Eye Health and Macular Disease

Andrew Gwynne Excerpts

Tuesday 11th January 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Nokes. I commend the hon. Member for Strangford (Jim Shannon) for securing this important debate. We have had some powerful contributions. I pay particular tribute to the hon. Member for Great Grimsby (Lia Nici) for setting out her personal experiences. It is those experiences that make for such an informed debate, and I thank her for putting those on the record.

The RNIB estimates that there are currently more than 2 million people living with sight loss in the UK. Fight for Sight estimates that by 2050 that number will reach 4 million. Without support, ophthalmology services will be stretched to capacity. As we have heard in the debate, eye health and macular disease are important issues. I am grateful to have been given the opportunity to respond to this debate on behalf of Her Majesty’s Opposition.

As has already been made clear throughout the debate, the demand for ophthalmology services has risen at a rapid rate. Referrals from primary care were up by 12% in December 2019 compared to 2013-14. With an ageing population, it is likely that referrals will increase still further. Around 600,000 people are living with age-related macular degeneration in the United Kingdom. Degenerative sight loss not only is physically traumatising but can have a severe long-term impact on mental health and quality of life. Some 90% of vision impairment is treatable, but treatment must be fast and accessible to limit impairment.

Back in 2018, the all-party parliamentary group on eye health and visual impairment published its report, which found that the current system of eye care is

“failing patients on a grand scale”.

It found that services are delaying and cancelling time-critical appointments, resulting in some patients not receiving sight-saving treatment and care when they need it most. The Government promised to consider the recommendations of the report, yet here in 2022, people are still suffering sight loss on an unprecedented scale.

Nationally, almost 35% of patients—more than 592,000 people—are waiting longer than 18 weeks to start ophthalmology treatment. Shockingly, at the end of October 2021 around 28,000 patients in England and Wales have been waiting a year or longer to begin treatment. It is important to note that there is stark regional inequality in access to eye health services. At the Tameside and Glossop trust, one of two that covers my constituency, over 50% of patients wait more than 18 weeks to begin treatment. That is around 15% higher than the national average. Those figures represent individuals whose eye health is deteriorating rapidly, and who are incredibly anxious and scared about what their future may hold. If they do not receive adequate treatment and care, they will suffer a permanent alteration to their vision and quality of life.

The Government have to tackle this situation, because we know that the figures largely represent the state of the NHS before the pandemic. Waiting lists for treatment have got worse because of the pandemic, but the situation was far from perfect before the covid storm hit these shores. The problem in eye health care is not new; for several years, many organisations and people, including Members of this House, have been calling for the Government to act on it. It is too easy to simply point to the pandemic to excuse lack of action. It will not wash with us or with members of the public, who understandably are frustrated and worried about their own treatments.

I would be grateful to the Minister, whom I respect a lot, if she could outline the Department of Health and Social Care’s current assessment of ophthalmology waiting times and what her Department plans to do to ensure that patient safety and care remains a priority over the next few months, particularly given the acute staffing challenges that the health sector is facing.

In December 2019, the getting it right first time programme’s national specialty report was published. The report was endorsed by the Royal College of Ophthalmologists, and is the product of two years of painstaking work. Over 120 trusts were visited across England and several recommendations were made. I am sure many Members are familiar with the contents of the report, but I want to highlight just a few key points that I believe are instructive to the debate.

The two most common medical retina conditions are diabetic and age-related macular degeneration. Despite how common age-related macular degeneration is, it is important to note that macular disease can affect people at any age, including children. The getting it right first time report recommended that attention be paid to improving the accuracy and efficiency of diabetic retina screening. By utilising cutting-edge 3D imaging techniques, we can generate more detailed images of the retina and thereby increase referrals for diabetic maculopathy. However, the report found that in 2019, only 45% of providers utilised optical coherence tomography to refine referrals.

What we do know—I would be grateful to hear the Minister’s thoughts on the recommendations—is that the Government and her Department need to improve access top treatment and referrals for eye conditions. Specifically, I would be interested to hear what the Department makes of calls to train more staff to deliver specialist AMD injections.

I would also like to draw attention to the proposed Health and Care Bill, and specifically its provisions relating to new integrated care systems. For those to be effective in tackling the crisis in eye health, the Government must ensure that ICSs can co-ordinate community optometry and hospital ophthalmology services, to ensure that patients are seen promptly and at the right time. I would be grateful for any clarity that the Minister could give on how ICSs can be best placed to deliver those important changes.

In conclusion, we cannot continue to overlook the challenges that ophthalmology is facing. It is the busiest outpatient service and was under extreme pressure before coronavirus. The Opposition have repeatedly called on the Government to be straight with the British public about the current strain in the NHS and to urgently set about addressing it. We have time and again urged the Government to undo some of their more damaging policies on the NHS. Waiting times have soared and patients have been let down before covid, yet there is no detailed plan, and patients, staff and people across the country are now looking to the Government to deliver on their promise to improve NHS care and to drive down waiting times and waiting lists. We look forward to seeing the detail, but as has already been mentioned in the debate, there needs to be a real consideration in the plan for eye health and how waiting times can be driven down. I ask that the Minister reflects on the points made during the debate, because people who are suffering poor eye health need to have reassurances from the Government that they are doing everything possible to address the concerns of healthcare leaders, staff and patients.