Preventable Sight Loss

Preet Kaur Gill Excerpts

Tuesday 30th April 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Sir Mark. I congratulate my hon. Friend the Member for Wirral West (Margaret Greenwood) on securing the debate. She is a fierce campaigner on bringing down NHS waiting lists, and for an NHS that remains true to the principle on which it was founded: to be a service that is there for everyone when they need it and that is free at the point of use. I also thank my right hon. Friend the Member for Hayes and Harlington (John McDonnell), who made a powerful speech about how eye care is often a neglected topic.

The RNIB estimates that more than 2 million people in the United Kingdom live with sight loss. Shockingly, at least half of that sight loss might be avoidable. A recent Royal College of Ophthalmologists workforce census found that 63% of eye units estimate that it will take at least a year to clear their backlogs; a quarter of them estimate that it will take more than three years. Across our country, the demand for ophthalmology services has risen rapidly and is set to increase by 40% over the next 20 years. The economic cost of sight loss is estimated to be £25.2 billion a year. Surely that is too big a price not to act.

The current Government have treated eye care as an afterthought. Today in England, 619,000 people are on a waiting list for a hospital eye appointment, and 250 people start to lose their sight every day. Yet this Government have no strategy for eye health in England, unlike every other UK nation.

The next Labour Government will take eye health seriously. We will crack down on the tax dodgers and use the money to bring down waiting lists. We will train a new generation of doctors, nurses and midwives to treat patients on time. We will double medical school places to ensure that we have the workforce we need, including across ophthalmology. We will reform the system, too, so that everyone can access the right care when and where they need it.

Moving more care to the community will help to support those who are suffering sight loss, as will focusing on the provision of non-clinical community support to complement the work of community optometrists, ophthalmologists in hospitals and rehabilitation officers. That is why the next Labour Government will seek to negotiate a deal with high street opticians to deliver NHS out-patient appointments for eye conditions such as glaucoma. There are currently 6,000 high street opticians in England, equipped with specialist staff and kit that can get patients seen faster. We will put them to work to beat the backlog and free up hospital specialists to treat the patients in serious need. That will all mean greater convenience for patients. As these are routine appointments, it will be less expensive to the taxpayer to deliver them on the high street than in hospital.

We know that delivering eye care in the community works. A 2014 study considered the impact of the introduction of minor eye care services in Lewisham and Lambeth on ophthalmology hospital departments. GP referrals to hospital ophthalmology decreased by 75% in Lewisham and by 30% in Lambeth. Costs in areas that did not have a minor eye care service increased, but costs in Lewisham and Lambeth decreased by 14%. A separate dataset from Hereford in 2022 showed that 92% of referrals to eye casualty by GPs could have been seen by an optometrist via the minor eye care services, and 83% of self-referrals could have been seen by MECS.

Perhaps the Minister can say today whether he backs Labour’s plan to try to strike a deal for high street opticians to deliver additional clinical services. Has he made an estimate of how many people now on hospital waiting lists are waiting to be seen for issues that could easily have been seen in community optometric services? According to a report published last year, more than 550 patients have suffered sight loss since 2019 because of NHS delays. That is absolutely tragic.

It is not just patients who stand to benefit from Labour’s plans. GPs stand to benefit from the removal of low-value, time-consuming paperwork that could be dealt with in opticians’ shops by optometrists themselves. Patients can already go directly to sexual health clinics, as well as to physiotherapists in some parts of the country, without seeing a GP; in Greater Manchester, where lung cancer is the biggest killer of people under the age of 75, patients with risk factors can now get walk-in chest X-rays. Opticians who spot a problem should not have to send patients to their GP for referral to an eye specialist instead of referring them directly. Why is direct referral not the case everywhere? Labour’s plans will see best practice adopted everywhere to allow opticians themselves to refer patients to eye specialists, meaning that patients can be seen faster and GPs can get on with more important and meaningful work.

We know how important eye care services are to our communities. Vision loss in older people has been proven to affect their physical and mental health and to increase the speed of cognitive decline. We know that sight loss can be a symptom of serious disease. The Government must set out a plan for these services, with a mix of strengthened community-based care and prevention policies. It is right that we address the gaps in care co-ordination that disproportionately affect those with the greatest need, to give everyone the best opportunities to access education and employment and to live well in older age. Let us give everyone a right to sight.