23 August 2018

Australia’s Hearing Health & Wellbeing

The Federal Government recently published its long-awaited
response to a report on a Parliamentary inquiry into the Hearing
Health & Wellbeing of Australia.

That original report recommended 22 actions that would improve

the lives of millions of Australians who live with hearing health
issues, and people whose first language is Australian Sign
Language.

The Government’s response was to support only one of the 22

recommendations. Yet it is more common than asthma, heart
disease, cancer and diabetes.

Read the reactions from the hearing health sector.

“The Government Response is concerning.”
“Why doesn't hearing matter to the government?”
“I am gutted. This is truly a pathetic response from our
government.”

How hearing tests can help guard against dementia

Ear Science Institute Australia in Perth has found that there is a
clear link between hearing loss and cognitive loss. Addressing
hearing loss allows patients to stay in the social mainstream and
is especially effective in patients in their 50s or 60s.

Hearing loss embarrassment

Gael Hannon writes about her top personal hearing-related,
crazy-making thing - starting to talk and being told to SHHH!
because someone else is already talking.
“It’s called ‘talking over’ someone. I can tell you that people
with hearing loss frequently do it.”

Deafness Forum acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and
community. We pay our respects to them and their cultures, and to elders both past and present. We acknowledge the challenge for Indigenous
leaders and families to overcome the unacceptably high levels of ear health issues among first Australians.
Listen up: how hearing tests can help guard against dementia
By Victoria Laurie, The Australian

John and Jean at Subiaco. Picture: Colin Murty

Hearing loss and the social isolation it causes can hasten the onset of dementia, but treating
hearing loss can help prevent or delay its onset.

Research into patients suffering hearing loss at the not-for-profit Ear Science Institute Australia in
Perth has found that patients benefit in other ways by restoring their hearing. Institute head and
cochlear implant surgeon Marcus Atlas says there is a clear link between hearing loss and
cognitive loss. Addressing hearing loss allows patients to stay in the social mainstream and is
especially effective in patients in their 50s or 60s. “We were interested to see if we provide a
cochlear implant or hearing aid, will it lead to a different outcome? We think it does,” he said.

Similar findings in the medical journal The Lancet identify more than a third of dementia cases
that theoretically could be prevented if risk factors, including hearing loss, are addressed early
enough. The Lancet study found social isolation aligned with peripheral hearing loss was a critical
factor in cognitive decline. Even mild cases could raise the risk of dementia.

“It’s exciting for us because we’ve spent the last five years trying to understand the link between
cognitive loss and hearing loss,” Professor Atlas said. “We began work with mild to moderate -
patients. The finding that dementia is linked to hearing loss is new, and we contributed to that
work.”

Cochlear recipient John Holsgrove said when he realised his hearing was deteriorating, he knew it
could also increase the risk of dementia. With several close relatives with Alzheimer’s disease, “it
wasn’t my main reason for getting a cochlear implant, but it was certainly a consideration that it
would lessen the risk,” he said. The 65-year-old psychologist’s hearing began failing in 2009 and
by 2014 he realised he could no longer hear his patients well enough to do his job: “Losing my
career was one thing, but the total isolation was a much bigger issue.”
We need to improve communication access for the elderly
As a community, we must do better to acknowledge communication disability and the impacts it
has on quality of life and take action to improve the situation, writes Gaenor Dixon.

Jane (not her real name) is 86-years-old and over the last few years her hearing and speech have
significantly deteriorated. She lives in a Melbourne aged care facility where most of the other
residents are deaf or near-deaf, which makes conversation difficult. To complicate matters
further, Jane has trouble speaking clearly and loudly, which makes it near impossible for her to
talk to other residents unassisted.

It wasn’t until a speech pathologist fitted Jane with a speech amplifier that Jane was finally able to
have a conversation with her friend, a woman with a hearing impairment she had been sitting
next to in the dining room for years.

Jane’s story is not uncommon. In Australia, 95 per cent of people living in residential aged care
have at least one communication impairment, which often results in social isolation, loneliness and
a poorer quality of life.

For most residents, a communication disability is usually accompanied by or the result of

conditions such as dementia or Parkinson’s disease. For instance, 50 per cent of people with
dementia experience communication difficulties, as do 85 per cent of those with Parkinson’s
disease.

On the surface, overcoming these problems appears insurmountable. And while there may not be
a cure for either condition, enhancing people’s quality of life by giving them back their ability to
communicate is something that can be done relatively easily, and with great rewards.

Speech pathologists are trained to help people communicate. And to correct a common
misunderstanding, they don’t just work with people who have problems speaking. Speech
pathologists are skilled in helping people who have difficulties with speaking, listening, hearing,
understanding, reading, writing and using their voice and body language in a range of social
situations.

In the context of residential aged care, speech pathologists can help residents directly by giving
them strategies and advice on using devices, such as hearing aids, to facilitate easier
communication.

They can also train staff to simplify what they’re saying and give staff tips on how to position
themselves so that hard-of hearing residents can see them more easily and use objects to help
support comprehension for people with dementia, such as holding up a tea cup when asking a
resident if they want a cup of tea.
As a community, we must do better to acknowledge communication disability and the impacts it
has on the quality of life. Often, it seems that because a communication disability is not as
visible, it’s less worthy of our attention.

The reality is, being able to communicate is a fundamental human right. People in aged care are
already facing significant health battles, many of which are incurable. Let’s make sure we focus
on improving the one thing we can support and give them back some joy in being able to
communicate and socialise with others.

The author of this article is Gaenor Dixon, national president of Speech Pathology Australia.

The opening of an Adelaide playground specifically tailored for children with disabilities is being
hailed as a milestone for social inclusion.

The facility at Park Holme in the city's south-west has been custom-designed to allow children
with special needs to play equally alongside others. The inclusive playground features specialist
equipment and sensory areas for children with mobility needs, vision and hearing impairments and
autism, and has now officially opened after more than two years in the pipeline.

The foundation's executive officer Bec Ho said "This is a place for everyone, it's a place where
everyone is accepted, invited, included. It should just be the way that we do things everywhere
in our society, so this is just a beautiful example of when communities, government, corporations
come together and create something really amazing."

By Candice Prosser for ABC News

http://www.abc.net.au/news/2018-08-10/playground-for-children-with-disabilities-opens-in-adelaide/10106980
Hearing loss embarrassment: talking over other people
By Gael Hannan

If you were to ask a person what bothers them the most about their hearing loss, be prepared to
hear a long list, starting with not being able to hear very well. But there are many more,
including these:
• The eternal need to say pardon or would you repeat that, please?
• Having people reply “oh never mind” when you do
• Not being able to follow the conversation
• Being forced into Bluff Mode – pretending to understand what’s being said
• Being caught at Bluffing
• Taking care of hearing aids, including remembering to take them off before showering
• Having to buy hearing aids in the first place, instead of buying that new car or paying off
your credit card
• Plus 93 other irritating, inconvenient and unavoidable aspects of hearing loss!

Included in my personal Top 100 list of hearing-related, crazy-making things is a situation that still
has the power to make me blush: starting to talk and being told to SHHH! – sometimes subtly,
sometimes not – because someone else is already talking.

This is called ‘talking over’ someone. I know that hearing people sometimes do this (the internet
has a lot to say about rude people talking over other people), but I can tell you that people with
hearing loss frequently do it. We’re not rude; we simply don’t hear that another person is already
talking. There might be background noise or several conversations happening at once, but
whatever the reason, we just don’t hear that someone else has the floor. So we jump in, often
loudly, with whatever we want to say.

When this happens – in my world – another person will hold up a finger to me and point to the
person talking. I suppose this is the best way, silent and relatively discreet because not everyone
will see that finger (you hope). Or, someone will look at me, shake their head slightly and say (at
what seems to be a thundering volume, but probably isn’t), “Hang on, Gael, Bob is talking.” This
is a nice but still embarrassing way of saying “Shut up, talk-hog, it’s not your turn.”

Occasionally – and this is worse with people you’re not related to by blood or close friendship –
you jump in and talk over someone, but are politely allowed to finish your bit. Only then do they
say something to the effect of, “That’s nice, Gael, but Bob was already speaking.” That’s when I
mutter “Oh. Sorry, Bob.” That’s when I consider leaving the conversation, the room, the building
and catching a train to a town populated entirely by hard of hearing people. If I can’t find one,
I’d start a community with a hearing loss-only population.

The only way to prevent ‘talking over’ is to make completely sure no one in your conversation
group is already talking; then it’s fair game who gets to speak next. But in reality, by the time
you see that the field is clear, someone else has already jumped into the silence. This is why
many people with hearing loss simply don’t join the conversation; they stay silent because they
don’t want to risk “talking over”.

It helps to understand that everyone does this from time to time. While you still might squirm
silently when it happens, it helps to have a little confidence and learn to say, “Oh, sorry Bob, I
didn’t hear you. What were you saying?” Then you listen with interest until it’s your turn.

https://hearinghealthmatters.org/betterhearingconsumer/2018/hearing-loss-embarrassment-12-talking-over-other-people/

Griffin Theatre in Sydney presents the new Australian play, The Almighty Sometimes.

Anna has been medicated for a range of mood and behavioural disorders for as long as she can
remember. Now she wants to know what life would be like without pills and prescriptions. More
fulfilling? More exciting? More real?

There will be a captioned performance of The Almighty Sometimes on Tuesday 28 August, 7pm at
the SBW Stables Theatre in Kings Cross.

We have three complimentary double passes to this captioned performance to give away. The
winners will be first three readers to email to hello@deafnessforum.org.au the correct answer to
this question – who is the play’s Sound Designer & Composer?

There’s information about the play at https://griffintheatre.com.au/whats-on/the-almighty-

sometimes/
National Disability Insurance Scheme: Parent Consultation
Workshop

A group of parents from across the country met in Melbourne this week to provide feedback to the
National Disability Insurance Agency, the organisation that runs the NDIS, regarding the proposed
improvements to the pathway from diagnosis to the NDIS for children under 6 years of age who
are deaf or hard of hearing.

There was a lot of constructive discussion and ideas with some consistent feedback on where
there needed to be greater support for families to navigate the system.

The need for balanced information about all options and assistance to make important decisions
independent of service providers was a consistent theme throughout the day. The parents
thanked the NDIA for the opportunity to participate in this consultation and hope the discussions
will further inform the review of the pathway in a way that benefits young children and their
families.

Brain Injury Australia and its partners – Metro South Health, Brisbane’s Princess Alexandra
Hospital’s Division of Rehabilitation and Brain Injury Rehabilitation Service – invite you to submit a
presentation proposal to Brain Injury Australia’s 6th National Brain Injury Conference, to be held
in the Hospital's Russell Strong Auditorium on the 13th and 14th November, 2018.
What this Government thinks about the Hearing Health &
Wellbeing of Australia
The Government has published its long-awaited response to a report on a Parliamentary inquiry in
2017 into the Hearing Health & Wellbeing of Australia.

The original report, called Still Waiting to be Heard, recommended 22 actions that would improve
the lives of millions of Australians who live with hearing health issues, people whose first language
is Australian Sign Language, and their families.

It took 11 months for the Government to announce this month that it would support only one of
the 22 recommendations made in the Parliamentary inquiry report – an inquiry that the
Government had itself commissioned.

Organisations in the hearing health sector have been meeting this week to talk about this negative
response by the Government.

Opinions from within the hearing health sector

Audiometry Nurses Association of Australia
The Audiometry Nurses Association of Australia found this response to the Inquiry into Hearing
Health & Wellbeing to be overall “disappointing”.

After several investigations into hearing health services, programs have been on the decline and
many cut completely.

There has been no succession planning for training & employment of Audiometry Nurses to
provide hearing services in secondary hearing clinics in community health over the last 10 years or
more.
Audiometry Nurses are highly trained registered nurses with a specialty in audiometry nursing who
work with children & adults in a multidisciplinary team.

We have seen a decline in hearing services to Indigenous & Vulnerable families in the community
with reduced services also in Aboriginal Medical Services in local health districts. Access to Ear
Nose & Throat specialists and ENT clinics in Public hospitals is extremely difficult for families who
can’t afford to pay.

There is a greater need for service today with a reduced workforce delivering it!

We have concerns that on the Supplementary report some of the “current government actions”
aren’t really taking place? We would encourage government to clarify these services provided
with consultation at the grass roots level to see what is actually being delivered.

Overall, we would like government to have clear actions and transparency when decision making
regarding service delivery, succession planning & building stronger foundations to provide
essential hearing services to the community.

As a small specialty nursing group, which has a huge impact on services, we would like to be
consulted when decision making occurs which impacts on our professional capacity in providing
hearing services in the community.

Australasian Newborn Hearing Screening Committee

Recommendation 18 of the “Still Waiting to be Heard” report was that “…states and territories be
required to report against the ‘National Performance Indicators to Support Neonatal Hearing
Screening in Australia’, and that the Standing Committee on Screening coordinates the monitoring
and reporting in this area.”

Given the very considerable work that went into developing the National Performance Indicators,
it remains a matter of grave concern to the Australasian Newborn Hearing Screening Committee
(ANHSC) that there is apparently still no national plan for putting those standards and
performance indicators into action.

The Government’s response of supporting Recommendation 18 “in principle" is acknowledged

(and welcomed) but, sadly, it remains the case that there is no clear indication of any plan of
action to ensure that such reporting occurs nationally.

The Government’s response noted that “States and Territories have primary responsibility to
action this recommendation”. This adds nothing new to the understanding of the current
situation. Indeed, it was because of a lack of coordinated action at any level—State or Federal—
that the ANHSC drew this issue to the attention of the Inquiry in the first place.
As was the case before the Inquiry, there is still no national requirement for jurisdictions to report
against performance indicators and, it would seem, there will still be no national plan in regard to
the collection or management of data in regard to newborn hearing screening as a consequence
of the recommendation in the report.

The expression of these concerns by the ANHSC in no way implies that there is currently any
failure or inherent problem in any of the jurisdictional screening programs. However, the fact
remains that there is no systematic process by which the quality or outcomes of those programs
can be reported relative to national quality and performance indicators and no national collection
or reporting of data.

According to the literature and the experience of such programs internationally, there is a clear
need for systematic monitoring of the outcomes of UNHS programs to ensure that all the aims of
such programs are being met.

Australian Sign Language Interpreters' Association

ASLIA's position is that there is very little commitment towards Deaf people who are Auslan users.
We currently have a dire situation with supply vs demand for Auslan/English interpreters.

This, we understand is outside the scope of what has been discussed to date but it is a major
issue that we would like to raise. This includes procedural and structural issues (education of
interpreters and Auslan courses) across the country that seems to "fall on deaf ears".

Better Hearing Australia

Almost a year after the Standing Committee on Health, Aged Care and Sport released its report,
‘Still Waiting to be Heard’ and we are still waiting to be heard.

The Federal Government has committed to the development of a Hearing Health Roadmap and
yet supports only one of the 22 recommendations made in the Still Waiting to be Heard Report.
While the roadmap is welcomed as a vehicle for advancing hearing health in Australia, the
destination, it now seems, is uncertain.

Better Hearing Australia (BHA) fully supports all 22 recommendations put forward by the Standing
Committee and also seeks to highlight the role that psychological and rehabilitative hearing
services can play in improving hearing health and wellbeing, particularly in equipping people with
the ability to effectively utilise a hearing device.

Reorienting the current device-centric paradigm that exists in Australia to an outcomes-based

model incorporating a multidisciplinary approach to rehabilitation in treatment and care is vital.
There is a clear need for evidence-based approaches that invest in rehabilitation and ensure
accountability for service outcomes.
BHA commends the Government’s support of the recommendation to develop a national strategy
to improve hearing health in Aboriginal and Torres Strait Islander Communities and understands
this work is already progressing.

BHA urges the Government to include the remaining 21 recommendations in the Hearing Health
Roadmap and ensure the one in six Australians experiencing hearing loss or a balance disorder are
not left at the side of the road.

CICADA Australia
CICADA Australia is a registered charity and volunteer organisation helping hearing impaired
Australians find a tailor-made hearing solution for them.

Recommendation 2:
Regarding Regional (and not necessarily Remote) access to hearing services, even in Dubbo NSW,
there is a group of local people and health care workers who started their own service “Hear Our
Hearts” due to the severe lack of available appointments for paediatric ENT services. They
fundraise and rely on volunteer help to get services to kids in need.

Recommendation 5:
There is still a lack of consistent provision for the elderly in aged care, who must rely on staff to
put their hearing aid or sound processor (for cochlear implants) on every day and to make sure it
is working.

Though each aged care centre is supposed to actively ensure that “care recipients’ sensory losses
are identified and managed effectively” it is usually up to family to ensure that nursing staff know
how to manage hearing aids/sound processors and to make sure that the device is working and is
put on every day. Staff do NOT have much understanding about hearing loss and there is often a
bare minimum of caring staff to cover the basic care needs, so any extra considerations around
sensory loss are not attended to adequately.

If there are no family members to drive this message home, the client with hearing loss (and
especially if they are physically unable to manage their own hearing device), is left isolated,
deprived of basic communication.

Recommendation 6:
Though it is important to educate people about noise related hearing loss and safe work practices,
there is still much that could be done to educate the general public about hearing loss and the
challenges faced by the deaf in our society. CICADA AUSTRALIA Inc put together a document
titled “Guide to Hearing Loss” which has been available on our website. This document was
designed to provide information for the general public to inform them about hearing loss generally
and the various hearing devices available. This document is currently being updated.
Recommendation 11:
Many Australians who are NOT unemployed or on low incomes struggle to pay for the parts,
batteries and repairs to their hearing devices which are necessary to stay employed! NDIS is
starting to cover these costs but there is no guarantee that the NDIS will cover the cost of
replacement hearing aids or sound processors when upgrade devices become available. NDIS
needs specialist Planners that fully understand hearing loss, so they can make appropriate
recommendations for funding

Recommendation 19:
While the NSW Education department has announced that AUSLAN will be included in the schools
curriculum, there is a shortage of AUSLAN interpreters who actually have teaching qualifications
and therefore are not permitted to teach this language in schools. It would be good to see
AUSLAN included as a language in more schools across Australia to increase awareness of the
language and increase numbers of people who can use it. AUSLAN is increasingly used for
children with disabilities other than hearing loss as a preferred way of communication, so it is
important that it is promoted and practised as widely as possible.

Deafness Council WA
There is very little real commitment to any of the recommendations. In particular;
− Despite this comment we are pleased to see the support for recommendation 1.
− The response to recommendation 5 is disappointing. The provision of support to residents
of aged care facilities is in desperate need of attention. There is little understanding by
staff in these facilities of the hearing issues facing their hearing impaired residents and little
or no co-ordination of services. Rather than supporting in principle the recommendation
their needs to be a commitment to commencing the review immediately.
− With recommendation 12 whilst it is pleasing to see that the Government has asked Health
to review the HSP to determine the best possible options to ensure clients receive the best
clinical service we must ask how long will this take? We have been asking for action on
this issue for at least two years and little, other than Australian Hearing no longer charging
commissions, has been done by government to address this issue.
− The response to Recommendations 14 & 15 is not acceptable. The recommendations, if
adopted, will ensure the best way forward for providing support to the early identification
and treatment of children diagnosed with a hearing impairment. The actions outlined in
the response will not.

Deafness Forum of Australia

Hearing loss is the second most common health condition experienced by Australians. It is more
common than asthma, heart disease, cancer and diabetes.

One in six Australians is impacted by hearing loss. This figure is rapidly rising, yet our national
and state responses are uncoordinated, and many Australians are not getting the hearing health
care and support they need.
We urgently need a coordinated national action plan to address the enormous costs to the health
and disability service systems throughout the country, as well as costs to the economy and to
individuals and families dealing with the consequences of hearing loss.

We are disappointed that the Government opposes the making of Hearing Health & Wellbeing a
National Health Priority Area (Recommendation 22). It has ignored the enormous health and
disability burden and lost productivity that such an approach can address. The Government has
overlooked the empowerment it would give to the community sector to rally its significant
volunteer workforces within a common national strategy. It has overlooked the opportunity it
would provide to generate conversations with all parts of government at all levels, and with
businesses to address issues in education, employment, transport and other services that prevent
people with hearing loss and those whose first language in Auslan from participating fully in the
life of the nation.

The Government merely ‘noted’ Recommendation 6: Public Education and Raising Awareness and
stated that “public health campaigns are primarily the responsibility of state and territory
governments”. Funding of an ongoing comprehensive multi-media campaign to raise awareness
of hearing loss and its consequences is as much a Commonwealth as a state responsibility and is
long over-due.

The sub-recommendation that such a campaign “include messaging aimed at destigmatising

hearing loss and educating the public on the challenges faced by deaf and hearing impaired
Australians” was not even commented on by the Government. Sadly, such stigmatisation is quite
common and has serious health implications - for example, creating anxiety and withdrawal into
social isolation. It is also quite a common reason for people refusing hearing devices.
Stigmatisation has other serious non-health related consequences. For example, all too often deaf
and hearing impaired people are reluctant to apply for jobs where they could make a real
contribution with some minor modification in the workplace or procedures.

Regarding the Recommendation 5 about education of aged care facility staff, Deafness Forum
welcomes the Government’s emphasis on the need for education and training of aged care staff to
assist care recipients with hearing loss. But this will need to be backed by stringent assessment of
hearing assistance provided by aged care services.

The Government points to the requirement for Commonwealth-subsidised residential aged care
providers to meet Accreditation Standard 2.16 with respect to management of sensory loss and
states that the Quality Agency “assesses and monitors the performance of residential aged care
services against these quality Standards”.

However, there is still widespread under-recognition and under-management of hearing loss in

aged care. Deafness Forum recognised that this situation reflected a general lack of awareness
and training for staff at all levels in aged care (and hospitals). It now offers a comprehensive
range of free hearing assistance education and training resources at
www.deafnessforum.org.au/resources/training-resources-in-hearing-assistance-in-aged-care-services-and-hospitals/
What else are we doing about it? Deafness Forum will advocate for inclusion of hearing
assistance requirements in the new VET national training packages as it did successfully in the
2014-15 review of the relevant current qualifications. The national requirements for these
qualifications are linked to the education and training resources created and provided free by
Deafness Forum on its website.

A new set of accreditation standards is expected to be effective from mid-2019. The

Government’s response states “The new standards will focus on quality outcomes for consumers
rather than provider processes”. Deafness Forum supports the intent but asserts that quality
outcomes for hearing impaired consumers will come only from effective and systematic provision
of hearing assistance. This will not result in additional work for care staff but will benefit both
staff and those they care for through easier and mutually more satisfactory communication.

The Government’s response includes a statement that “aged care providers can also... provide
assistance with maintaining hearing aids (including training for staff). However, these services are
offered at the discretion of the provider and may attract additional fees.” This position is strongly
opposed by Deafness Forum as basic trouble shooting of hearing aids should be expected of
trained aged care staff and service or repair of hearing devices should be referred to a hearing
services provider.

Deafness Forum individual members

• I am gutted. This is truly a pathetic response from our government.
• My gosh that’s disgusting!!! Time to vote ‘em out and get real people who will listen!
• Why doesn't hearing matter to the government?
• Dear Federal Government, regarding only supporting the one recommendation aimed at
supporting ATSI communities and ear health. What about the rest of Australia - a huge
percentage of the population has been completely dismissed as being important? Australia
deserves better.
• Just proves they have a problem hearing and reading the important issues of this country.

First Voice group of early intervention services

We are disappointed that only one of the 22 recommendations was supported.

We are hopeful that the ten recommendations 'noted' will ensure a commitment by government to
these recommendations being appropriately measured and prioritised.

We acknowledge that the Government does not support Recommendation 22, that hearing health
is made a National Health Priority Area; it is our hope that an integrated approach to chronic
health conditions can lead to improvements in hearing health for all Australians and not detract
from establishing a co-ordinated national approach to awareness, prevention, and treatment for
people with hearing loss.
Hearing Care Industry Association
HCIA made a number of suggestions to improve hearing services in Australia which include:
• Improving eligibility, particularly for low income people of working age to keep them
engaged and contributing to national productivity
• Funding awareness and prevention measures specifically aimed at young people; and
• Implementing a national screening program for all Australians over the age of 50.

HCIA will continue to pursue these and other opportunities through its participation on the
Government’s newly established Hearing Sector Committee, charged with developing the first ever
Hearing Health Roadmap for Australia – a work program for government that gives hearing health
greater priority.

HCIA is also pleased that Ministers Wyatt and Hunt recently placed Hearing Health on the COAG
Health Minister’s agenda and workplan, and announced new measures to improve the hearing
health of indigenous Australians.

Independent Audiologists’ Association

IAA, amongst other things, supports regulation of the profession of audiology under AHPRA. As
an association, and also some of our members representing their own clinics, called for mandatory
registration during the inquiry into hearing health and wellbeing. We also called for more
resources to be allocated to services, not just devices. We were pleased that regulation was
included in the 22 recommendations of the Still Waiting to be Heard report, which we felt were all
valid but we were also aware of additional issues that could have been incorporated – in particular
the need for rehabilitation beyond hearing devices. We were not surprised that the response from
Federal government does not include acting on regulation because under the current structure,
that is a decision for state governments. Of great concern to us, however, is that the justification
for Federal government not to support regulation contains inaccuracies and misunderstandings
which create a false impression that could skew future decisions by state governments and others
on the issue of regulation.

IAA is disappointed and very surprised that 21/22 recommendations can be dismissed with vague
and undefined explanations of “noted” and “support in principle”.

SHHH Australia (Self Help for Hard of Hearing People)

SHHH Australia commends the Government’s response to Recommendation 1 that focusses on
improving the hearing health of Aboriginal and Torres Strait Islanders which is well recognised as
in need of urgent, well-integrated and sufficiently resourced attention.

However, disappointingly this is the ONLY Recommendation of the 22 that is fully supported!
Others which have been ear-marked as needing to be addressed by state and territory
governments and/or classified as “Noted”, “Supported in Principle” or “Not Supported” are part of
a very weak and non-committal overall Government response. The entire report reflects little or
no clear Government commitment to address, act on or provide direction to most of the issues
raised during the inquiry in spite of the wealth of evidence presented as to the need for action in
so many areas of hearing health care.

Recommendation 5: Education of aged care facility staff. Government response: “Supported in

Principle”
The Government Response is concerning. Hearing loss is often associated with the process of
aging and where an increasing percentage of the Australian population is represented. Whilst the
Response “supports in principle” an OHS review of the need for better management & education
to support seniors with hearing loss & other sensory losses, and although Aged Quality Standards
towards achieving quality outcomes may well be in place, the Response provides little direction to
address current issues or improve current practices. It reflects a very broad brush approach to
ensuring that the hearing health base in this sector is covered. It is well documented that there is
a high turnover of staff in many aged care facilities and there are often low staff to resident ratios.
Stories abound of care provider staff who fail to take into consideration some of the overlapping
issues affecting the elderly such as cognitive decline, reduced auditory processing & dexterity to
manage hearing devices in their interactions with those who are hearing impaired. Vocational
training for hearing loss needs to be quite specific and it would be hoped that it not be a one size
fits all approach. People’s lives and their ability to communicate with their carers and loved ones
depend on it.

Recommendation 6: Public Education and Raising Awareness. Government Response: “Noted”

The Government Response regarding the implementation of education and awareness campaigns
“in consultation with states and territories & key stakeholder groups” has been “Noted” and is
clearly passing the buck, yet again! A similar recommendation was raised and supposedly acted
upon in 2010 and 2011 re awareness raising around the
management of workplace & recreational noise practices, but why is it still an issue; why does the
need still exist and why are the same challenges such as stigmatisation still faced by those
affected? There still appears to be little understanding amongst the public of the real
consequences of hearing loss. Clearly a commitment by the Government towards a nationally
funded and well-coordinated collaborative approach by stakeholders is required to ensure that ALL
Australians benefit.

Recommendation 11 - The 26-65 age bracket. Government Response: “Noted”

Whilst the recognition of eligibility for assistance for low income and unemployed people aged
between 26-65 with hearing loss if they are a “complex client” is “noted”, the Government
Response is very limited and does not address the needs of this wide section of the population
affected by hearing loss. There are many in this age bracket with mild or moderate hearing loss
who don’t qualify for some of the stated benefits but whose employment prospects are severely
reduced particularly if they are not classified as a “complex case”. Depending on who assesses a
person as a “complex” case the benchmark can’t just be narrowed down to a specific decibel loss
(another example of the need for specific assessment training). Hearing loss at any level can
impact on a person’s functionality particularly in the workplace and can severely limit one’s
educational prospects, employability and lifestyle choices. Due to the high costs associated with
hearing devices, particularly if you don’t qualify for benefits, many in this age bracket do not have
the financial resources to afford appropriate assistive hearing devices which would enable them to
become more employable and have better lifestyle choices. This in turn creates other social,
economic and health related ramifications which have been widely identified and documented and
which the Government Response chooses to ignore.

Recommendation 13 – Regulation. Government response: “Not Supported”

It is disappointing that the pursuance of registration of the audiology and audiometry professions
is not supported in the Government Response. Without regulation in the industry there are no
benchmarks or clear guidelines for appropriate and optimal care for hearing loss conditions. Many
of SHHH’s clients and members have been impacted by the lack of clear regulation in the hearing
care industry. How are consumers able to easily identify appropriately qualified care providers?
How can they distinguish between health care professionals who provide accurate diagnostic and
optimal care services and some commercially allied providers who are offering lucrative retail-
based service often based on rudimentary and incomplete testing by sometimes minimally trained
staff? The extreme version of this is situation is the sale of hearing aids on-line or through
discount grocery chains. The result of non-regulation is inconsistent & poor advice and practice
which often leads to very expensive mistakes being made by consumers and increased follow-on
co-morbidities which ultimately add to the Government’s health care costs.

Speech Pathology Australia

It is commendable to see a positive push for better programs for the Aboriginal and Torres Strait
Islander peoples. However, there is little stated in the response nor the early recommendations
regarding the need for communication support and development. While there are some mentions
of Auslan Interpreters, this is a limited response to the communication needs of children and
young people with ongoing conductive hearing loss. It is known that Aboriginal and Torres Strait
Islander peoples are over represented in the justice system as a result of education issues
stemming from underlying language and communication issues, which are a result of the high
prevalence of conductive hearing loss. This is ignored across a number of the recommendations
by the committee and responses from the Government. A multidisciplinary approach is mentioned
in response to recommendation 2, but it is not clear as to the professions involved in this
approach.

The limited support to Aged Care Facilities is disappointing for the elderly of our community.
While the government states the AACQA will monitor the performance of aged care facilities
meeting the hearing needs of their clients as part of the regular review process, there is likely to
be little focus on this with more pressing issues in the aged care facilities such as nutrition, health
and life-threatening medical issues likely taking precedence. Hearing loss is an isolating disability
within the community. This will have significant impact on the quality of life and mental health of
aged care residents with hearing loss.

With reference to recommendation 9, while we are aware of current discussions underway as part
of the MBS items review, we would like to see a stronger commitment from the Government, with
expedited decisions, to ensure speech pathology services, along with audiology and ENT services,
are included in MBS funded telehealth services.

Regarding recommendation 11, the Government’s response states some people with hearing loss
between the ages of 26-65 are eligible for vouchers/services, but it appears that it is limited to
complex clients. However, there are more who require this service who cannot afford it. Hearing
aid purchase and maintenance is very expensive; many thousands of dollars. To not have access
to appropriate hearing technology affects socialization and importantly employment. This again
impacts on the mental health of this community. What the Government appears to be saving in
hearing technology support, they will lose with these members of our community unable to pay
income tax; accessing disability pensions, and requiring mental health support.

Finally, while we acknowledge that there is some access to speech pathology services via the MBS
Chronic Disease Management items and Follow-Up Allied Health Services for people of Aboriginal
and Torres Strait Islander Descent items, we would argue for these to be increased as the current
five consultations per year is often inadequate for children and adults with communication
difficulties associated with hearing impairment.

You may read the full set of recommendations made by the Parliamentary inquiry in 2017 and also
the Government’s responses to each of its recommendations in the previous edition of One in Six,
online at www.deafnessforum.org.au/wp-content/uploads/2018/08/One-in-Six-16-August-2018.pdf

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