Ear wax

Ear wax.¹ What happens in other countries? In Canada people are advised they can use a warm shower after softening.² In Europe personal ear bulb syringe kits are available. Where I work, in Kent, the integrated care board has told me in writing that GPs should be providing an ear syringe service but take no action with those practices who don’t, and so people either have to pay out £60, put up with it, or overwhelm the ear, nose, and throat services. The suggestions that the primary care network provide a hub service make sense but who is to fund this? Though a ‘minor problem’ it has significant consequences for many. If self-cleaning with a warm shower works, can we promote this as first line if no known perforation etc.?