time, sometimes suddenly.
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.
Patrick Dawes, President of the New Zealand Society of Otolaryngology, Head and Neck Surgery, backs SCIP’s position on the issue.
“There is an immediate need for funding to address the backlog, as well as the current annual expectation that there will be 200 new adults presenting each year with hearing loss that can only be addressed by a cochlear implant,” says Patrick, who wrote a letter to the Minster of Health David Clark on the issue earlier this year.
“The current funding paradigm condemns most adults to a future life without hearing.”
To read the article online, please click here.