John Crown (Independent) | Oireachtas source

I move amendment No. 4:

In page 24, between lines 10 and 11, to insert the following:“81F.Should any person registered by the Optical Registration Board, in the course of an examination, discover a medical condition that would require medical treatment, or arrive at the suspicion that there exists a medical condition that may require treatment, that person shall—

(a) inform the patient of the presence of that medical condition, or the suspicion of the existence of a medical condition, and
(b) recommend that the patient consult with a registered medical practitioner.”.”.

This is the first of a series of three amendments I am offering which deal with three critically important issues, namely, patient safety, saving public money and attempting to prevent the development of any kind of closed shop. We are blessed to have a phenomenal cohort of professionals in this country. I speak of the fabulous nurses, doctors, dentists, physiotherapists, opticians, medical specialists, ophthalmologists and social workers who keep the show on the road. The show is not well organised and was not rationally constructed, and the thing that saves our bacon is the quality of the people who work in it.
I have occasion to see many people whose lives have been saved by opticians. Approximately 50 to 100 people get a primary cancer in the eye. They may present to their doctor or eye specialist, but may typically present to an optician with vision change merely for a check-up. In this case, an eagle-eyed optician doing an appropriate examination may find evidence of an eye tumour which could be fatal but which is usually cured if treated early. My hat is off to our colleagues who have this critical role. They are sometimes the first persons to diagnose a person with diabetes, tuberculosis or circulatory disease. In some parts of the world, they are the first to diagnose a person with HIV. These conditions can all present with abnormalities of the eye, and very often the first person the patient presents to is not a doctor, ophthalmologist or GP but an optician. We must acknowledge the critical role they have had and I would not wish to demean this.
In this amendment I seek to ensure that a classic medical situation of falling through the cracks is less likely to occur. With this amendment, an optician examining a patient who finds something that might indicate an underlying medical condition, would not have, as has been widely circulated to Members of the House, an obligation to refer the patient – we never said that – but an obligation to inform the patient and suggest the patient seek medical attention. I cannot see why it should be controversial. Some would say it is gilding the lily because this obviously happens anyway. In the overwhelming majority of cases it happens, and all I am saying is that it should be enshrined as part of the code of professional practice of opticians, optometrists, formerly known as dispensing opticians, and the various associated specialties.
I understand the Minister of State needs to consult. I have said before that she is an extremely courteous contributor to the business of the House and I would never seek to stop her from doing necessary consultation. All we are asking is that it be codified in law and regulation that this is expected of people. It should be uncontroversial.
There is a certain amount of understandable confusion about the issue. Ophthalmologists are the medical doctors who pursue senior postgraduate training in eye diseases. They are usually, but not always, eye surgeons. Opticians and optometrists are part of that other very esteemed profession who do not have a medical qualification but who go directly into training to look after optical and ocular issues.
This is not something I thought up on the back of a bus. The ophthalmologists approached me expressing their concern that the new regulations under which CORU and the regulatory boards could act would, perhaps, be strengthened in the case of the opticians if this requirement were inserted. People may ask why we are not suggesting it for everybody else. It is because the amendment relating to the opticians has come up now. A similar amendment may be relevant to some of the other fine specialties. The opticians are different in that they tend to act entirely appropriately but more independently than some of the other specialties to which people are often referred by doctors, dentists or nurses. I ask the Minister of State to consider this uncontroversial amendment. It would strengthen what is a very good Bill and would help our very fine cohort of opticians to continue to play their critical but unsung role.

We often hear about how great it is to get one's eyes tested or to get one's contact lenses but we should remember that opticians save a bunch of lives as well.