Eye Health and Macular Disease

Margaret Ferrier Excerpts

Tuesday 11th January 2022 Westminster Hall

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

In 2018, the Royal College of Ophthalmologists found that there was a need for an extra 230 consultants and 204 staff and associate specialists over two years. Does the hon. Gentleman agree that recruiting and retaining staff in the ophthalmology workforce needs to be a primary consideration?

[Jim Shannon]

I certainly do, and I thank the hon. Lady for that intervention. That was one of my points; the Minister has heard it said there, and I will not repeat it. The importance of having the staff in place, to which the hon. Lady referred, is one of the asks in this debate. How can we address that? If we have the staff in place, we can address the issue of eyesight loss earlier.

We are all aware of the demand for NHS eye-care services over recent years. Ophthalmology is now the busiest outpatient specialty in the NHS, with some 7.9 million attendances in 2019-20. That gives one an idea of the magnitude of the issue. That is why this debate is important, and why today we need to look to take things forward. Waiting times have been made worse by the covid-19 pandemic—we understand that. The pandemic has meant that some patients faced a waiting time of up to six months to access care. We know that the wait can be a matter of weeks, but if patients have to wait six months for a diagnosis and medical response, their eyesight can deteriorate significantly in that time. Up to 22 people a month may suffer severe or permanent sight loss as a result of delays to follow-up care. Can the Minister tell us what we can do to address those issues, and what has been done to catch up on that in the pandemic?

--- Later in debate ---

[Jim Shannon]

How pertinent that intervention is. I will give a couple of examples now that I was going to give later because they are pertinent to this. The opticians and ophthalmologists in Strangford and Newtownards town have told me of two occasions in 2021 when people who went for their test were sent straight away to the Ulster hospital in Dundonald because they had a tumour. They had no other ailments, but their ophthalmologist or optician spotted something early on. They say the eyes tell the health of the whole body, and I think they do. In that case, two lives were saved, and there are probably many others.

[Margaret Ferrier]

Following that point, it is really important to use the available data effectively in understanding the level of serious eye issues experienced across the UK. Does the hon. Gentleman agree that streamlining data sharing across all health care providers should be mandated?

[Jim Shannon]

It is always important to have the data on health issues. The Minister, the shadow Minister and hon. Members will know that. If you have the data, you can respond to where the problems are. The hon. Lady is right; we need to have that data in place.

In 2018, the APPG on eye health and visual impairment took evidence from the charity SeeAbility. People with learning disabilities, including children in special schools, are much more likely to have a sight problem, but much less likely to access NHS sight tests. Last night, in a different debate on the welfare cap, the right hon. Member for Hayes and Harlington (John McDonnell) referred to those who will feel the pain of the welfare cap, but those with disabilities will feel it more. That is very real when it comes to health issues and it is why this issue is so important.

With that in mind, the APPG and SeeAbility asked for sight testing and glasses dispensing facilities in all special schools, which has now been taken forward by NHS England. That is excellent news and it shows that sometimes—hopefully all the time—APPGs and their partners can bring about changes. This will reach around 130,000 children and help to address and prevent avoidable sight issues and reduce the need to use hospital eye clinics.

The commitment by NHS England to reform must continue as these children have an equal right to sight. We will all follow matters closely, and I would like to see the rest of the UK following Northern Ireland. The excellent work by the Ulster University Centre for Optometry and Vision Science in special schools has also shown the same need. When we see that issue being addressed, it is good news. Let us all look at the opportunity for reform in England and in the devolved nations and seek to improve sight testing for adults with learning disabilities in the community too.

There are targeted schemes with optical practices in every area. Unfortunately, Minister, at the moment we see a patchwork across the UK. In some areas the service is good and in other areas it is not. We need to act across the board in all postcode areas to see the level of care and attention that we seek in today’s debate.

The health inequalities experienced by people with learning difficulties justify more attention. People with learning disabilities are dying of avoidable health issues at least two decades before their peers. We cannot have people living without good sight and even going avoidably blind because national health services overlook their needs. That cannot happen and should not be allowed to happen.

I have outlined the issues, but I want now to look at the good news; the positive, glass-half-full news about how we make the changes to address those issues, including improving the quality of life for people with macular disease and the pressure on family and friends that inevitably comes with that.

With rapid and appropriate treatments, whether those are pharmaceutical treatments, laser treatments or surgery, we can do the job better, working alongside opticians. They are keen to be involved, and to address these issues. As my hon. Friend the Member for East Londonderry (Mr Campbell) said, when a person gets an appointment from their optician, they should go to it: it is so important that they do so, and we want to make sure that people do that. So many cases of sight loss could be either treatable or preventable.

As the UK builds back from the covid-19 pandemic, there is an opportunity to transform eye care services, increasing capacity to deliver rapid and appropriate treatment for macular disease and other causes of sight loss. NHS planning guidance for 2022 focuses on tackling elective care backlogs. Minister, what has been done to address those backlogs? I understand that there are many backlogs—we know them all too well. We need to deliver 110% of pre-pandemic elective activity, but we must also support the NHS to transform services for the long term, to ensure there is enough capacity to treat patients who start to experience sight loss. Improved integration of eye care services must also be a priority for integrated care systems as they move towards implementation. That should include supporting lower-risk patients to be treated in the community, freeing up specialist service capacity for those patients who need it most. At the same time, as the hon. Member for Rutherglen and Hamilton West said, data sharing needs to be improved, for example through the electronic eye care referral system. That is just one example of what could be done to ensure that everyone has the information they need to improve the quality and timeliness of care.

We must also ensure that the NHS is making use of the most innovative treatments—the hon. Member for Sedgefield (Paul Howell) has referred to one of them—especially those treatments that help people living with sight loss to manage their condition as independently as possible, with less frequent need for hospital visits. If we can reduce hospital visits and improve care, we will reduce costs and improve long-term health. We must invest in the workforce we need to deliver current and future eye care. I am very pleased to note that the Government have already confirmed that the process to appoint a new national clinical director for eye care has begun. I hope that this role will provide much-needed leadership and drive forward a transformation of NHS eye care services, including improved integration, better use of data and expansion of the workforce, which I believe is essential to provide the high-quality care that will, in turn, deliver better outcomes for patients. That national clinical director should therefore be appointed as a matter of urgently, and I look to the Minister and to Government to give us a clear timetable for making that appointment.

To ensure accountability and transparency, the national clinical director for eye care should report to a single Minister with responsibility for eye care services across primary, secondary and community care. The role of that individual is critically important for outlining a strategy and moving forward. Sight loss is widespread, and its implications are significant for the NHS. The cost of sight loss to the public purse cannot be ignored, but it is most important for the patients whose lives will be irrevocably altered by a diagnosis such as macular disease. Timely access to appropriate treatment could quite simply be the difference between someone losing and keeping their sight. We want to ensure that people can keep their sight, so it is vital that we do all we can to ensure that every patient can get the treatment they need, when they need it—the earlier the better. When it comes to sight, every day matters. Every appointment is essential, and that principle must underpin our approach to the necessary changes to macular eye health in this post-covid world.

I thank the Minister again for offering her time. People will say, “Well, that’s her job”, but she comes here with a passion and an interest in this issue. It makes it much more pleasurable for me introducing this debate, and for other Members as well, that we have a Minister who can respond positively. I welcome the opportunity to continue these discussions following today’s debate—I know that the Minister is always agreeable to doing so. In anticipation of their speeches, I also thank all of my colleagues, right hon. and hon. Friends and Members, in this Chamber. Working together, we can and will achieve.