Niall Blaney (Fianna Fail)
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Senators Gallagher and Conway are sharing time. I call Senator Gallagher to commence.

Robbie Gallagher (Fianna Fail)
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I welcome the Minister of State, Deputy Peter Burke. My colleague and I wish to highlight the problem of accessing public eye care in Ireland but we have a potential solution. I look forward to the ministerial response in due course.

Unfortunately, many adults and children must wait too long to receive public eye care in this country. Figures for 2022, compiled by the National Treatment Purchase Fund, show that over 33,000 people were on an outpatient eye care waiting list, with over 12,000 of them having waited longer than a year. In fact, HSE figures show that almost 10,000 people had waited for over a year for urgent eye care treatment as of November 2022. Therefore, the current hospital-based system is not fit to meet the current demand, let alone any future need.

Optometrists have told us that there is an opportunity to address the waiting lists for eye care through greater use of their services. Optical practices and optometrists are ready to work in collaboration with the entire eye care sector to deliver a shared care service that will reduce the burden on the HSE, improve clinical outcomes for patients and save sight. Such an initiative would go a long way to tackling the current long waiting times. Optometrists have told us that they believe this can be best achieved by increased availability of primary eye care within communities. There is evidence to support the belief that their plan is working because a pilot scheme is under way, and has been for some time, in Sligo. That scheme has worked very well.

I have raised this issue on a number of occasions. Optometrists appear to have a solution to this problem. They want the HSE and the Department of Health to engage with them. Apparently, there are 300 optometry practices and 700 practitioners throughout the length and breadth of this country. They have the expertise and the equipment. I understand it is 50% less expensive to provide routine examinations, monitoring and care in the community via optometrists than it is to do so within the hospital system. Of course, if optometrists did more of this work, it would alleviate the pressure on hospitals. I look forward to the address by the Minister of State after my colleague Senator Conway has said a few words.

Martin Conway (Fine Gael)
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I fully support and agree with Senator Gallagher. It says a lot about eye care that we both tabled the same Commencement matter this morning.

I welcome the Minister of State, Deputy Peter Burke, to the House. I am aware of his commitment to this particular issue because we have spoken about it on many occasions.

It is a national embarrassment when politicians are taking photographs and putting them up on social media of buses going to the North with taxpayers and citizens going up there to have their cataracts done. We need to eliminate that practice. We need to ensure that it does not happen. Imagine the indignity of people from this country being photographed and being put on social media going to the North to have their eye conditions dealt with. We need to stop that. We need a national strategy for eye care.

We need to eliminate preventable blindness. Would the Minister of State believe that four out of every five people in this country who go blind do so unnecessarily? That means 80% of people who lose their sight in this country do so unnecessarily. They do so because they are not caught in time. They are not screened or operated on in time. The interventions do not happen on a timely basis. We need to eliminate that. It is not good enough.

Imagine if you closed your eyes, you had to keep your eyes closed and you had to walk around with your eyes closed forever, amen. That is what happens with people who lose their sight.

The one thing we can do in this country is ensure that people who have sight keep sight. There are people like me who were born without sight, have limited sight and are grateful for the amount of sight they have. That is unpreventable, but what is preventable is people who have full sight who end up losing their sight or becoming seriously blind or visually impaired because of the system, the HSE and untimely interventions.

I call on the Minister of State to deal with the waiting lists but, more importantly, introduce a national eye care strategy to eliminate preventative blindness.

Peter Burke (Longford-Westmeath, Fine Gael)
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I thank Senators Gallagher and Conway for bringing this important issue to the table and for this Commencement debate this morning, and acknowledge Senator Conway's advocacy from lived experience, which is an important value to bring to the table in a debate like this.

The Minister, Deputy Stephen Donnelly, is unable to attend this morning. He appreciates the considerable contributions of optometrists to public health in Ireland. He recognises that optometrists played a key role in responding to the health needs of the public during the Covid-19 pandemic.

Professionals in this field continue to provide a valuable service to people in Ireland, helping them to maintain good optical health.

The HSE contracts optometrists to provide routine eye examinations and glasses for people with a medical card under the community ophthalmic services scheme. This provides patients with the freedom to choose a practice and time that best suits them. As the Minister has previously stated, the fee paid to optometrists for providing this service will be reviewed this year.

Beyond the services already provided, making greater use of the skills of optometrists is recognised as an important element in improving health care delivery. The Primary Care: Eye Services Review Group Report of 2017 examined this in detail. The report recommends the expansion of the community ophthalmic services scheme to allow for the care of children aged over eight to be managed by their local optometrist. This would occur when visual impairment has been identified in screening.

Transferring care for this group would alleviate pressure on other services, allowing them to focus on more complex or urgent cases. It would also make greater use of the vast experience held by optometrists. Work on this proposal was delayed by the pandemic, but the HSE has resumed the process of exploring how best to implement this recommendation.

A further recommendation of the report is the establishing of primary care eye teams. These multidisciplinary teams include community ophthalmic physicians, orthoptists, specialist nurses, technicians and administrative staff. Adopting an integrated approach will utilise the full skill sets of each team member and provide a comprehensive service to patients. Primary care eye teams have been established in the following community healthcare organisations, CHOs: 6, 7, and 9.

The introduction of these teams in those CHOs has had a substantial effect on waiting lists. In 2023, the HSE will seek to establish primary care eye teams in other CHOs.

The Government recognises that waiting lists must be addressed. As part of our multi-annual approach to this issue, the Minister published the 2023 Waiting List Action Plan at the start of this month. Building on the work done in 2021 and 2022, €443 million has been allocated in budget 2023 to improve waiting times for patients in Ireland. This includes recurrent funding of €123 million for the HSE to implement longer-term reforms such as modernised care pathways and closing capacity gaps, and non-recurrent funding of €240 million for the National Treatment Purchase Fund, NTPF, and the HSE to provide additional public and private activity to clear the backlogs exacerbated during the Covid-19 pandemic. This includes support from the NTPF for the provision of ophthalmic treatments. The Minister expects that the combination of these various initiatives and funding streams will contribute to an improvement in service for patients in need of immediate care.

Robbie Gallagher (Fianna Fail)
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I thank the Minister of State for his response.

Members regularly come into the Chamber to highlight problems. We have done that this morning but we are also highlighting a potential solution and I would ask that Government grasp that.

I take some encouragement from the response that the Minister of State has given us in that work is taking place. I implore him to expedite that work so that, as Senator Conway outlined in his contribution, a stitch in time saves nine. It is imperative that we work fast on this particular issue.

Martin Conway (Fine Gael)
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I fully agree with my colleague, Senator Gallagher. Gabhaim buíochas leis an tAire Stáit for his reply.

We can eliminate preventable blindness. Look what they have done in the north-east region under Professor David Keegan and the initiatives that they have rolled out there.

I very much welcome what the Minister of State has announced but we need to see it actioned. We need to see it scaled up. We need to see our waiting list diminished, reduced and ultimately eliminated.

People deserve to keep the eyesight they have. If we can do that and if we can use the next 18 to 24 months to eliminate the waiting lists, we need to have a contract with ourselves that we never let them get out of hand again.

I thank the Minister of State for his reply, which is encouraging. Hopefully, we will see it scaled-up and actioned.

Peter Burke (Longford-Westmeath, Fine Gael)
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I thank Senators Gallagher and Conway again for raising this important issue. I will, indeed, follow-up with the Minister to liaise with them on the progress on both of the initiatives that have been referenced in my opening statement.

I absolutely understand the importance of sight. It is how you live your everyday life. It is critical in terms of your environment, your surroundings and to have reasonable quality of life.

Both of those are important initiatives in that, as Senator Conway quite rightly pointed out, a stitch in time saves lives. It is important to have these initiatives enacted quickly.

Prevention is the best key right across our healthcare system. When issues are not treated, which is one of the challenges from Covid-19 in delayed healthcare, they get inevitably worse and the system has to expend huge resources trying to resolve difficult healthcare issues.

I thank Senators Conway and Gallagher for bringing this important debate. I will revert to the Minister for Health to keep in contact with the Senators about both initiatives.