Calls to increase funding for cochlear implants as hundreds wait for surgery

In May 2019, health reporter for Stuff, Hannah Martin, reported on the continued call for increased funding for cochlear implants for adults affected by a severe to profound hearing disability.

She wrote:

Working as a nurse in a busy mental health unit, Laura Williams needs to be able to hear what's going on around her at all times – something the profoundly deaf woman can do thanks to cochlear implants.  The 27-year-old is one of about 40 New Zealanders who receive a funded cochlear implant each year. 

A cochlear implant is a surgically implanted electronic device which restores hearing for those with profound hearing loss. 

Nearly 200 New Zealanders currently meet Ministry of Health criteria for cochlear implant surgery, but most will likely never hear again – unless the government increases funding, experts say. Neil Heslop, the general manager of the Southern Cochlear Implant Programme, said the number of people eligible for the funded procedure each year had not changed in more than five years. 

It was "now inadequate" and did not take into account increasing demand or wait times, he said.

The Southern Cochlear Implant Programme, one of two cochlear implant providers nationwide, looks after adult and paediatric patients south of Taupō. It receives five referrals for every funded adult cochlear implant. If things kept going at the current rate, there could be 500 adults waiting for an implant within four years, Heslop said. Heslop and SCIP were calling on the Health Minister to increase the annual number of adult procedures from 40 to 120 in Budget 2019, to address the most urgent cases.  Unlike other surgical procedures, cochlear implants are not covered by health insurance.  The devices and operation cost about $50,000. The speech processors need replacing every seven years, to the tune of about $10,000. 

"For adults, as well as children, cochlear implants restore hearing and completely change lives," Heslop said.

Williams was at kindergarten when someone first picked up she was struggling to hear.  She started using hearing aids at 4 years old. By 9, her hearing had deteriorated so much she needed a cochlear implant. She couldn't hear any high-frequency sounds – the sound 'S' makes, the chirping of birds and cicadas – and had speech difficulties and required a teacher aide at school. 

That all changed when her implant was "switched on". She didn't need help at school, started getting "really good grades" and, with therapy, her speech improved.  At the time the Ministry of Health only funded one implant for children, so Williams continued using a hearing aid in the other ear to ensure the nerve was still "active" if and when she needed a second implant.  That day came in 2015 when Williams was 22. 

She had already been working as a registered nurse for 18 months when her parents funded the second implant. Because she already had one, she wasn't funded for the second.  Having two implants meant Williams could now locate where sounds were coming from, something which was "really important" while working in an ICU or high-risk environment, she said.

"I couldn't do my job without them at all." 

The Ministry of Health funds cochlear implants for people with severe to profound hearing loss, where hearing aids prove ineffective for acquiring or maintaining the spoken language. For those who meet criteria, children under 19 are funded for bilateral (two) implants. Adults are funded for one. Minister of Health Dr David Clark told Stuff priority was given to those with the "greatest need and ability to benefit". 

Newborns and children were prioritised for cochlear implants because hearing was "critical to children's learning", he said.

Adults waited 24 months on average for funding. Adults whose need and potential benefit from an implant was greatest were prioritised, and would "receive an implant faster", he said. Clark said some funding had been reprioritised in the current financial year to provide an additional 24 implants, "but taking money from other services is not a long-term solution". 

In 2017/18, the previous government provided a one-off increase of $6.5 million for an extra 60 cochlear implants. This did not roll over to 2018/19. 

Currently, the Ministry of Health invests $8.43m per year to the Cochlear Implant Programme. The Ministry of Health was meeting with advocates to understand their concerns and was discussing options for a "sustainable answer to this unmet need", Clark said. 

To read the article online, please click here.