Children waiting up to five years for eye care

Children who require eye care in the public system have to wait up to five years to be seen depending on where they live, the Association of Optometrists Ireland (AOI) has said.

It is calling on the next Government to tackle these ‘unacceptable delays'.

In a submission to all newly-elected TDs this week, the AOI said that these waiting lists could be eliminated by moving to a community-based model of care.

It proposed that routine eye care be delivered in the community through optometrists, rather than the current system of referring all cases to HSE clinics and specialist hospital services, which are already ‘overwhelmed by demand'.

Such a model has already been successfully introduced in parts of the UK.

"There are 300 optometry locations across the country with the skills, capacity and equipment to provide a service for all referrals (19,000 per annum) within days.

"Routine cases, such as prescribing glasses, treating a basic condition, or monitoring an early stage disease, could be wholly managed at community level. More complex or urgent cases can be referred by the optometrist to specialist clinic and hospital services," commented AOI optometric advisor, Lynda McGivney Nolan.

She said that in particular, children's waiting lists could be solved quickly if children were referred from the existing Primary School Children Optical Scheme to their local optometrist, rather than to a community clinic.

These clinics have waiting lists of up to six months for urgent case and two-to-five years for non-urgent cases.

The AOI insisted that this move would be cost effective.

"On the estimation of a HSE community clinic examination costing €100 per visit and an optometrist €60 per exam, plus other additional savings, at the current level of 100,000+ children's annual examinations, annual cost savings of €5.4 million can be achieved," Ms McGivney Nolan said.

She insisted that the way in which public eye care is currently delivered is not the best use of skills or resources, and it does not ensure optimum health outcomes for those affected by eye issues.

"Unacceptable waiting times mean that opportunities for prevention through early intervention are missed. It also means that diagnosis and treatment are delayed and prognosis worsened.

"Also there are very significant variations in waiting times and access to services across the country, depending on regional HSE infrastructure, which is highly inequitable," she pointed out.

She said that these waiting lists and regional disparities are caused by ‘a historical dependence on almost exclusively using HSE clinics and hospital-based services, even for basic and routine cases'.

The AOI told TDs that the current system is ‘unsustainable'.

"It has inadequate capacity, requires large capital outlay, removes care from the community, is administration heavy and is expensive to run. Against this, demand on the system is increasing significantly year on year as the population increases and ages."

The AOI is calling for a community-based model of eye care, which would see optometrists dealing with all routine cases, with more complex or urgent cases referred to regional multidisciplinary teams or specialist services.

"In adult eye care we have calculated that savings of €14.5 million can be made by taking routine diagnosis, check ups, and monitoring of diseases such as glaucoma, cataract and diabetes-related eye problems out of the hospital system," Ms McGivney Nolan said.

She added that all of the political parties had promised a shift away from hospital-based health services to community-based services in their General Election manifestos.

"As negotiations to form the next Government are currently taking place, we are providing an evidence-based, proven and cost-saving model for how that change can be done in eye care."

For more information on the AOI, click here

 

[Posted: Wed 23/03/2016]

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