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2021 Federal Budget: our commentary

There’s nothing new or unexpected in this week’s Federal Government budget announcement. What’s there is welcomed but opportunities were missed.

A $5miillion hearing loss prevention public campaign is scheduled for late 2021. It will try to destigmatise hearing loss and encourage people to seek treatment.

The interface for audiology clinics with the Hearing Services Program – called the Online Portal – gets a necessary cash injection to enable a technical upgrade. The old system is in dire need of replacing. There is not a direct benefit to people who are customers of audiology clinics, but any improvement to the way businesses access the Hearing Services Program – and the resulting data that can be collected – will ultimately improve the service customers receive.

There were missed opportunities. We are disappointed that there was not an investment in hearing health services for older people and those who are vulnerable.

Significantly enhance hearing health for older Australians in aged care

Research has shown there is a very high prevalence of hearing and communication impairment in older people living in aged care facilities, more so than is found in the wider elderly population. In many cases hearing loss in aged care facilities is under-identified and unaddressed. Research has also shown that traditional models of service delivery are not meeting the needs of people living in aged care facilities. If the hearing needs of aged care residents were well supported it would make a significant difference to their quality of life. Therefore, a new approach is needed that will enhance the hearing health of older Australians in aged care.

The audiological management of residents in aged care facilities is more complex as the residents have other serious co-existing health conditions that complicate the hearing rehabilitation process. They are more likely to have more complex health conditions combined with hearing loss such as dementia, vision loss and physical impairments.

The staff in aged care facilities are often not well equipped with the skills to work effectively with people with hearing loss or to help them manage any technology they may have.

The physical environment in aged care facilities is problematic because of a lack of privacy, high reverberation levels and high levels of glare.  Similarly, the social environment is restricted with residents having few opportunities to talk, few people to talk with, and limited topics of conversation and reasons to talk.

The traditional approach of providing hearing tests and devices isn’t an appropriate model of care for residents in aged care facilities and leads to poor outcomes for clients.   A model that addresses the communication needs of the client, the upskilling of staff, improves the environment and provides ongoing support for clients through a volunteer program is more appropriate and effective.

Provide greater support for vulnerable Australians, including those on low incomes in accessing affordable hearing healthcare

There are several groups of vulnerable Australians who are unable to access the hearing health care they need.  Access to culturally appropriate and affordable hearing services could improve the person’s opportunities for further education, employment (paid or unpaid) or advancement within existing employment, community, and social engagement and improve their quality of life.

These groups include:

  1. People on low income

These people may be unemployed, in low-paid employment or self-funded retirees who do not have high levels of superannuation who do not qualify for government-funded hearing services (NDIS or Hearing Services Program).

  1. People in the criminal justice system

Research has shown the high prevalence of hearing loss among prisoners. The presence of hearing loss could impact the person’s ability to adequately hear in a courtroom and could impact negatively on daily interactions in prison, and on the person’s progress through a rehabilitation program.

While prison authorities have responsibility for the health and welfare of prisoners, there is limited understanding of the importance of screening for hearing loss, and the budget for health services is not usually sufficient to cover the cost of hearing devices.  Several government inquiries have recommended action to address the hearing needs of prisoners yet no progress has been made.

  1. People living in rural and remote areas

People living in rural and remote areas may need to travel significant distances in order to access hearing services.  While there is financial support to help with travel expenses for medical appointments, this funding does not extend to attending hearing services appointments. This may prevent people from accessing the services they need. Also, some people are unable to leave their local area due to family or work responsibilities or due to poor health.  There need to be more incentives for hearing services providers to deliver services in rural and remote areas and through telehealth services where appropriate.

  1. People from culturally and linguistically diverse backgrounds

People from culturally and linguistically diverse backgrounds may not have access to information on the hearing services available in their preferred language so they are unaware that the services exist, they may not feel comfortable in accessing hearing services for cultural reasons or they may need assistance in paying for interpreter services in order to access hearing services.

  1. Aboriginal and Torres Strait Islander peoples

The level of hearing loss in Aboriginal and Torres Strait Islander people, particularly children is well documented.  Culturally appropriate, affordable hearing services need to be available in locations where Aboriginal and Torres Strait Islander people are able to access them.