Josepha Madigan (Dublin Rathdown, Fine Gael)
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482. To ask the Minister for Health if his Department will consider funding for an increase in fees to community optometrists and for a national public eye care programme for patients over the age of eight years; and if he will make a statement on the matter. [24007/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.

Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.

All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to preschool children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.

The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.

Increasing the fee payable to contractors for a standard eye examination under the COSS (to ensure parity with that payable for the same exam under the Department of Social Protection’s Treatment Benefit Scheme) is a priority for my Department, and work with stakeholders is ongoing in this regard.

The Department has also been meeting with Optometry Ireland to discuss the contribution that optometrists provide to our healthcare service and how this contribution could be further expanded.

The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.

The National Clinical Programme for Ophthalmology developed a model of care, also published in 2017, detailing how the realignment of eye services from the acute hospitals to the community will be undertaken.

Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists. A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative. I have asked the HSE to prepare a detailed implementation plan in regard to this matter.

There will be engagement between my Department and the Department of Public Expenditure, National Development Plan Delivery and Reform during the Estimates 2025 process in regard to the funding needed to progress healthcare priorities, including the provision of eye care.

I believe that there is a real opportunity to work collaboratively with community optometrists, and with other healthcare providers, to make a significant difference to patient outcomes. Of course, any publicly funded ophthalmic service expansion should address unmet public healthcare needs and improve access to public health services while ensuring value for money.