Time to act on an important report – Croakey Health Media


Introduction by Croakey: Disability rights advocates this week expressed shock and worry (see tweets at bottom of article) that Auslan’s performers were missing in COVID-19 update briefings from new NSW Prime Minister Dominic Perrottet.

Australian Human Rights Lawyers (ALHR) Express significant concern, stating that “press conferences regarding COVID-19 are a fundamental source of information for the public to know the latest news in an ever-changing environment”.

“Failure to provide this information in an accessible, real-time manner violates the human rights of people with disabilities and puts them at great risk,” he said, adding that he wrote to the prime minister on his behalf. express concerns.

On a more encouraging note for people living with hearing loss, a final report has been delivered to the federal government on a long-awaited review of the hearing services program, making important and welcome recommendations.

Federal government must now act urgently to provide better and more equitable hearing care in Australia, writes Dr Jessica Vitkovic, Acting CEO of Soundfair and prominent audiology researcher, in the post below.

Jessica Vitkovic writes:

Famously, there are two certainties in life – death and taxes – but as Australia’s population ages, for one in four of us hearing loss will soon be a certainty as well.

Therefore, as it shapes the delivery of hearing care in Australia, we should all pay attention to Hearing Services Program Review (HSP), and final report recently by its group of independent experts.

Established in its current form in 1997, the program has historically focused on the provision of hearing aids and aids.

But, while many Australians benefit significantly from HSP and hearing aid technology, our community tells us that, even at its best, this form of hearing care does not fully meet their needs.

As one member put it:

“No one told me about security. No one told me about the difficulties I would encounter in noisy environments. No one told me about how to strategize before socializing. No one told me about the embarrassment of having to say “Sorry, I’m sorry, can you repeat? Over and over and over again.

No one has told me about the social isolation that can arise after hearing loss. I received no advice on how to navigate my new normal, and I received no strategy for overcoming community challenges. “-Maxine.

It is clear from the research that hearing care is device-centric and paternalistic.

The funding model also encourages providers to focus their business models on high volumes of device equipment rather than the time needed to help customers use the device effectively or other services, including education. to communication or advice, limiting the provision of high quality services and meaningful results.

Simply put, currently the Australian government and taxpayers are not getting the maximum return on their investment.

Personal and economic costs

Enter the HSP exam. As the Review recognizes, hearing loss is an extremely personal experience that can have a significant impact on relationships, careers, friendships, and social connections.

It is above all an obstacle to communication. Thus, hearing loss is itself a social determinant of health in itself – influencing health outcomes in subtle and pervasive ways, reducing employment opportunities, creating barriers to access to care, or encouraging withdrawal. social.

There is also some evidence of a link between hearing loss and an increased risk of dementia.

However, the costs of hearing loss are more than personal and are borne by all of us.

The Hearing Care Industry Association, with assistance from Deloitte Access Economics, estimated the financial costs of hearing loss in fiscal year 2019-20 in Australia to be in the range of $ 20 billion, including:

  • health system costs of about $ 1 billion
  • productivity losses of $ 16.2 billion
  • informal care costs of $ 174.7 million
  • deadweight loss in tax and administration payments of $ 1.9 billion
  • other financial expenses of $ 683.4 million.

What should change?

So what does the review say that should change about the provision of HSP hearing care?

First, the review notes that the program has been operating for 20 years without clearly defined and measurable goals. It is important to note that the review suggests that the goals of the program are that eligible people with hearing loss:

  1. have equitable access to prescribed services which include hearing assessment and rehabilitation, hearing aids and other supports
  2. are able to make informed choice and have control over how to live with hearing loss
  3. are able to make an informed choice and have control over the selection of their service provider; and have clear and independent processes for resolving any complaints.

The devil is in the fine detail of if, and how, this will be implemented, but it is encouraging that the Journal explicitly recognizes that hearing aids and aids are just one of many treatment modalities for hearing loss. and calls for the integration of rehabilitation services into the provision of hearing care. It is interesting to note that the draft report recommended that rehabilitation services be independent of the fitting, but the recommendation of independence was not included in the final report.

Guided by co-design principles, with lived experience embedded in the development of service delivery, Soundfair’s position is that social and emotional supports are just as important as physical interventions for hearing care: people are more than ears and hearing loss requires more than just devices.

The Review’s recommendation to significantly expand the FSS eligibility criteria is also welcome.

In 2018-19, the National Aboriginal and Torres Strait Islander Health Survey reported data from a voluntary hearing test, which indicated that more than 43% of Aboriginal and Torres Strait Islander people aged seven and over had hearing loss in at least one ear at the time of the interview.

The review committee is to be applauded for the recommendation that the HSP be expanded to include all people who identify as Aboriginal and / or Torres Strait Islander, regardless of other eligibility criteria.

Likewise, the recommendation to extend eligibility to all low-income health card holders has the potential to transform the lives of many people, including those who have lost their jobs due to their loss. untreated hearing loss.

What should happen?

Just as good communication is a shared responsibility, transforming the delivery of hearing care to ensure it is fit for purpose, evidence-based, and person-centered, rather than device-centered, will take action. all areas: government, industry, clinicians and consumer groups.

Soundfair works for a just world – fulfilling, accessible, inclusive, respectful – for people with hearing disabilities. A just world encompasses not only the provision of Auslan interpreters, universal captioning, equitable access to hearing care, but much more.

Overall, the review is a welcome, thoughtful, and nuanced response to meet the needs of people with hearing loss. However, and as the authors themselves note, this is only the latest in a long line of comprehensive reviews and reports on the delivery of hearing care in Australia.

With the Hearing Health Roadmap, released in 2019, the federal government made a comprehensive commitment to improving the lives of the millions of Australians affected by hearing loss.

The roadmap calls for a seven-year implementation timeline, but we cannot afford to wait. The time has come to implement the Journal’s recommendations both to the letter and in its spirit of good service delivery.

On #Auslan via Twitter

Earlier this year, Croakey covered the launch of Soundfair’s HearMe Project report. You can read our story here:

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