Preventable Sight Loss

Kirsty Blackman Excerpts

Tuesday 30th April 2024 Westminster Hall

[Kirsty Blackman (Aberdeen North) (SNP)]

Thank you for chairing the debate, Sir Mark. If my voice goes during my speech, I will just sit down, and hon. Members can assume that the rest of it would have been fabulous.

I congratulate the hon. Member for Wirral West (Margaret Greenwood) on securing this important debate. As the right hon. Member for Hayes and Harlington (John McDonnell) said, it is important to highlight these issues before we get to the point of total crisis. I will talk about what has been happening in Scotland on preventable sight loss.

I thank and commend everybody who works in eye care, whether they work as optometrists or in ophthalmology in hospitals, and everybody who provides those incredibly important services to people. We recognise the hard work and dedication that they put in to ensure that as many people as possible continue to have the best possible eyesight.

As the hon. Member for Wirral West said, whether someone can see properly has a significant impact on their life. When I was eight years old, I lost my eyesight completely over a week. I had optic neuritis, which is incredibly unusual for an eight-year-old. For a short period, I genuinely could not see almost anything. Thankfully, I was treated well and helpfully by the team at Aberdeen Royal Infirmary and got my sight back entirely, which does not always happen with optic neuritis. Although I did not have to deal with that situation in the long term, I am aware of how terrifying it is. It has a major impact on people’s lives.

With our public platform, we should do everything we can to encourage people to get their eyes tested regularly and have regular eye examinations. Eyesight is important, but most people probably take it for granted most of the time. Regular checks can ensure that optometrists and community optometrists discover any possible future eye conditions and that people are given treatment as early as possible. Eye checks can also highlight more serious conditions such as cardiovascular issues, high blood pressure or diabetes. In Scotland, we have free universal NHS eye checks in community optometrists. Those check-ups are available for everybody—UK residents, refugees, asylum seekers and some eligible overseas visitors— and people do not have to pay. I encourage people to get their eyes checked regularly: it is important to go along.

I will talk about our strategies and workstreams for ophthalmology. In Scotland we have what is called the national ophthalmology workstream, which has brought together the views of a huge number of people working in ophthalmology, particularly around hospital care, to ensure that the best possible service is provided to everyone. There are workstreams on things like cataract surgery, which the hon. Member for Wirral West has mentioned, to ensure that people are given the best cataract surgery as early as possible. Successful surgery in the first instance also reduces the need for follow-up appointments.

The strategy tries to ensure that, even with Scotland’s fairly unique geography, as many conditions as possible can be treated close to people’s homes and in their communities. If hospital appointments are needed, they should be there, but if the need for hospital appointments can be reduced by providing the same or a similar service closer to home, that is encouraged.

We recently had a pilot of the NHS glaucoma service in communities, which started in Glasgow and has been rolled out across Scotland. It aims specifically to ensure that the number of hospital appointments is reduced. Going to hospital when you do not necessarily need to can be stressful. If someone can be treated in a primary care setting that they are used to, it is easier and better for everybody. It takes some of the stress off NHS services, ensuring that the necessary services are delivered and that capacity matches demand where possible. As I say, it is about providing the best possible services that suit people, as close to home as possible. We cannot get away from the fact that there is a capacity and workforce issue, not just in England but across these islands, but we have been doing what we can to recognise that. The strategy has been in place since 2017 and is leading to real differences and real improvements for people.

We have a couple of other things in place in Scotland. The See Hear strategy is specifically about ensuring that services are improved for sensory-impaired people. Under the See4School system, every pre-school child has their eyesight tested to ensure that they are as ready as possible to learn when they go to primary school and that those conditions can be picked up as early as possible.

Lastly, I encourage everybody to please get their eyes tested. For anyone who has not been for some time, I thoroughly recommend going. It is not just about being able to see incredibly well with 20/20 vision; it is about ensuring that conditions are picked up. I ask everybody to encourage their constituents to go.

--- Later in debate ---

[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?