Ms Siobhan Kelly:

I thank members for providing the Irish College of Ophthalmologists, ICO, with the opportunity to address the joint committee. The ICO is the training and professional body for eye doctors in Ireland. One of our key concerns is to ensure that members of the public are educated about and aware of good eye care practices.

To reiterate Mrs. O'Donnell's point, the decision to have a medical or surgical procedure can have a profound impact on the health and well-being of patients and their families. While there is little doubt that a medical or cosmetic procedure can be positive for patients when undertaken by trained specialists with appropriate aftercare, it is essential that patients receive balanced information. Advertising is a legitimate and important source of information for members of the public and can help to inform patients of services and treatment options. However, important questions arise in this regard. For example, given the potential significance of the decisions involved, is regulation in the area of direct advertising to patients required to ensure they receive unbiased information?

Providers use advertising and marketing to compete for consumers. While advertising can play a positive role, it can also have a negative effect, particularly if it trivialises the risks of procedures, targets vulnerable consumers or misleads by portraying an outcome that may not be attainable for all. For some people, cost is more likely to influence their decision than the qualifications of the person doing the procedure and the quality of care he or she provides. Trivialising surgery to the point that the decision to proceed is solely based on cost is not compatible with the prioritising of patient safety and quality outcomes.

Ireland does not have specific legislation in place governing direct-to-patient advertising. There are no requirements that advertisements or marketing material provide any information on the health risks of procedures. Both surgical and non-surgical interventions can have a serious impact on an individual’s health and well-being, yet questionable advertising trivialises the procedures and presents them as a desirable commodity.

As cost is the key deciding factor for some people choosing a procedure or provider, financial inducements are likely to have an impact on purchasing behaviour. Discounts for procedures or offering procedures as competition prizes may impair an individual's ability to give proper thought to what is being offered. Time-limited deals, which offer discounts within a certain timeframe, allow little or no opportunity for proper consideration of the risks involved.

The current regulatory system needs to be updated to provide clearer rules through which to hold advertisers to account and which reflect the changing market, particularly the significant growth in non-surgical procedures and increasing use of digital marketing. Standards must ensure that advertising is conducted in a socially responsible manner. Advertising and marketing practices should not trivialise the seriousness of procedures or encourage people to undergo them hastily. Any claims must be based on high-quality evidence and should not raise unrealistic expectations.

The Irish College of Ophthalmologists proposes that statutory restrictions be imposed on the advertising of medical and surgical procedures. The advertising regulations which apply to solicitors are an appropriate framework and one that should be considered.