Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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In Ireland there are approximately 200,000 visually impaired people and approximately 14,000 who are blind. They cannot see what is happening around them, including the beautiful view and the smile on their grandchild's face. They lose independence and confidence. However, most cases of blindness are preventable and some 75% of them need not arise. That they do is a scandal and a disgrace. Treatments and therapies, including preventive therapies, are available for the four main conditions, namely, cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy. Preventable blindness is not just a Third World issue; it is also an Irish issue.

Approximately four years ago, my brother, Anthony, became one of the 14,000 who suffered from blindness in Ireland. My family has seen at first hand the difficulties he faces every day. Not only do he and others like him miss seeing beautiful things, but their day-to-day working lives are also complicated by practical difficulties. We should reflect on the fact that half of those aged over 80 years suffer from one of the four main eye diseases. Those with a visual impairment are eight times more likely to break a hip, three times more likely to suffer from depression and are admitted to nursing homes three years sooner than others.

It is not only the human cost that I want to consider because there are serious economic costs associated with sight loss. Blindness in Ireland cost €386 million in 2010 and that figure is expected to rise with current trends to €486 million by 2020. According to the National Coalition for Vision Health in Ireland, a fully implemented strategy to reduce preventable blindness would save thousands of people from blindness and visual impairment and the Exchequer an estimated €76 million per annum. There is a need to redeploy and invest in current services to achieve these savings. We need a national vision strategy in order that professionals can provide good care in community and hospital settings. Imagine preventing almost 200 people a year from going blind and making a saving for the Exchequer; it is a no-brainer and makes sense.

What do we need to do? The National Coalition for Vision Health in Ireland argues that if we introduce interventions such as screening for cataracts and diabetic retinopathy, in addition to early intervention, we could ensure the eyesight of hundreds of people would be retained. The human tragedy of blindness could be significantly decreased. The national coalition believes we should have a national strategy with strategic infrastructure and resources to deliver care. This includes attending opticians, patients accessing community and hospital-based eye services and service user groups such as the NCBI and the Irish Guide Dogs for the Blind. The strength of the national vision strategy is based on a coming together across the spectrum of all the groups involved, including the NCBI, Fighting Blindness, the Irish Guide Dogs for the Blind, ChildVision, the Irish College of Ophthalmologists, the Association of Optometrists Ireland, Diabetes Ireland and health care professionals, including Dr. David Keegan from the Mater Hospital.

Alex White (Dublin South, Labour)
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I am taking this Topical Issue on behalf of my colleague, the Minister of State at the Department of Health, Deputy Kathleen Lynch. I thank the Deputy for giving me the opportunity to outline the current position on health services for people who have a visual impairment orare blind. It is important to emphasise that the core objective of the health service is to maximise people's health status throughout their lives. The emphasis is on the prevention of disease and the management of health conditions at the lowest level of complexity which is safe, cost-effective and accessible to service users. These principles inform the approach to people's eye health, in addition to the wide range of other health issues that may affect them.

There are a number of eye conditions which require specialist health services, including cataract, refractive error, glaucoma, diabetic retinopathy and age related macular degeneration. There are detection and treatment services available at present in community and acute hospital settings for these conditions. In addition, the HSE has an established a clinical ophthalmology programme to improve access, quality and cost effectiveness.

The Health Service Executive, HSE, provides a sight testing service as part of the school health screening programme. Children who are identified as requiring treatment or intervention are referred to the HSE ophthalmic services. Urgent cases are given priority. Children between 12 and 16 years of age also receive services under the medical card scheme or are eligible to be seen by the HSE ophthalmic service when there is a medical reason for the eye condition, rather than refractive error. HSE community ophthalmology services also provide assessment, information and intervention for adult medical card holders with vision disorders. In addition, the HSE makes eye testing, treatment and optical appliances available to adult medical card holders through contracted optometrists and dispensing opticians.

The HSE is establishing an ophthalmology review group to examine issues around primary care ophthalmology services and many of the issues the Deputy has quite correctly raised this evening. This review group will consider the changes required and will identify any matters which it considers should be addressed on a priority basis. Screening by the national diabetic retinopathy screening programme is well under way and is on target to invite all eligible participants for screening by the end of 2014.

Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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I thank the Minister for his reply. The national vision strategy is a roadmap to improved eye care in Ireland and points to an integrated care system that is effective, research evidence based and, most important, has visually impaired people at the centre of the decision making. Professor Keegan, in his presentation to the committee last Thursday, made the very strong point that the national cancer strategy, introduced in 2006, has led to improved patient survival rates and improved patient care, as well as internationally acclaimed, ground-breaking research. Professor Keegan firmly believes that a similar national strategy could improve the lives of the visually impaired. As I said earlier, preventable blindness is not just a Third World issue, it is also an Irish issue.

Alex White (Dublin South, Labour)
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The Deputy is absolutely correct. I have outlined the breadth of health service provision for people with visual impairment. The State's objectives in providing ophthalmic care include the elimination of avoidable sight loss; a focus on prevention and early intervention; equitable access to efficient high quality care, supports and treatment; to improve the quality of care; and improve cost effectiveness. The Government remains committed to the provision and development of vision services and supports through prevention, screening and intervention, all of which contribute to address the priority goal of Vision 20/20 which is to eliminate avoidable blindness in Ireland. I commend the Deputy on her emphasis on the importance of a national strategy and the importance of it being addressed in the way she has outlined. The Minister and I share her objectives in that regard and I thank her for raising the matter.