Eye Health and Macular Disease

John McDonnell Excerpts

Tuesday 11th January 2022 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I join others in thanking the hon. Member for Strangford (Jim Shannon) for securing the debate. I congratulate him on providing a service to us all by securing so many debates on so many relevant issues. I concur with the previous speaker, the hon. Member for Hendon (Dr Offord), that it is time for a national strategy; we have been calling for one for a while.

Like my hon. Friend the Member for West Ham (Ms Brown), I will talk about refractive surgery. I completely concur with the hon. Member for Strangford, and the general tone of the debate, about the need for longer-term, stable investment, and the worries that we all have about the postcode lottery in access to eyesight assessment, and services to tackle any problems that are identified. Part of the problem of the postcode lottery is that people who have concerns about their eyesight can become desperate and resort to alternative methodologies, one of which has been refractive surgery.

Refractive surgery is often successful, but there is always a risk. We are talking about both laser surgery and lens replacement, in larger numbers every year. It is a growing issue. Thousands upon thousands are receiving refractive surgery, basically from three main companies: Optical Express, Optimax, and Optegra. Tragically, of those thousands, many hundreds are now experiencing serious problems. They have failed to find a solution to their eyesight problems by turning to surgery, but in many instances have been harmed by the surgery itself.

I have been campaigning on this issue for over a decade. I have worked with other MPs and campaigners. We have had private Members’ Bills, ten-minute rule Bills and debates in the House. I pay tribute to the external campaigners. Sasha Rodoy from the My Beautiful Eyes Foundation has brought together literally hundreds of cases, providing people with support and exposing some of the appalling practices. My hon. Friend the Member for West Ham referred to the GMC. There are specific examples of where the GMC guidelines are ignored, resulting in real harm. The guidelines basically say that the surgeon undertaking the surgery should meet the person who is to be operated on. There should be a proper assessment of their suitability for the surgery, and advice should then be provided.

Over the past decade, we are finding too many examples of where the assessment has been given largely by salespeople rather than clinically qualified staff. Often, the person will not see the surgeon until the day of surgery. Owing to the oligopoly of the companies involved, the pressure of meeting sales targets seems to be more important than achieving good outcomes for the clients or patients involved. Inadequate advice then leads to unsuitable judgments and people undergoing surgery that damages their eyesight.

My hon. Friend the Member for West Ham mentioned one tragic case, but there are so many others: paramedics who can no longer pursue their career; police officers who are unable to drive professionally any more; and, as hon. Members may have seen in the media, one health worker who took his own life as a result of the distress.

When things go wrong, the companies often deny responsibility. Sometimes they accept that they need to do something, but they will often delay appointments with the surgeon beyond 12 months and then refuse to accept any responsibility, with people having to be sent off to the NHS for treatment. I want to raise the same issue with the Minister as my hon. Friend the Member for West Ham. It would be really helpful if we ensured that the NHS collated the information about the work it has to undertake and the investment it has to put in to correct the damage and harm caused by those private companies. There was even one company that went into administration and therefore denied all responsibility and liability to patients, only for it to restructure itself and form a new company to continue providing the same services.

On the complaints, I have to say there have been numerous complaints to the GMC and the General Optical Council. Unfortunately, it is often judged that the case does not meet the seriousness threshold and therefore little or no action is taken by those bodies to regulate and monitor companies that are not abiding by basic guidelines. We have discovered that people are operating without being professionally qualified even in cases that are coming up this year. Those shocking examples demand a response now, after all these years.

I am happy to meet with the Minister or, as I know she is busy, with her colleagues and officials to talk through the review that needs to be undertaken into the operation of refractive surgery, as well as what needs to be done to improve regulation and to ensure that the harms caused by the operations largely being carried out by private companies are addressed and that people are supported in the very distressing situations they have found themselves in.

--- Later in debate ---

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

I commend the hon. Member for Strangford (Jim Shannon) for bringing forward this debate on a hugely important subject. Macular disease is the biggest cause of sight loss in the UK, with up to 40,000 people developing wet age-related neovascular macular degeneration every year, with wet macular degeneration being the worst of all known eye diseases.

Age-related macular degeneration is a common condition that affects the middle part of a person’s vision. It usually affects people in their 60s and 70s, rising to a rate of around one in 10 people aged 75 and above. However, it can strike at any age. It can happen in one eye or both and, as we have heard from the hon. Member for Great Grimsby (Lia Nici), it affects the middle part of a person’s eye. AMD can make things such reading, watching television, driving or even facial recognition difficult. Other symptoms can include seeing straight lines as wavy or crooked—which was how the hon. Lady established that she had a problem—objects looking smaller than normal, colours seeming less bright, or seeing things that are not even there.

AMD is not painful and does not affect the appearance of the eye. It does not cause complete or total blindness, but it can make everyday activities incredibly difficult. Without treatment, vision may worsen gradually over several years, which is known as dry AMD, or quickly over a few weeks or months, known as wet AMD. The exact cause is unknown; it has been linked to high blood pressure, being overweight, smoking or having a family history of AMD.

I am sure Members agree that the figures and statistics prove the seriousness of the disease, and why pre-emptive measures should and must be taken. I am proud that that is exactly why we are leading the way in optometry in Scotland. We are currently the only country in the UK to provide free, universal, NHS-funded eye care examinations. Since 2006, adults in Scotland have been able to attend a free eye health check biannually, with children under the age of 16 and adults over the age of 60 entitled to an annual visit. That proves that the Scottish Parliament is committed to delivering a world-leading eye care service for its people.

An NHS eye examination in Scotland is more than just a sight test. It provides a general eye health check that can detect early signs of sight-threatening conditions and other general medical conditions, including diabetes, high blood pressure, cardiovascular disease, tumours, dementia, or even arthritis. Optometrists in Scotland deliver a system of eye care services in which all areas of the ophthalmic workforce are truly at the top tier of their professional competency and expertise. That enables higher quality, safe, effective and person-centred eye care services to be delivered in the community and closer to people’s homes, freeing up hospital services to focus on the most complex eye conditions and urgent patient cases.

Community optometrists are already the first point of contact for any eye problems and they can diagnose and treat a number of conditions without the patient requiring an appointment with their GP or an ophthalmologist, easing pressures on an already burdened health service. An increasing number of community ophthalmologists are also registered independent prescribers and can issue patients with an NHS prescription to treat their eye problem or condition.

I was fortunate enough to be able to visit one of the opticians in my constituency of Coatbridge, Chryston and Bellshill just yesterday. Tuite Opticians in Coatbridge is a family-owned optician currently run by Eamonn Tuite, which has been at the heart of our town since 1973. Tuite understands the needs of the community it serves and always goes the extra mile to ensure the best healthcare and support are provided to all service users. As a result, it not only provides eye examinations in the practice, but also a bespoke service for the housebound, ensuring minimum fuss is required by the patient for such a vital check. I am pleased to be able to place on record my gratitude to the optometrist Stephen Kirley, who took the time to explain to me in great detail the impact of macular degeneration on individuals and why early intervention is so important in treating the disease.

That all lies within and is covered by the free eye test and the fantastic policy of the Scottish Government. By ensuring there are no barriers to accessing eye care, optometrists such as Stephen have a positive impact on patients’ health needs. In return for every eye test carried out, the Scottish Government provide practices such as Tuite with a fee to cover the cost of its work and ensure the business can continue to support as many in the community as possible.

Tuite Opticians was kind enough to carry out my own eye test yesterday and I sure all Members will be happy to learn that I have a clear bill of health—all the better for keeping a beady eye on this Government.

[John McDonnell]

I went for my eye test yesterday. I could not get an appointment in Hayes, my constituency, so I went to Uxbridge. Unfortunately, at the same time the Prime Minister did an official visit to the eye test and disturbed it. How inconsiderate could he be?

[Steven Bonnar]

That is so surprising. This Prime Minister is known for his consideration of others.

I put my thanks to Tuite Opticians on the record, not only for having me, but for its tremendous commitment to the wider community of Coatbridge for over 30 years.