Wednesday, 19 October 2011
National Vision Policy
Cuirim céad fáilte roimh an Aire Stáit. Tá mé thar a bheith buíoch di as ucht teacht isteach ar an gceist iontach tábhachtach seo.
I raise on the Adjournment this issue which relates to the Vision Impaired Service Providers Alliance, VISPA and services for persons with visual impairment. As the Minister will be aware, last week was World Vision Day and a group from VISPA marched to the Dáil and handed a letter in to the Taoiseach, and my party organised an information session with them on the previous evening.
The VISPA group is made up of four organisations. They are: the National Council for the Blind of Ireland, the Irish Guide Dogs for the Blind, St. Joseph's Centre for the Visually Impaired and Fighting Blindness. They are trying to draw awareness to the issue of visual impairment.
Some 224,832 persons in Ireland are affected by sight loss and 12,995 persons in Ireland are classified as blind.
I want to recognise at this stage the input of Senator Conway to this debate and, certainly, last week as well. He is always vocal on this issue and I commend him on that.
The real financial cost of visual impairment and blindness in Ireland is estimated to be €386.09 million in 2010 and the charities mentioned provide essential services and lead innovation. For over 70 years, Ireland's vision rehabilitation needs have been met largely by charitable organisations and while they receive Government funds, their success depends on individual generosity and fund-raising. They provide essential services and lead innovation in the areas of education and retraining, mobility and independent living, social care and counselling, developing better assistive technologies, and also funding social and medical research on blindness.
A commitment was made in 2003. I refer to the WHO global resolution, supported by the Government in 2003 and 2009. In that commitment the Government committed to create a national co-ordinating committee by 2009 to implement the recommendations in Vision 2020, yet nothing has been established to date. Some 118 World Health Organisation member states have established national committees, as was indicated in that commitment.
The Government must honour the commitments in that document and it should do this as quickly as possible. The cost of sight loss survey indicates that the State's investment in vision health is more than €380 million, that is more than €1 million a day. This funding should be co-ordinated and delivered through a national vision strategy, which is another part of the Adjournment motion.
Included in a vision strategy would be the following: access to resources such as opthomology, which is under-funded, and critical planning.
With regard to rehabilitation, with the right support people affected by sight loss can maintain a good quality of life and this is very important. Research needs to be continually funded. Interestingly, although this area involves people with a disability, it also has great potential because it is the area in which some of the top research in the world is being done at present. Last week, I was told by the experts dealing with it that clinical trials would be imminent if funding was continued. If clinical trials can be put in place, not only would they provide great help to those suffering from loss of sight or blindness, but they would create the potential for jobs in the country because the cures that potentially could be developed on Irish soil would make us a world leader in the area. It would make no sense whatsoever to stop investment in research, and this investment should be increased. We also need to increase the awareness of people about the issues involved.
Is the Government willing to support VISPA's recommendations? It has called on the Government to work with all vision health stakeholders to develop and implement a vision health plan for Ireland. We cannot afford to wait to plan for the imminent vision health crisis. Tá mé thar a bheith buíoch don Aire agus tuigim go bhfuil a fhios aige go maith faoin gcás seo agus go dteastaíonn an tacaíocht seo. Tá mé ag tnúth leis an bhfreagra a bheidh le fáil ón Rialtas.
I appreciate the Senator raising the issue as it gives me an opportunity to set out the Government's thinking on it.
Vision 2020 is the global initiative for the elimination of avoidable blindness. It is a joint programme of the World Health Organisation and the International Agency for the Prevention of Blindness. On a worldwide basis, it is estimated that up to 80% of blindness is avoidable, which indicates cost-effective treatments are available. Vision 2020 has targeted a number of diseases that contribute to blindness. Many of these diseases are related to infections commonly found in tropical regions.
The World Health Organisation monitoring committee for the elimination of avoidable blindness stated in 2006 that, generally speaking, the prevention of blindness is, for the most part, not a public health issue in a large percentage of countries in the Americas and Europe. It went on to state that many of the countries in these two regions have long solved their infrastructure problems and their health care delivery systems function efficiently.
It is not proposed to set up a national co-ordinating committee to develop and implement a national vision policy, strategy and plan. However, the Government will continue to provide and develop vision services and supports through health prevention, screening and intervention policies and programmes. I will outline these services in a moment. We will also continue to support the members of the Vision Impaired Service Providers Alliance, including the National Council for the Blind, the Irish Guide Dogs for the Blind, St. Joseph's Centre for the Visually Impaired and Fighting Blindness, regarding service provision, research and support for visually impaired people in Ireland.
A number of eye conditions are part of Vision 2020, including cataract, refractive error, glaucoma, diabetic retinopathy and age-related macular degeneration. Detection and treatment services are already available throughout the country, in community and acute hospital settings, for many conditions which can lead to vision impairment and blindness. For example, diabetic retinopathy is one of the most serious complications of diabetes. We know that screening, followed by treatment of retinopathy, is very effective in preventing blindness. Earlier this year, the national cancer screening programme was formally requested by the Health Service Executive to commence the development of a national diabetic retinopathy screening programme. A total of €4 million has been made available in 2011 for the development of a screening model.
Screening tests for glaucoma are available and treatment involves anti-glaucoma medication, which is also widely available. Age-related macular degeneration is the most common cause of blindness in industrialised countries. Treatment options are available for certain types of macular degeneration, although it is generally agreed that further research is required and this is on-going on a global basis. The Health Service Executive provides screening through child health examinations. Children are eligible for ophthalmic treatment and optical appliances in respect of any problems noted at child health examinations. More than ten years ago, a scheme was launched which provides free eye examinations and free spectacles to adult medical card holders.
Cataract is clouding of the lens of the eye and is amenable to surgical intervention. This surgery is widely available in acute hospitals. In July, the Minister, Deputy Reilly, announced changes in the role of the National Treatment Purchase Fund. The special delivery unit, working in close collaboration with the NTPF, will introduce a more focussed strategy to target treatments for patients and systematically reduce waiting lists.
Where people are blind, the focus of any health or personal social service support is to facilitate full participation in the social and economic life of the community. When we develop policies, strategies or action plans for people with a disability, those who are blind or with a visual impairment are included. The Government will finalise a value for money and policy review of disability services before the end of the year. The report of the disability policy review has been published for public consultation and I urge everyone with an interest in the area to participate and give their opinion; we will be interested to hear them. It is my intention to examine both the policy report and the value for money report, and in conjunction with the Minister, Deputy Reilly, I will bring proposals for the future of our disability services to Government.
I contend that, while it is not proposed at this time to develop a specific vision strategy, we are working through the actions required to address the goal of the WHO's initiative, namely, to eliminate avoidable blindness in Ireland.
I am very disappointed to hear the Government does not intend to establish a national co-ordinating committee to develop and implement a national vision policy, strategy or plan. We are often told that we have international commitments. The Government made commitments to the WHO in 2003 and 2009. If we are able to renege on a health commitment, why can we not renege on our commitments to the EU, the IMF and the troika? It beggars belief that we can meet our commitments in an economic area but not in health.
With respect, the reply did not address the issue of research funding. People suffering from this disability do not have time and we need to implement a strategy. They tell us research is crucial and we strongly urge that funding in this area is not cut. It deserves essential funding, and certainly funding for research should be maintained or increased because of the economic and job potential which exists.
I have no indication that visual impairment research funding will be cut. It would be wrong to state it will be. We have several obligations with regard to disability. We have not yet signed up to the UN Convention on the Rights of Persons with Disabilities but we intend to do so. It is a process and we will continue along the road in respect of our other international obligations also. When it comes to how we deal with people who are visually impaired, our priority should be to provide this service to them and we are well on the way to this.