Impact on children from a sale of Australian Hearing

One in Six, Deafness Forum of Australia’s newsletter, published this piece in their January 28 issue. It gives a detailed look at the government’s proposed privatisation of Australian Hearing services. See the Sector News page for more information.

The Australian Government is currently investigating the future ownership options for
Australian Hearing. If the sale proceeds, it will introduce significant risks to the programs
and services received by hearing impaired and Deaf children in Australia and consequently
could have a detrimental effect on the outcome for these clients.

There are approximately 20,000 hearing impaired and Deaf children and young adults
across Australia who receive their services at Australian Hearing’s national network of
service locations. The clients range in age from birth to 26 years. A proportion have
multiple disabilities. 11% are Aboriginal and Torres Strait Islander clients who may receive
their services in mainstream hearing centres, or via a culturally appropriate outreach
program in urban, rural and remote areas of Australia.Children diagnosed with hearing loss, particularly infants diagnosed with hearing loss through newborn hearing screening programs, are given the highest priority for service over other client groups seen at Australian Hearing. Client programs are delivered according to international best practice standards. The services incorporate the principles of Access and
Equity and Social Inclusion. Current arrangements ensure the Australian Government receives the best value for money due to:

  •  the economies of scale achieved by Australian Hearing’s purchasing power and
  • services being delivered as a Community Service Obligation.

This arrangement ensures the paediatric program benefits from the existing infrastructure of Australian
Hearing as a provider in a broader market, and payments to Australian Hearing are
based on the actual cost of service delivery without any profit margin.

Families appreciate that:

  •  the program allows for a family centred response, giving families time, information
    and support to allow them to make an informed decision for their baby or child
  • the child receives an individually tailored program to meet the needs of the child and
    the family, and to support the child to reach their full potential
  • there are strong relationships between audiological services, educational services
    and other support services including referrers
  • the service is provided by highly skilled clinicians
  • the clinical programs are research based and supported by clinical protocols
  • the programs are solely focussed on achieving the best outcome for the child and
    are not influenced by commercial practices such as sales targets or financial
    incentives
  • services are equitable and not based on the family’s ability to pay
  • information and guidance is impartial and unbiased
  • services are well located to minimise the need for travel

    Any changes to existing arrangements introduces risks for the following reasons:

1. Expertise
There are no formal qualification in paediatric audiology and no registration system for
Audiologists. Australian Hearing provides in-house training and a support network for its
clinicians to ensure that services are delivered by people with appropriate skills. Given
the small client population involved, there may not be interest from clinicians or the
training institutions to take over this responsibility from Australian Hearing leaving high
need clients without access to appropriately skilled clinicians.
Also, the small number of hearing impaired and Deaf children will make it difficult for
clinicians to maintain their skill level if the program is fragmented and delivered by
multiple providers.

2. Service access
Clients in rural and remote areas may lose access to services due to the cost of
delivering services in these locations. Clients from culturally and linguistically diverse
clients may lose access to interpreters and translated materials due to the cost of
providing these services.

3. Technology
Technology levels may be reduced due to cost, or because the new Provider is aligned
with a particular manufacturer. Technology recommendations from the child’s
Audiologist may be compromised due to the introduction of commercial practices such
as financial incentives for fitting particular devices.

4. Advice and guidance
Advice and guidance may no longer be impartial if the new Provider is aligned with a
particular educational provider or device manufacturer.

5. Clinical programs
Programs for children, particularly babies, are very time intensive. There is a risk that
children and their families may not be provided with the time they need.

6. Newborn hearing screening referrals
The success of newborn hearing screening programs is dependent on strong
relationships between the diagnostic hospital and Australian Hearing. This ensures
timely appointments and reduces the risk of children being lost in the system. There is a
higher risk of infants being lost to follow up if there are multiple provider.

Because Australian Hearing has been the sole provider of services to hearing impaired and
Deaf children in Australia for almost 70 years, the private sector has not had the need to
build resources to provide services in this area.

Therefore it is not clear how the paediatric program might transfer from Australian Hearing
to the private sector without impacting on clients and their families. Making the contract to
deliver the paediatric program a condition of the sale of Australian Hearing, might appear to
protect the interests of this client group, however there is no guarantee that the new owner
would give the paediatric program the priority that it currently receives with the Government
Provider, and the new owner may decide to withdraw at the end of the contract leaving
Deaf and hearing impaired children and their families with no reliable service.

Changing the service delivery arrangements to a private provider will increase the cost of
the Program as a profit would need to be factored into the payment arrangements. This will
have a flow on effect to the cost of providing services under the National Disability
Insurance Scheme (NDIS) as well, as hearing impaired and Deaf children who qualify for
services at the NDIS pilot sites continue to receive their audiological program from
Australian Hearing under the Community Service Obligations Program.
Families are concerned that the services their children receive will be reduced in order to
offset the cost of paying a commercial rate for the Program to be delivered by the private
sector.

The government’s decision on the future of Australian Hearing is not only about the
financial benefit that may be realised from the sale of a Government asset.
More importantly, a decision on the sale has to be considered in the context of the impact
on the lives of hearing impaired and Deaf children and their families.
It is essential that the needs of this client group are protected and that client outcomes are
not compromised if the sale proceeds.

You may download this and other fact sheets on the impacts on indigenous peoples, adults
with complex needs and the future of hearing research in Australia at
http://www.deafnessforum.org.au/index.php/issues/112-uncategorised/245-submissions

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