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Demand on the NSW surgical system is forcing one in 10 patients to wait more than a year for a 15-minute ear procedure, leaving children at risk of learning delays and long-term hearing loss.
The problem is most acutely felt by children in regional areas – where hospitals are struggling to recruit specialists – and Indigenous children, who experience some of the highest rates of chronic ear disease in the world.
“Hearing loss is a developmental emergency,” said Kelvin Kong, Australia’s first Indigenous ear, nose and throat (ENT) surgeon and a professor at the University of Newcastle.
“Our kids spend approximately 32 months of their first five years of life with no hearing because of glue ear … [it] is appalling.”
Glue ear, or otitis media, is a common childhood condition where fluid builds up inside the middle ear and cannot drain away, gradually becoming thick and sticky.
The condition typically happens after an ear infection and can cause temporary hearing loss.
Some children with chronic ear infections require grommets, which are tiny ventilation tubes – typically made of plastic or metal – inserted into the eardrum.
These help air get into the middle ear and thick fluid drain out, preventing chronic ear infections and restoring hearing.
The surgery, called a myringotomy, involves creating a small hole in the eardrum and inserting the grommet. It is performed under general anaesthetic and typically takes between 15 and 30 minutes.
National hospital data shows patients in NSW are waiting almost twice as long as those in other states for the procedure.
Half of NSW patients wait 120 days for the surgery, compared with 69 days in Victoria and 50 days in Queensland.
One in 10 wait at least 367 days. In Queensland, fewer than one in 100 children wait longer than a year.
A NSW Health spokesperson said the majority of myringotomy procedures were performed within the recommended 365-day window.
NSW Health is spending $30 million on short-stay surgeries to reduce the number of overdue patients. The spokesperson said this was leading to an increase in median wait times, which are recorded only once a surgery is performed.
Kong said this increased demand for operating theatres was leaving patients waiting longer for less-urgent procedures.
“They’ve probably already been waiting two years … to actually see [a specialist], let alone get on the waitlist,” he said.
Jenna, who asked to withhold her surname due to her husband’s employment in the justice system, has been waiting since September 2024 for son Rowdy to have grommets fitted at Dubbo Hospital in the NSW Central West.
The three-year-old’s paperwork sat in his specialist’s office for almost a year because the hospital was not accepting referrals.
Rowdy was accepted onto the public waitlist in July – almost a year later. Dubbo Hospital has been unable to say when his surgery will be performed.
“We have a very big hospital with lots of specialists,” Jenna said. “Why is this happening out here?”
Until the surgery, Rowdy will need to wear a bone conduction hearing aid and rely on a special sound system in the classroom to help his learning.
Two services offer free hearing tests and referrals to children in the Dubbo region, but those who need surgery can get on the waitlist only through a private appointment with one of two ENT specialists in the town.
Bureau of Health Information data shows no myringotomy procedures were performed at Dubbo Hospital between October and December.
In a statement, a Western NSW Local Health District spokesperson said there were 175 children on the ENT waiting list at present, 12 of whom were listed for grommet surgery.
The hospital was attempting to increase its ENT surgical capacity but had not been able to find the staff, they said.
“Recruiting specialists to regional areas is a long-standing challenge,” the spokesperson said. “We do everything possible to manage waitlists and reduce waiting times.”
Kong said ASOHNS, the representative body for ENT doctors, had proposed a number of potential solutions, and workforce shortages should not be used as a “bartering chip” to delay surgeries for children in regional areas.
Monique Mitchell said her two-year-old son Ashton, who has a rare genetic condition called 22q11.2 deletion syndrome, waited more than six months for a surgery that was recommended to take place within 90 days.
Despite the wait, his speech skills have improved dramatically with the help of the grommets and hearing device.
“If it wasn’t for his aid, you probably wouldn’t know he has a hearing problem,” Mitchell said.
Kong said the surgery can be life-changing for children. One recently described the excitement of hearing a toilet flush like “listening to a waterfall”.
“You help them out at an early stage, and the parents and the kids come back as different people,” he said.
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