Professor David Keegan:

I would triage again. One aspect we are considering is the quality of letter that is sent to patients. That is not to bounce things back to a GP or optometrist. What we have heard loud and clear from our work with the cataract team, led by Mr. Tim Fulcher and Dr. Lisa McAnena, is that when they worked with standardised referrals, GPs wanted optometrists front and centre and engaged on this, with support from GP services. That would ensure more accurate referrals coming so that the referral coming in can be risk stratified. That is not the full answer. With that information, we triage urgent patients. A patient may have comorbidities, diabetes or other issues or may have good vision in one eye. Some cases should be expedited. In this day and age, nobody should be waiting five years. I can only talk to our region, and the target is to reduce the time involved to less than 12 months by the end of the year for everybody. Within three years, the target is a zero to three-month waiting list as an absolute.

Unfortunately, patients are accessing care through emergency services. We have a disproportionate number of patients accessing the eye emergency department in the Mater hospital, the eye and ear hospital in Cork or elsewhere for care that should be delivered through an outpatient setting.

I would advise the lady to whom the Deputy referred to go back to the optometrist or GP, and for a fresh letter to be sent to state the urgency of her case and request it is triaged appropriately. I am more than happy to discuss the case with him directly. Obviously, we cannot take all cases in, but sometimes it is an index shocking case such as that that drives change. That should not be necessary, but we will react to that and provide an answer.