Fidelma Healy Eames (Fine Gael) | Oireachtas source

This is a well-intended amendment, however, I also see reason to reject it. It is very important that if a condition of concern is detected that a correct referral takes place, but referring people back to the GP who may not even have the right equipment to determine that and creating another waiting list is not sensible. We are trying to have a good public primary health care system. I know the HSE is doing its best to achieve that. There are 781 optometrists in Ireland. They are the primary health care providers as regards people's eyes. WHO research has shown that 80% of blindness is preventable. It is prevented by regular eye examinations and it is the duty of the optometrist to detect eye diseases and to refer for appropriate treatment. The waiting lists for most eye diseases are horrendous and the probability of a patient losing vision by the time he or she is seen is very high so we do not need to make those lists any longer. This is where optometrists can help.

While I accept that Senator Crown's amendment is well meaning, if it were carried, it would add to the already very long waiting lists. He is proposing that if persons present with a condition, professionals must refer them to their GPs straightaway and tell them to get medical attention. This defies logic. GPs are not equipped with the machinery to measure pressures. They do not have machines such slit lamps, which is a microscope for examining the front and back of the eye. There are another six vital pieces of equipment that GPs do not have. In England, Wales and Scotland, there is a direct referral system from the optometrist to the appropriate department within a hospital. This eliminates unnecessary referrals. Optometrists are not claiming to be doctors but they have all completed a four-year Bachelor of Science degree in optometry and complete professional qualifying examinations before they can practise.

We also know that we are living with an aging population and it is predicted that visual impairment will increase by 50% in the next 20 years. As we all know, as we get older, we can see the power of our sight deteriorating. It is in the public interest that unnecessary referrals are avoided because they will just further clog up the system. In the interests of correct care, which is the intention of the amendment, why not do as they do in England, Wales and Scotland and have that direct referral system to the appropriate expertise or consultant as opposed to going back through the GPs which is an unnecessary loop? I thank the Acting Chairman for the opportunity to address the amendment.