Glaucoma and Community Optometry

Andrew Gwynne Excerpts

Tuesday 30th April 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered glaucoma and community optometry.

First, a special thanks to the Backbench Business Committee for selecting the debate for this morning. I am my party’s health spokesperson—it is no secret—and am particularly interested in health issues. As such, I secured this debate off the back of a number of people who had contacted me. What I am particularly pushing for—I am sorry for the short notice; I put the request in the Minister’s hand only two minutes ago—is that we do something now so that we can save sight further down the line. If I were pushing for one thing only, that is the one thing I would wish to have.

Optometrists in my Strangford constituency—I will send them a copy of this debate in Hansard afterwards—asked me to secure this debate. A number of bodies here on the mainland asked me the same thing. That is my purpose, but the issue of sight and sight-loss problems affects every constituency equally throughout this great United Kingdom of Great Britain and Northern Ireland. Therefore, the approach to making the system more fit for purpose must also be UK-wide.

I am pleased to see the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), in his place. We are sparring partners, although when I say that I do not mean that we hurt each other—we fight things together. I am also especially pleased to see the Minister in his place. He has a deep interest in this subject, as well as a deep interest in Northern Ireland, which I much appreciate. He has told me about his times in Northern Ireland in the past month or so, and how much he loves going there. Indeed, every MP who visits Northern Ireland—including you, Dame Caroline—always comes back with the most wonderful memories of the occasion and of the people they meet. Just this morning, a Conservative Whip was telling me that he was in Hillsborough two weeks ago, and about how much he enjoyed it.

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

I want to place on the record the fact that a month ago I made my first visit to Belfast. I had an incredible time meeting Members of the Assembly at Stormont, and going to Harland & Wolff, around Belfast and to an inclusive school. It is a remarkable place, and I just wanted to add, as the hon. Gentleman is putting on the record that everyone else has been to Northern Ireland, that so have I—although I know that is not the subject of our discussion, Dame Caroline.

[Dame Caroline Dinenage (in the Chair)]

Order. I gently remind Members that, charming as it is to hear about Northern Ireland—we are all wildly in favour of going there at every available opportunity—this is a debate on glaucoma.

--- Later in debate ---

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

I start by passing on the apologies of my hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill), who leads for the shadow health team on the issues we are focusing on today. She is otherwise detained on the Tobacco and Vapes Public Bill Committee, which is taking place at the same time.

I sincerely thank my hon. Friend the Member for Strangford (Jim Shannon)—I know that the custom in this place would be for me to call him “the hon. Gentleman”, because he is not of my party, but he is a friend—for securing this crucial debate and for the positive spirit he always brings to these proceedings. Glaucoma is a common yet serious condition that, if left untreated, can cause real damage. Anyone is at risk of developing glaucoma at any age, but it particularly affects people as they get older.

I declare a bit of an interest here: my grandmother had glaucoma. Because my mum died at the age of 50, they do not if the condition was hereditary, so every time I go to my opticians I have to have the glaucoma test in case it is hereditary. However, it is really important that people are tested routinely, because it is a serious condition that, if left untreated, can cause real damage.

Several factors increase an individual’s risk of glaucoma, including a family history of the condition; being of African, Caribbean or east Asian origin; and having long or short sight, diabetes or blood pressure problems. Glaucoma tends to develop gradually, and it is often entirely symptomless for a long period. As a result, many glaucoma patients are diagnosed only during routine eye tests. The impact of glaucoma can vary greatly, ranging from misty or blurry patches in vision to struggling to complete day-to-day tasks such as reading, and permanent sight loss.

When it comes to accessing basic care, many glaucoma patients face significant challenges. Across eye care, more than 600,000 patients are currently on waiting lists for treatment. Given the risk that glaucoma poses if left untreated, such extensive waiting lists are a serious threat to patient outcomes. Sadly, that statistic shows no sign of changing, and demand for ophthalmology services is set to increase by more than 40% in the next two decades. Given an estimated annual cost to the economy from sight loss of more than £25 billion, the case for action could not be clearer.

I have a degree of frustration with the Government’s approach to the issue. Given the statistics, I would like to see the Minister commit today to turbocharge access to ophthalmology services and make eye tests more commonplace for people who do not routinely test their eyes, but also to get people access to eye care services once conditions have been diagnosed.

The next Labour Government are committed to reforming the system so that those with glaucoma and other eye health conditions can access care when and where it is needed. We will provide 2 million more operations and appointments on evenings and weekends, paid for by clamping down on tax dodgers, so that patients can be seen on time again. We will have a laser-like focus on prevention, tackling the social determinants of ill health and ensuring that eye conditions such as glaucoma are tackled at source. We will ensure that the NHS shifts from an analogue to a digital service, embracing the latest developments in technology and artificial intelligence to provide the best possible care and deliver the best possible patient outcomes.

Again, I declare an interest: being a bespectacled Member of Parliament, I obviously have routine eye tests. I am short-sighted, although age is catching up with me, and this is the first time that I have had varifocals for reading and for distance. However, my optometrist, Dr Shen of Boots opticians in Denton, has brought in and embraced some of the latest technological advances for testing different eye conditions. At my last eye test, I was amazed at the wizardry and machinery they have brought in, revolutionising the way they can diagnose.

[Jim Shannon]

The hon. Gentleman is speaking very powerfully and I endorse those comments. What I have seen with optometrists in Newtownards in my constituency of Strangford is the amount of money and investment that they have put in. They have not asked for any help from the NHS for those things. They are doing it themselves. I think there is a wonderful opportunity for a partnership with optometrists who are investing money—all they need is the people to come in for testing—and that, I believe, is a role for Government.

[Andrew Gwynne]

I could not agree more with the hon. Gentleman. Boots Opticians in Denton is a franchise, and the owner of that franchise has invested in this remarkable technology. I have now seen parts of my eyes that I never believed it would be possible to be able to see. It is incredible digital technology, and it allows opticians to diagnose eye stroke. That is particularly important for people with diabetes, glaucoma, high blood pressure and cardiovascular disease. The technology can also be used to diagnose diabetic retinopathy, in which people’s retinas are leaky, which can lead to temporary vision loss, and age-related macular degeneration. That detailed eye care allows other eye problems, which ordinarily would have gone unchecked, to be found and the appropriate treatments to be provided. I have seen how transformative the use of modern technology by my own optician can be for testing for a whole range of conditions and eye health.

That is why this debate is relevant and why changes across the system are clearly needed. That is most evident in community optometry. There is a real potential to utilise, as the hon. Member for Strangford has said, the existing capacity on our high streets and in our town centres—crucially, where people are—to get a firm grip on the crisis in eye care. That is why the next Labour Government have committed to seeking negotiations with high street opticians to strike a deal to deliver more NHS outpatient appointments. That partnership, which the hon Gentleman was rightly discussing, will underpin Labour’s eye care policy.

With 6,000 high street opticians serving communities across the country, we cannot afford to sit back and waste their incredible potential. We will work with high street opticians to beat the backlog and to get the system moving again. By utilising community capacity, we can free up specialists in the NHS to support those patients with the greatest need, providing greater accessibility, convenient care and, most importantly for all of us taxpayers, better value for money for the public purse.

This approach is backed up by evidence, proving the tangible impact of community-based eye care and eye health services. A 2014 study of the introduction of minor eye care services in Lewisham and Lambeth showed how significant that impact is. GP referrals to ophthalmology specialists in Lambeth decreased by 30%, with an even greater reduction—75%—in Lewisham. Costs in areas without minor eye care services increased, while there was a drop in costs in Lewisham and Lambeth of 14%.

Given that the sector is in clear need of reform, with patient outcomes continuing to suffer, will the Minister back Labour’s plan to unlock the potential of community optometry? With more than 550 patients suffering sight loss because of delays in the NHS since 2019, does the Minister accept that further inaction is simply not an option? These are people whose lives, and those of their loved ones, have been fundamentally changed through no fault of their own. We owe it to them to fix this system once and for all, working in partnership with the devolved Administrations across the United Kingdom, as the hon. Member for Strangford says, so that there is not a postcode lottery on these services, and we get the best outcomes for all British citizens across the United Kingdom. We owe it to them to ensure patients with glaucoma and other eye health conditions get the care they need, when they need it, and where they need it.

We will support the Government in the remaining weeks or months that they have to get this policy right, but mark my words: the next Labour Government see this as a priority and we will act.