A charity that works for the deaf is concerned about the number of people who have access to health care earwax removal services.
Traditionally, the ear injection was a service provided by general practitioners.
Since 2018, however, earwax removal is no longer one of the core services that practices have to offer.
Hearing loss charity RNID said it was important that the services were accessible and that not everyone could afford the option of paying privately.
The Health and Social Care Board (HSCB) said if a general practitioner cannot perform earwax removal through the use of an electronic irrigator or microsuction, they should refer the patient to a health foundation.
“Each of the trusts offers an earwax removal or microsuction service,” HSCB said in a statement.
“However, rather than waiting, patients may prefer to seek and pay for private treatment.”
A local private clinic said the number of people paying for earwax removal has increased by 31% since March 2020.
A 77-year-old man from County Down said he believes that in the future, the more money people have, it will depend on how healthy they are.
Cavan Granleese paid privately for earwax removal at his local optometrists.
Mr Granleese said a buildup of earwax had affected his hearing.
“If your ears are full of wax, you can’t hear anything,” he said.
“If you have hearing problems or are deaf, you can’t deal with people properly because you’re always trying to get them to repeat what they said.”
BBC News NI is able to report that Northern Ireland’s largest health foundation, Belfast, has 536 patients waiting for ear, nose and throat services, a nurse-run service, with the longest waiting time at 24 weeks.
The Trust said it would like to offer its “sincere apologies” to those waiting.
“This clinic is impacted by the ongoing impact of Covid-19 and a change in the way this service is provided by some primary care GP practices based on current NICE guidelines,” a spokesman said.
“Earwax removal is a potentially aerosol-generating procedure and as such, our staff had to take extra safety precautions to protect patients and staff.”
At Southern Trust, 351 patients are waiting for their first nurse-led treatment with an average waiting time of two years.
At the Northern Trust, eight people are waiting and the longest waiting time is 32 days – the service has only been operational for about a year.
The South Eastern Trust said it has 189 new routine patients – the longest wait is as of July 2019 with no appointment being offered. They also have 261 review patients with a 12-month backlog.
At the Western Trust, wax removal is provided by an ENT specialist nurse, “however this should be for patients where treatment in the community is contraindicated”.
They said there is no specific waiting list for wax management or removal.
The RNID, which works to make life inclusive for the deaf and people with hearing loss, has said earwax removal should be made available in the NHS where there is a clinical need.
The charity’s Franki Oliver said she had raised the broader issue with the Northern Ireland Health Minister
“From our understanding, there hasn’t been much discussion with local people about what services are being commissioned and provided to them,” she said.
“That might be because it’s not as important as other services — but it’s really important that people can access these services because it can be so life-changing and it’s so easy and quick to fix.”
Ms Oliver added that the effects of wax buildup can be debilitating.
“The effects of hearing loss or being unable to wear your hearing aids can make people socially isolated, they might withdraw, they might not feel like they used to,” she said.
“It can be embarrassing, and we know that untreated hearing loss can be linked to falls or dementia in the long term, so it’s so important that it’s offered to those who need it.”
Local optometrist Michael McCourt said he recognized the need for earwax removal in his patients.
At his office in Holywood, County Down, he said hearing, like sight, is an essential service.
“We started it in our Crumlin office, then here in Holywood and now we’re doing it in seven different locations across Northern Ireland,” he said
Mr McCourt said demand had grown over time and those struggling to hear it wanted to sort it out as soon as possible.
“People need it, people come in with a problem, their ears are blocked, they have trouble hearing, sometimes with discomfort, even pain, and they get it fixed,” he said.
Microsuction has replaced the injections, in which GPs removed earwax by injecting water into the ear with a large metal syringe.
But since the National Institute for Clinical Excellence, or NICE – which approves treatments for the NHS – advised GP practices to use electronic irrigators or suction devices, many have stopped the service.
There is a cost to privatization – treatment in private clinics or opticians on the High Street can cost between £65 and £80.
Paul Clarke, 50, lost his hearing to meningitis as a child.
He wears a hearing aid but is currently whistling due to earwax causing interference.
Because he refuses to pay for treatment, Mr Clarke has been placed on a hospital waiting list to have his ears checked.
That was in August and he has not been contacted since.
He said he was reluctant to go private, believing it was a public service that should be available to everyone.
Mr Clarke has criticized the lack of publicity surrounding the service, which is being withdrawn from many GPs’ practices, and said people needed to be made aware.
“I lost my balance and fell. I contacted the family doctor who examined my ears. He gave me two options, either go private or put me on a health foundation waiting list,” he said.
Mr Clarke said there were many people who couldn’t afford to go private as it was very “expensive and if you had to go private all the costs would add up”.
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