Charity RNID - which supports people who are deaf and with hearing difficulties in the UK - says people are being forced to pay for private health care - which can cost up to £100 - or risk using "dangerous self-removal methods".

The common cotton bud, for instance, is deemed dangerous to insert into the ear as it could push wax further down the canal or, if pushed too far, could perforate the eardrum.

Around 2.3 million people need ear wax removal services every year in the UK, especially older people, hearing aid users and people with a learning disability.

Without treatment, ear wax build-up can cause symptoms including hearing loss, tinnitus and earache.

RNID said there was "no medical reason" for the withdrawal of the service in certain parts of the country.

Less than half of local health bodies were providing these services to patients, an RNID Freedom of Information request found, against guidelines from the National Institute of Health and Care Excellence (NICE) which state they should be available in GP surgeries or other local ear care services.

Out of 40 integrated care boards - NHS organisations responsible for planning health services for their local population - that provided a response, only 18 said they were fully commissioning services in line with current guidelines.

Seven boards said that none was commissioned at all. Two care boards didn't respond.

The charity estimated that 9.8 million people do not have NHS access to ear wax removal and urged the government to make sure people are able to in every part of England.

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'Vital' service and 'not a luxury'

"Ear wax removal is not a luxury, a 'nice to have', or a cosmetic procedure. It is a service that is vital for people's quality of life and wellbeing," the authors of the RNID report said.

Victoria Boelman, director of insight and policy at the charity, said it was "absolutely wrong" that people needing ear wax removal are "being left to face painful and debilitating symptoms, forced to fork out for private treatment, or risk dangerous self-removal methods".

She said "thousands of people" were being "let down" by commissioners who were not heeding to public health guidelines.

The charity called for the Department of Health and Social Care (DHSC) to commission "an urgent review" of the provision of local ear wax removal services.

The DHSC told Sky News: "Audiology services that would carry out ear wax removal are delivered by local integrated care boards, who ensure provision of services that meet the needs of patients in their area.

"GPs can also refer patients where a build-up of ear wax is linked with hearing loss."