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nhsManagers.net

12th January 2026


News and comment from

Roy Lilley



Speak up...

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Short on time? Get yer ears-on and listen to Roy Lilley read this morning's eLetter... free!

This is the story of an old geezer…


The iPhone announced seven. The old-geezer rolled his legs over the side of the bed.


He’d watched a youngster on YouTube set up a short-cut so the alarm fired up Times Radio. He’d long since abandoned the Today programme…


He sat on the edge of the bed. Something wasn’t right. He couldn’t hear the programme properly?


The old-geezer fiddle with the buttons to turn up the sound. Even on full-blast the sound wasn’t right. 


He put the iPhone next to his ear and it was like the studio was in a wooly jumper. He put it to his other ear… and it blasted him across the bed. 


Ah… the old-geezer knew exactly what’s-what. His lughole was bunged up with wax.


The old-geezer went about his ablutions. 

Cocked his head to one side, to see if the shower might wash the wax away… gave his ear a good wriggle and a pull but nothing happened… apart from making his ear sore.


After a cuppa-builders, two slices of toast and Marmite, the old-geezer pulled on his raincoat and headed for the paper shop for his routine ‘put-the-world-to-rights’ with Mr Ahmed. 


He said something about Trump that the old geezer didn’t hear. He nodded and laughed, walked out of the shop, into the path of a Tesler, he never heard it coming.


Lucky escape.  


Later, he rang the GP and ploughed through the options;


  • If you are calling for an appointment, don’t press anything, hang up and try tomorrow.
  • If you are calling because you couldn’t get through yesterday, hang up, you’re either better or properly ill, so dial 999.
  • If you are anxious, keep pressing any number… it’s therapy.
  • If your ears are bunged up and can’t hear this message, why are you bothering us.


Eventually, the old-geezer spoke to a bright young thing. Told his ‘bunged-up-lughole’ story. The cheery voice told him to ‘hold the line’.  


What emerged was the tale of an unravelling.


Before 2019, most people could get ear-wax removal at their GP. Thereafter, RNID research reported; GPs increasingly, stopped providing it. 


By January 2024, there was a postcode lottery. Surveys indicated millions no longer had access to the service. 


From April-July 2025, some practices and local health commissioners formalised the withdrawal of routine ear-wax services, despite there being no publicly available national policy from NHS England nor the DHSC, that officially bans the practice.


The DH+ say; ‘ear syringing’ is no longer recommended. That's a red-herring. They know full-well, no one syringes anyway… most private de-waxing companies use MG Electric Sam MS Electric Ear Microsuction Unit… it costs about £900, and…


… that brings the old geezer back into the picture. He was about to join around 8–10 million people who can’t access de-fugging on the NHS. 


The cheery receptionist referred him to a private service for sixty quid.


In a year, the private sector carryout over 2.3m de-waxings… on the same scale as other major chronic conditions. Getting on for Type 2 diabetes and more than COPD... 


... making the market a nice little earner, worth north of £115m.


Older people are more likely to have wax build-up. Many on fixed incomes. Limited budgets.


Sixty quid isn’t trivial. Many need treatment several times per year and becomes a significant outlay.


Around a quarter of people needing wax removal say they can’t afford it… 15% didn’t have treatment. A large subset of people needing wax removal are priced out.


Wax-related hearing impairment has wide-ranging consequences for communication and daily life.  Social isolation, mental health impact, withdrawal, risk of depression and loneliness. Mental wellbeing.


Older adults, already at higher risk of isolation, are particularly vulnerable, plus…


  • cognitive decline
  • falls
  • reduced quality of life
  • abrupt conversations in the paper shop and,
  • being run over by a Tesler…


… all coming with a knock-on NHS cost.


In the dying days of the last Tory administration, in answer to a parliamentary question, the minister said;


‘… [HMG] has no plans to include ear wax removal services in the national Standard General Medical Services Contract.’


Adding to all this… official statistics show; of over two million requests for adult social care support in 2023‑24… only ~42 % of requests resulted in some form of service… 31 % received nothing.


Warning, don’t get old in Starmer’s Britain, no one's listening…


… and yes, you’ve guessed it. I am the old geezer, so speak up.

NEW YEAR - NEW PODCAST

In the Loop...

the BIG Questions 

Niall Dickson CBE and Roy Lilley

with their latest guest

David Gregson

founder of

#BeeWell


To start their 2026 podcasts, Niall and Roy make a departure from their usual focus on the politics and management of the NHS, and explore the worrying state of our young people. 


The awful reality is that youngsters in the UK appear to be unhappier than nearly all their European counterparts. 


Their first guest of the New Year is David Gregson an entrepreneur and philanthropist who has embarked on an ambitious and innovative programme called #BeeWell.


Its aim is to improve the wellbeing of young people throughout the country, starting in Greater Manchester and a few other areas of England.


But can this programme, which demands action and a mind-shift from statutory and voluntary services, really be the catalyst to change the prospects of the next generation? 


In a fascinating exchange, David Gregson points to weaker family relationships, restrictions on child freedom, and the fact that adults often no longer understand the world in which their youngsters live.


He applauds moves by the UK government to raise the profile of youngsters’ wellbeing and its support for idea of conducting surveys in every school, but he wants them to go further and faster.

For all the previous

In the Loop

podcasts with

Dr Charlotte Refsum

Tony Blair Institute

Rob Webster

ICB CHEx

Sarah Woolnough

CEO of the King's Fund

Sir Jim Mackey

Dame Jennifer Dixon

Lord Darzi

Professor Tas Qureshi

Dr Penny Dash, chair NHSE

Richard Meddings,

former chair NHSE,

Sir Jeremy Hunt,

Sir Andrew Dilnot,

Paul Johnson IFS

CLICK HERE


-oOo-


Probably, the most listened to

Podcast in the NHS!

FREE!

Want to contact Roy Lilley?

Please use this e-address

roy.lilley@nhsmanagers.net 

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Dr Paul Lambden


Clinical Negligence


'... All clinical healthcare staff will do their very best in the care of their patients but sometimes things do go wrong.'


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__________


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