Billy Lawless (Independent) | Oireachtas source

I express my deepest sympathy to the Cosgrave family on the death of their father, the former Taoiseach Liam Cosgrave. He did the State a great service in his time as Taoiseach at a very difficult time politically. At his funeral on Saturday he was described by Monsignor John Wilson as a man who had loved his family, faith and country, which was a fitting tribute to a man who had dedicated his life to all three. May he rest in peace.

I want to discuss the sugar tax. A sugar tax was introduced in Chicago a few months back and it has caused ferocious controversy. It will be rescinded either today or tomorrow and it is probable that the president of Cook County will lose her seat over it. I hope the same will not happen here. I was shocked. She put on a penny per ounce, which was going to bring in more than $200 million in Cook County, of which Chicago is part. I want to warn people that it is an issue. As with everything in the United States, Coca-Cola and Pepsi launched a massive multi-million dollar campaign against it and publicly stated they would finance a fund to be used against the president of Cook County in the primary next March. That shows us how politics works in the United States.

Last weekend I met an old friend who was an optometrist in private practice. We used to row together many years ago. We got to speak about his profession. I was shocked by the figures that he told me were on the waiting list for eye procedures in this country. At the end of August this year, almost 12,500 people were waiting for inpatient eye procedures. It is the highest waiting list in any medical specialty. More than 3,000 of the people in question have been waiting for more than a year, while 800 have been waiting for 12 to 18 months. A further 38,000 are on an outpatient waiting list waiting to receive appointments.That 38,000 has gone up from 32,000 at the end of 2016, an increase of almost 20% in eight months. Hospital eye departments cannot meet the ever-growing demands of patients, whose health is being compromised by these crisis-level delays.

The problem could be tackled effectively if community and hospital-based services were to work together much more closely, with routine care provided in the community and only specialist or complex cases being referred to hospital eye departments. In the United Kingdom and elsewhere across Europe there has been an increasing trend towards community-based eye care. That is where Ireland needs to go. It is estimated that €32 million could be saved, while at the same time providing a better and quicker service. It is 50% less expensive to treat patients through the local optometrist than through the hospital system. There are 600 optometrists across the country who are highly skilled, trained, have the necessary equipment and are available to solve the problem. The Association of Optometrists Ireland, AOI, estimates that savings of €32.3 million could be made here, including €7.2 million in the provision children's eye care services; €19 million in the treatment of glaucoma; €4 million in triage services; and €2 million in the treatment of red eye. An optometrist's examination costs €45 on average, while an examination in an outpatients department or community clinic is estimated to cost more twice that amount, more than €100, plus associated costs such as travel costs and parking fees, etc. There is also a high level of patient non-attendance, putting a cost on hospital services.

There are three areas where the optometrist can immediately reduce waiting times and, given that this is budget day, save the State a considerable amount of money: the paediatric list; the cataract list and the review of stable patients post-treatment. This is particularly relevant in the treatment of glaucoma and macular degeneration. It is very frustrating to hear about the difficulties people have as waiting lists grow and they suffer needlessly. The position could be improved hugely by an immediate discussion between the AOI and the HSE.