health & science

More New Zealanders living in silence

Since a one-off funding boost for cochlear implants ended in June the waiting list has grown to 198 with some people on the list for more than six years.

Currently only 40 implants are publicly funded for adults per year. The funding boost allowed an additional 60 implants of the device which electronically helps those with profound hearing loss.

According to a hearing specialist the waiting list only represents those whose hearing conditions are the “worst of the worst”. The number of people who would benefit from implants and don't even make it onto the list is far higher.

“I didn’t think I was depressed but I was in hindsight.”

Irvine Ward experienced noise-induced hearing loss through his job and wore hearing aids for 15 years before they stopped working for him. He spent three years on the waiting list before receiving an implant in February. Without the funding, he thinks he would still be waiting.

“It’s a whole new life now.”

With a cheeky chuckle Ward said he tells his wife the biggest change he has noticed since he received a cochlear implant is that she has finally stopped mumbling. Her response, according to him, is a raised eyebrow.

For the three years his world was silent Ward struggled to cope. Teaching himself lip-reading helped with one-on-one conversations, but group conversations were impossible.

“You can see when someone is blind or lame, but you can’t see when people are deaf. Although people can be quite understanding, they still revert back to their normal speech pattern and you end up sitting in the corner.”

Ward said he became withdrawn “and all the rest”. At the prompting of his wife he saw a doctor and was referred to a counsellor for depression.

“I didn’t think I was depressed but I was in hindsight.”

“I’ve got people on our list who have been there six and a half years. To be completely honest, they are no closer to getting an implant than they were when they went on the list.”

Part of Ward’s frustration was the uncertainty of the needs-based waiting list, where time on the list doesn't represent when you are likely to receive an implant. People with greatest need leapfrog over those already on the list. While he doesn’t disagree with the approach, with funding for just 40 adult implants per year there are many on the list who may never make it to the top.

It’s a waiting game with high-stakes. Not only are there practical and emotional impacts of not hearing, but the sooner someone receives a cochlear implant after losing their hearing the higher the likelihood is the implant will be effective in helping them hear.

The Hearing House provides services to the Northern Cochlear Implant Trust which has contracts with the Ministry of Health. Its adult cochlear implant programme manager Caroline Selvaratnam told Newsroom an average 100 people per year are added to a waiting list where only 40 will receive implants. The average waiting time according to a Ministry of Health spokesperson is 23 months but some wait a lot longer. 

“I’ve got people on our list who have been there six and a half years. To be completely honest, they are no closer to getting an implant than they were when they went on the list.”

The other option - to go private -  comes with strings attached said Selvaratnam.

“If you have a hip replacement done privately you can still access public services later on. With the public cochlear implant programme, it’s very different. If the person is not implanted within the public programme they can never access public services.”

An implant will initially cost between $50,000 to $60,000. This covers the operation, the device and rehabilitation which includes training people to decipher sounds they may not have heard for a long time, or at all.

After the first year, maintaining the implant costs around $400 per year. Every six to eight years the exterior part of the device is likely to need replacing. This costs around $10,000.

“It’s a huge ask for people to privately fund an implant when they know it’s not just now. If they are younger and they privately do it, they have to anticipate they are going to have enough money when they retire to actually fund equipment and appointments.”

Despite the implications of privately funding an implant, Selvaratnam said she’s seen an increase in those choosing to.

Some are people eligible for public funding, but so low on the list there is little chance they will get an implant unless funding increases.

The other group are those who don’t make the list.

“Eligibility for funding is not the same as suitability for an implant. If we were using worldwide recommended guidelines as far as fitting of a cochlear implant, we would be seeing substantially more people coming in to the public programme.”

The waiting list reflects just the “worst of the worst in terms of hearing and communication”, she said.

Young people are seeing their life needs to “fall apart” before they are eligible for public funding, and in order to stay in the workforce are choosing to pay for an implant themselves.

There are no statistics of the number of people who would benefit from implant, but who are not on the waiting list.

Almost 20 percent of New Zealanders are affected by hearing loss. A 2016 report by Deloitte estimated hearing loss costs New Zealand $4.9 billion that year, with $254.6m of the cost due to lost productivity.

The current funding for implants is $8.4m per year. This covers implants for children, where there is no waiting list as they are seen as high priority due to language development concerns as well as adults. The $6.5m one-off boost provided under the National government - which cleared 60 people off the adult waiting list - was not continued in the last Budget.

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