Cataract Operations

Lord Patel Excerpts

Wednesday 16th November 2016 Lords Chamber

[Lord Prior of Brampton]

The cataract operation is remarkable; it can literally give back people’s sight in the course of a 10-minute operation. I think I am right in saying to the noble Baroness that the first cataract operation was done in 1787.

[Lord Patel (CB)]

My Lords, the Minister is absolutely right in accepting that there is a huge variation in the availability of cataract surgery. In fact, the variation is fourfold. Nearly 35% of people over 65 will require cataract surgery, and such surgery is the definitive form of treatment for cataracts. Incidence will rise with age and, with ethnicity, it is even higher. As the Minister accepted in part, the variation is caused by variation in commissioning, which is based on clinical judgments, not the scientific evidence that CCGs need. Better guidance will help, as he suggested, but unless the guidance is appropriately monitored and the CCGs follow it, nothing will change—40% of people do not get second eye surgery because CCGs will not commission it.

[Lord Prior of Brampton]

I mentioned earlier that NICE will bring forward its evidence-based guidelines in 2017. It will be up to CCGs to commission on the basis of those guidelines, and they in turn are monitored by NHS England. Clearly there is variation; there is variation wherever we look in the National Health Service. One of the reasons why Professor Briggs is doing his Getting it right first time work is to try to identify that variation and address it.