Preventable Sight Loss

Andrew Stephenson Excerpts

Tuesday 30th April 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is always a pleasure to see a fellow Lancastrian in the Chair, Sir Mark. I thank the hon. Member for Wirral West (Margaret Greenwood) for bringing forward the debate. This is the second debate today on eye health to which I am responding on behalf of the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), who has been busy in the Tobacco and Vapes Bill Committee. I also thank those who contributed to the debate—the right hon. Member for Hayes and Harlington (John McDonnell), the hon. Member for Aberdeen North (Kirsty Blackman) and the shadow Minister, the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill)—for their thoughtful contributions.

Preventing sight loss remains one of my right hon. Friend’s top priorities, and it is right that we should dedicate parliamentary time to this important issue. Losing one’s eyesight can be devastating, and I want to pay tribute to some of the charities that I did not have time to mention in this morning’s debate—Fight for Sight, the Vision Foundation and Sightsavers, to name just a few more.

About 2 million people live with sight loss in our country. That number is projected to double by 2050, mainly because of our ageing population. We are doing a huge amount to reduce the number, through preventive measures and early detection. One of the best ways to protect eyesight is through regular sight tests. That point was made eloquently by the hon. Member for Aberdeen North, and I am pleased to confirm to her that I am having my next eye test tomorrow morning.

This debate is why the NHS invests more than £500 million every year on free eye tests for people on benefits, people over 60, and people at risk of serious conditions. That investment delivered more than 12 million NHS sight tests to those groups between 2022 and 2023, and extensive discounts on glasses and contact lenses for children and people on income-related benefits, through NHS optical vouchers.

We have also taken great strides in preventing some of the causes of sight loss, including smoking and obesity. As I mentioned at the start, my right hon. Friend the Member for South Northamptonshire is taking our landmark Tobacco and Vapes Bill through the House, and we are backing quit-smoking campaigns with unprecedented funding and support.

On obesity, we have taken a raft of measures on sugar reduction and healthy eating. We have made strong progress in reducing the average sugar content in soft drinks through the soft drinks levy, and almost halved their sugar content between 2015 and 2019. For two years, we have also been restricting the placement of less-healthy products in shops and online, thereby helping consumers to make healthier choices.

Our wider prevention work goes hand in hand with our efforts to catch eye problems early. Glaucoma—which was covered in the debate this morning—and diabetic retinopathy are two of the main causes of preventable sight losses, and both can cause blindness if left untreated. That is why we are offering screening tests to nearly 4 million patients with diabetes at least once every two years. Since 2010, the number of adults between 16 and 64 who became visually impaired from diabetic retinopathy fell by almost a fifth. Our approach has been commended by the World Health Organisation, and we will build on that progress. In October, we begin phasing in optical coherence tomography scans as part of the screening programme, to reduce unnecessary referrals to hospital eye services and improve the quality of the service overall.

It is vital for patients who need to be in secondary care to have access to timely diagnosis and treatment. That is why we have set ambitious targets to recover services that suffered over the pandemic, through our elective recovery plan, which is backed by more than £8 billion of funding, and why we have expanded surgical hubs and harnessed capacity in the independent sector so that more patients can be seen more quickly. Our plan is working and it is delivering results. Waiting times are falling. The number of patients waiting 78 weeks or longer for ophthalmology treatment has reduced by 96% since its peak. But we know we have much further to go.

While we work to recover from the pandemic, we are reforming eye care services to be fit for the future. NHS England’s transformation programme is currently funding seven projects across each ICS area, testing how improved IT links between primary and secondary care could allow patients to be assessed and triaged virtually. Where appropriate, that would keep patients out of hospital, freeing up hospital eye-service capacity for those who need specialist care the most.

The initiatives have shown promising results. For example, the project in North Central London ICS has improved the flow of information from community optometry to Moorfields Eye Hospital, reducing the triage time from 11 days down to one. The appropriate use of clinics has doubled to more than 70% and reduced the waiting time for first appointments by up to 35 days. NHS England is now using the data from the projects to build the case for a wider roll-out.

[Kirsty Blackman]

I appreciate what the Minister is doing in this policy area. Some of the initiatives he just mentioned, such as electronic assessments and triaging electronically, were put in place in Scotland seven years ago. We decided that they were working and that we would roll them out. Has he spoken to Scottish colleagues and looked at the work done in Scotland in order to ensure that the Government do not have to replicate the same pilots that we have proven do work, so that people can get treatment and things can be put in place more quickly?

--- Later in debate ---

[Andrew Stephenson]

As a proud Unionist, I am always happy to learn from different parts of the United Kingdom. After I was appointed to my role, one of the first things I did was to go to Edinburgh and visit various universities and companies across Scotland, and I saw some of the great work going on in Scotland. I also met the then Health Secretary, Michael Matheson, to talk about areas where we can work together, particularly on things such as research. However, we can also trial different things in different parts of the country. Many people in this House talk about regional variations, which can be a concern. Nevertheless, one of the benefits of being able to trial different things in different regions is that we can learn the lessons, learn what works and then build on that best practice.

As well as helping our primary and secondary care sectors to reach their full potential, we have a long-term plan in place to support our workforce and put it on a sustainable footing, which is the first ever long-term workforce plan for the NHS. We have again increased training places for ophthalmologists in 2024 and improved training for existing staff, helping them to deliver for patients while reaching their full potential.

The right hon. Member for Hayes and Harlington raised what sounded like a very important and serious issue. He will forgive me for saying that this area is not my specialist subject, but I am happy to raise his concerns with my right hon. Friend the Member for South Northamptonshire. However, I will say now, in response to his comments on laser eye surgery, that refractive laser eye surgery is not generally available on the NHS. Doctors who perform such surgery must be registered with the General Medical Council and the Care Quality Commission. All locations where refractive eye surgery is carried out should be monitored and are required to report any adverse events. As I say, I will be happy to relay his concerns to my right hon. Friend.

[John McDonnell]

I appreciate the Minister’s response; that is really helpful. It would also be useful if a Minister met some of the families who have experienced issues in this area, because over the last 20 years we have had the same ministerial response with regard to regulation, and there have just been too many examples where that regulation and monitoring have not worked and therefore people have been endangered. That is why in the Government’s own report Professor Sir Bruce Keogh recommended further regulation; I think we need to revisit that.

[Andrew Stephenson]

I thank the right hon. Gentleman for making those points. I am not instinctively anti-regulation; indeed, just a few weeks ago I put through this place the statutory instrument on the regulation of physician associates and anaesthetist associates. There are certain parts of the healthcare sector where regulation is very much needed and I would very much advocate for it. As I have said, I will defer to my right hon. Friend the Member for South Northamptonshire. This is her ministerial responsibility, and I am sure she will read the right hon. Gentleman’s comments with interest and may want to take the discussions further.

Finally, on research, the Government are backing scientists and researchers to take strides in understanding sight loss and in making new treatments available. Two years ago, we awarded £20 million to Moorfields Biomedical Research Centre to undertake another five years of vision research, and almost £6.5 million to Moorfields Clinical Research Facility to support cutting-edge treatments for all eye conditions.

Eye care services face challenges and we are taking decisive action to address them, both now and in the long term. The hon. Member for Wirral West and I will never agree on the use of the independent sector. I strongly believe, and think the Labour Front Bench team strongly agrees, that using the independent sector enables us to fully realise our healthcare system’s capacity and to reduce the time that patients spend on waiting lists. I would argue that that does not represent any move to privatise our NHS. As I have said on the record before, the overall proportion of NHS England’s spend on independent sector providers has not increased significantly in recent years. In 2013-14, 6.1% of total health spending was spent on the purchase of healthcare from independent sector providers; in 2022-23, the proportion was 6.5%.

This morning, the shadow Minister in the first Westminster Hall debate, the hon. Member for Denton and Reddish (Andrew Gwynne), talked about making better use of the independent sector to help to ensure that we deliver the best outcomes for patients, and the shadow Minister in this debate, the hon. Member for Birmingham, Edgbaston, reiterated that point. On the use of the independent sector, then, I gently say that it is something on which there is broad cross-party support. While recognising that there are always challenges with the use of the independent sector, it is not in any way a privatisation of the NHS.

I firmly believe that through prevention, innovation and investment in our workforce, we will deliver for all our people across the United Kingdom access to the important healthcare services, including ophthalmology services, that they deserve.

[Sir Mark Hendrick (in the Chair)]

I call Margaret Greenwood to wind up the debate.