Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister of State to the House. I am delighted to support the motion, on which there is much international research. A 2019 study on the impact of eye clinic liaison officers at various ophthalmology clinics in the UK found that eye clinic liaison officers who had a presence at hospital ophthalmology clinics were valuable for streamlining processes within the clinic, not least for providing continuity of care for patients when they are discharged after medical treatment. That is important, given that people are often lost once they are discharged from the clinic and they return home.

Eye clinic liaison officers have also saved staff time at the clinic because they are often responsible for providing emotional and practical support for patients living with sight loss. The study further found that the impact of eye clinic liaison officers may depend on efficient communication within the clinical team, being trusted by other staff and having good knowledge of local and national sight loss support services outside the hospital setting. Eye clinic liaison officers work directly with people with low vision, deteriorating vision, sight loss or impending sight loss and, most important, with their carers. The emotional and practical support is extended to carers and family members of all ages. They provide timely one-to-one support, high-quality information and advice, emotional support and access to other statutory and voluntary services. Eye clinic liaison officers connect people with the practical and emotional support they need to understand their diagnosis, deal with their sight loss and maintain their independence, which is of most importance. They have time to dedicate to people following their appointment in order that they can discuss the impact the condition will have on their life.

In July of this year, the National Council for the Blind Ireland, NCBI, highlighted the success of the eye clinic liaison officer service by celebrating the 100th patient referred to the service in a matter of weeks. Mr. Stephen Farrell, a consultant ophthalmologist at Temple Street hospital, stated:

[T]he ECLO service is a fantastic addition to our Ophthalmology Unit, it is a much needed resource to the children and their parents attending our service. For hospital staff being able to refer to the ECLO has been really reassuring.

The NCBI has stated:

ECLOs act as key point of contact, working closely with medical and nursing staff across Dublin eye clinics. ECLOs aim to bridge the gap between hospital and community based services and education providers like ChildVision ... The ECLO service across all three Dublin hospitals are staffed by two qualified NCBI personnel who have extensive knowledge in meeting and responding to the changing needs of ophthalmic patients.

The NCBI has stated it aims to have an eye clinic liaison officer embedded in all hospital clinics throughout the country by the end of 2021, with the goal of providing early intervention and support at the time of diagnosis. Ms Elaine Crossan, an eye clinic liaison officer at the Mater Hospital, has stated:

[A] diagnosis of a sight condition can be devastating, which can bring enormous practical and emotional consequences and challenges. Many patients report feelings of panic and anxiety. It is my job to act as a key contact point for patients by providing vital information on their eye condition, as well as offering practical and emotional support where and when they need it most. Most importantly, patients now receive the time and support that is essential to them and to their families.

Often as doctors we are very good at diagnosing things, but once there is a label put on it, and a treatment and a prescription handed out, we often forget about the patient and that is wrong. That is the vital role of the eye clinic liaison officer, ECLO, as a support not only to the patient but also to the family.

The ECLOs are helping prevent avoidable sight loss, which is done by talking patients through treatments and helping family members to understand the importance of compliance with their medication. It has to be said that more than 50% of medication prescribed in this country is not taken properly, so reassurance and embedding in people's minds the message with regard to compliance is of vital importance, and that is another role for the ECLO. This role effectively releases clinical staff to focus on more complex cases. Being co-located with the clinical team enables the ECLOs to receive referrals as soon as possible and to advise acute staff on the appropriateness of a referral to a community-based service. In other words, people and patients do not always have to be seen in the hospital sector. Many patients can be transferred to the community-based sector, thus shortening waiting times and preventing people with sight loss having to travel often on public transport or on poor road networks over long distances. The importance of the ECLO in transferring patients from the hospital sector to the community sector cannot be overemphasised.

Given the sharp increase in the number of children with serious visual impairment and blindness, the National Council for the Blind Ireland, NCBI, was keen to further partner with Children's Health Ireland at Temple Street Hospital to support the heightened demand on the system. However, as Senator Conway mentioned, we need to comment on the incredible waiting lists and waiting times for eye care currently. There are more than 60,000 people across the various ophthalmology waiting lists. The outpatient list, as Senator Conway mentioned, is 43,000. The inpatient day case list for ophthalmology procedures is more than 8,000, and the primary care list is more than 15,000. In 2018, the NCBI said that ophthalmology waiting lists had become unmanageable. It said also that more than 75% of sight loss is avoidable and that 40,000 people are missing out on vital, early intervention because waiting lists are out of control.

The Government has committed to eliminating avoidable sight loss, but we have seen absolutely no progress on waiting times in the last year. Delays in access to treatment for conditions like age-related macular degeneration, which is the biggest cause of sight loss in Ireland, can cause irreversible sight loss. We have much work to do with regard to the waiting times. I echo the support for this excellent motion. ECLOs are a vital cog in delivering a modern healthcare system and take many ophthalmology patients out of the hospital setting into the community setting, where most of these services can be provided.