Category: Health

Gordon Brown – 1997 Comments on Increasing NHS Spending

The comments made by Gordon Brown, the then Chancellor of the Exchequer, on 14 October 1997.

This new money for NHS patient care will go to where it is needed most.

The Government’s approach is clear.

We will maintain the control totals we set and therefore achieve the public spending discipline needed for sustainable finances. Savings will be found from within existing resources.

And we will use money saved to fund our priorities, of which NHS patient care is one.

Indeed, we will continue to be relentless in our search for savings, where money can be redirected to priorities.

The new initiatives, including the appointment of best practice teams, will ensure better use of resources. We are satisfied that the money announced today will go to where it is needed most, for patient care during the winter months.

18/12/2022
Dan Poulter – 2022 Article on Increasing Pay for Nurses

A section of the article written by Dan Poulter, the Conservative MP for Central Suffolk and North Ipswich, with the full article in the Guardian on 16 December 2022.

The government’s decision to squeeze nursing pay will push more nurses to vote with their feet, to leave the NHS and earn more money by either working for temporary NHS staffing agencies or to work for private healthcare providers. This could even result in the perverse situation where reductions in real-terms pay mean that the same nurse could leave their NHS job and return to work for the NHS, perhaps even in the same hospital department, as an agency nurse. The NHS will foot the bill for the agency costs and the increased salary paid to the nurse.

This is poor healthcare economics. Pay needs to be set at a level that helps to recruit and retain the NHS workforce and the time has come for some joined-up thinking from government. Investing in better pay for nurses and other NHS staff would help improve staff retention and reduce the ever-growing temporary staff bill.

17/12/2022
Margaret Greenwood – 2022 Comments on the Infected Blood Inquiry

The comments made by Margaret Greenwood, the Labour MP for Wirral West, in the House of Commons on 15 December 2022.

Margaret Greenwood (Wirral West) (Lab)

One of my constituents has been deeply affected by this issue. She has endured, in her words,

“a long, upsetting and depressing process.”

The strain on her and her family has been enormous.

The Hepatitis C Trust has warned that people affected by the infected blood scandal are falling through the gaps in the present frameworks for financial assistance and compensation, including those whose medical records have been lost and destroyed, which the Minister touched on—I would like him to expand on that—and people who were born abroad. What assessment have the Government made of the number of people who fit into that category, or when can we expect to receive such an assessment? What will he do to put things right?

Jeremy Quin

First, I absolutely sympathise with the hon. Lady’s constituent. However, I hope that, since 2017, with the statutory inquiry, the report and the payment of interim compensation, they have seen that we have got a direction of travel and that things are moving in the right direction. I know, given the weight of people’s loss, that that has taken too long, but we are working on it.

I recognise that there are issues in regard to hepatitis C and in particular hepatitis B. In relation to hep B, Sir Robert said that Sir Brian needed to take further medical evidence. It is one of the areas where, because of the absolute complexity, we may need to wait for the Langstaff report before we can be specific, but are we aware of the issues? Yes, we are, and I am grateful that the hon. Lady has brought the matter to the House’s attention.

17/12/2022
Patricia Gibson – 2022 Speech on the Infected Blood Inquiry

The speech made by Patricia Gibson, the SNP MP for North Ayrshire and Arran, in the House of Commons on 15 December 2022.

We in the SNP pay tribute to those affected by the infected blood scandal—one in three infected with HIV were children—and their continued decades-long struggle for justice. Today’s announcement of a swift response to Sir Robert Francis’s final recommendations relating to compensation is indeed welcome, but the Minister will understand the widespread disappointment about his inability to commit today to a date for publishing a response to Sir Robert’s compensation framework report.

The Minister will be aware that there is understandably a significant and remaining lack of trust between those impacted by infected blood, the UK Government and existing support schemes. Recommendation 16 of Sir Robert’s study calls for an arm’s length body to

“administer…compensation…with…independence of judgement and accountable directly to Parliament”.

I hope the Minister will tell us today that he will keep the House updated on the progress of that.

Thousands of families across the UK have experienced great trauma after they have cared for loved ones suffering—or in many cases dying—due to contaminated blood. Does the Minister support the notion of the interim scheme being extended to families and carers who have cared for people with infected blood?

Jeremy Quin

There are two points in particular. On the arm’s length body, a persuasive case is made in recommendation 16. Looking at the principles of that, particularly on independence, we are not yet ready to commit to an ALB, but we definitely want to have a body that will have the trust and respect of those whom we are seeking to support. Work is going on as to how that will best be constituted, but recognition of independence is key behind the principles of the recommendation of an ALB. I look forward to updating the hon. Lady on other issues as the work progresses.

17/12/2022
Peter Bottomley – 2022 Speech on the Infected Blood Inquiry

The speech made by Sir Peter Bottomley, the Conservative MP for Worthing West, in the House of Commons on 15 December 2022.

I welcome the Minister coming to make an oral statement. We know that both he and the Leader of the House have been deeply involved in this issue over the months and years.

The right hon. Member for Kingston upon Hull North (Dame Diana Johnson) is the most powerful advocate trying to hold Government to account and to get them to come forward. I think she will want to write—and I will happily join her—a whole series of detailed questions to the Minister, some of which he may be able to answer now. For others, he may have to say what conditions need to be met for them to be answered.

One important thing to my mind is allowing those who are not yet registered as possibly entitled to compensation to preregister, so that, when the Government come out with their response to Sir Brain Langstaff’s report, they will be able to take that up fast and make up any missing medical records, which will be a problem for some people who have been infected or affected.

The all-party parliamentary group welcomed the Government accepting the first point of Sir Robert Francis’s report about the moral case. I thank the Government for that. We are also grateful that Sir Robert is going to be invited to help Sue Gray to take forward the work she is doing. We should not underestimate the amount of work.

As and when people get compensation, are they going to be protected from the scams and so-called financial advisers who may not protect their income and use of that money? Can the Minister consider whether he can answer whether inheritance tax will not be applied to someone’s payments if the household is within the inheritance tax limit?

Jeremy Quin

I should have said this in response to the hon. Member for Vauxhall (Florence Eshalomi) but, in response to the Father of the House, I have greatly appreciated spending time with him and the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), who has been a tireless campaigner on this, as has the entire all-party parliamentary group on haemophilia and contaminated blood. I very much appreciated the time they spent with me.

I absolutely recognise the point on preregistration, which is one of the issues at the forefront of our minds as we go through this. The Father of the House recognises that there are particular issues, including in relation to medical records that may have been lost over time, dating back decades. There needs to be a clear system so that people know how to take advantage of the scheme.

On compensation and scams, I share my hon. Friend’s concern. I am not certain how we will be able to address that. It is obviously an issue that afflicts many of our constituents in many circumstances, but I am sure that it will not be impossible to deliver timely advice alongside the scheme.

In terms of tax, the recommendation is clear that this should be tax free and should be disregarded for benefits. In relation to inheritance tax in particular, there are complexities that need to be examined. Whether we need to have legislation as part of that process is one of the issues that we are working on. If my hon. Friend or other hon. Members have detailed questions, they are more than welcome to write to me and I shall respond.

17/12/2022
Florence Eshalomi – 2022 Speech on the Infected Blood Inquiry

The speech made by Florence Eshalomi, the Shadow Cabinet Office Minister, in the House of Commons on 15 December 2022.

I thank the Minister for the statement, which is welcome but long overdue. It is very disappointing that the Government did not find time for an oral statement in the House earlier this year when they published Sir Robert’s report. Ministers were dragged kicking and screaming to publish the report when it was leaked. That has been the pattern throughout this long painful process and it seems no different today.

Victims of the contaminated blood scandal will be watching today with great interest. Heartbreakingly, many of those infected have not lived to see today’s exchanges and the prospect of proper justice at the end of the inquiry. My right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) has campaigned tirelessly to raise awareness of this issue, but throughout that time more than 3,000 people have died and statistics from the Terrence Higgins Trust show that, between the start of the inquiry in July 2017 and February 2022, some 419 infected people have died.

I know personally how important this issue is and what it is like to have a loved one rely on a clean blood supply. My late mother suffered from sickle cell anaemia and because of that disease she required regular blood transfusions, which were vital. Without those blood transfusions, her life would have ended a lot earlier. I cannot imagine the pain and trauma experienced by families who were let down by basic failures of standards. The least they deserved was a prompt and thorough response from the Government. While we await the conclusion of the report and inquiry, one person dies every four days. Every day that we delay the compensation is justice denied to those people. The Minister owes it to those victims to provide real answers today.

In a recent Westminster Hall debate, the Minister’s colleague, the Parliamentary Secretary, Cabinet Office, the hon. Member for Brentwood and Ongar (Alex Burghart), gave a frankly insulting response on the subject. He dodged the question and failed to give any certainty about the timeline for payment or the publication of the Government’s response to the report, which they have had for more than eight months. Victims will not accept empty gestures. It seems to families that the plan changes with every announcement.

Can the Minister make a promise to the House today to publish a timetable for the compensation framework for those affected by the infected blood scandal? What plans does he have to work in partnership with the infected blood community to develop the compensation framework for those affected? When will he end the Government’s silence on the other 18 recommendations that have gone ignored? How will the Minister make sure that everyone who wants to respond to the proposals has the opportunity to do so? Rather than sporadic updates without any substance, will the Minister commit to more regular updates on progress and the direction of travel on this heartbreaking issue, ahead of the report next summer?

The contaminated blood scandal had a life-changing impact on tens of thousands of victims who were promised the hope of effective treatment. It can only be right that they see the justice they deserve as soon as possible.

Jeremy Quin

I thank the hon. Lady for her remarks. She spoke movingly of the impact on those infected and affected. I concur that time is of the essence. I appreciate that, for family reasons, she knows how difficult it must be for the people who saw these things happening to their relatives, and how awful that process has been. I also appreciate that it is incredibly important, given all that has happened to this community, that trust is built and retained. I certainly commit that we will update the House regularly.

I cannot commit to a timetable. The reason is that I do not want to say anything in this House that we cannot meet. There is a complex series of steps to be taken and work to be done across Government and with the devolved Administrations. But I assure hon. Members that it is my intention to update the House as we make progress. We must do so in order to ensure that those infected and affected are fully apprised of the progress we are making.

I am grateful to Sir Robert and Sir Brian for how they have incorporated the views of those infected and affected in their work. My impression is that those infected and affected have appreciated the engagement they have had through the work undertaken. I hope that means that Sir Brian’s work is fully reflective of the thoughts of the community. I have said that I wish to meet members of the community. I want to ensure that our work is timely and ready to fully consider and respond to the work that Sir Brian produces during the course of next year.

17/12/2022
Jeremy Quin – 2022 Statement on the Infected Blood Inquiry

The statement made by Jeremy Quin, the Minister for Cabinet Office, in the House of Commons on 15 December 2022.

With permission, Madam Deputy Speaker, I will make a statement to update the House on our preparations for the infected blood inquiry, which is expected to conclude next year.

I took over as the Minister sponsoring the inquiry on 25 October. While I have been aware of this issue for many years, as have so many of us who have been contacted by affected constituents, undertaking this role has further impressed on me its scale and gravity—not only the direct, dreadful consequences for victims, but the stigma and trauma experienced by many of those infected, by their families, and by those who care for them. I recognise that, tragically, we continue to see victims of infected blood die prematurely, and I also recognise that time is of the essence.

I commend the work of the all-party parliamentary group on haemophilia and contaminated blood. I am pleased to have met the co-chairs, the right hon. Member for Kingston upon Hull North (Dame Diana Johnson) and the Father of the House, my hon. Friend the Member for Worthing West (Sir Peter Bottomley), and I am grateful for their insight.

In July 2017 my right hon. Friend the Member for Maidenhead (Mrs May) established the infected blood inquiry, chaired by Sir Brian Langstaff. My predecessor as Paymaster General, the current Leader of the House, went further by commissioning a study from Sir Robert Francis KC, which is entitled “Compensation and redress for the victims of infected blood: recommendations for a framework”. The purpose of the study was clear, namely to ensure that the Government were in a position to fully consider and act on the recommendations. Sir Robert delivered it in March this year.

The Government had intended to publish a response alongside the study itself, ahead of Sir Robert’s evidence to Sir Brian Langstaff’s inquiry. However, as the then Paymaster General explained, the sheer complexity and wide range of factors revealed in Sir Robert’s excellent work meant that when the study was published by the Government on 7 June, it was not possible to publish a comprehensive response. The Government remained absolutely committed to using the study to prepare for the outcome of the Langstaff inquiry, and that is still the case.

On 29 July, in response to Sir Robert’s recommendations, Sir Brian Langstaff published an interim report on interim compensation. It called for an interim payment of £100,000 to be paid to all those infected and all bereaved partners currently registered on UK infected blood support schemes, and to those who registered between 29 July and the inception of any future scheme. The Government accepted that recommendation in full on 17 August. Quite rightly, a huge amount of work was undertaken across Government during the ensuing weeks to ensure that the interim payments could be exempt from tax and disregarded for the purpose of benefits, and that an appropriate delivery mechanism existed. This involved work across many Departments, and with the devolved Governments in Scotland, Wales and Northern Ireland. Interim compensation is just one part of our overall response, but it was important that we got it right.

I fully recognise that interim compensation was but one of the recommendations in Sir Robert’s study. I want to stress to the House and to the many people who have a direct and personal interest in the inquiry that those interim payments were only the start of the process, and work is ongoing in consideration of Sir Robert’s other recommendations. I am pleased that all the interim payments were made by the end of October. Sir Robert recognised in his study that the Government could not give in advance a commitment on the exact shape that redress will take. Our comprehensive response must await the final report of the infected blood inquiry. However, I want to assure those affected that this Government, which delivered a statutory inquiry and interim compensation, remain absolutely committed to our intentions in commissioning the compensation framework study. Accordingly, and recognising the need to continue to build trust with the affected community, I want to share with the House the progress we are making.

A cross-Government working group, co-ordinated by the Cabinet Office, is taking forward work strands informed by Sir Robert’s recommendations. A cross-departmental group at permanent secretary level has been convened, chaired by the Cabinet Office second permanent secretary, Sue Gray, to oversee that work. I am pleased to be able to say that Sir Robert has agreed to provide independent transparent advice to the group as work progresses. I am grateful to him for his continued input into our thinking. It is my intention over the coming months to update the House on progress and, where it is possible, to provide greater clarity on the Government’s response to Sir Robert’s recommendations prior to Sir Brian’s report being published.

In the meantime, I wish to make clear one critical answer to a recommendation posed by Sir Robert. In the first recommendation of his study, Sir Robert sets out that there is in his view a moral case for compensation to be paid. The Government accept that recommendation. There is a moral case for the payment of compensation. We have made that clear in our actions with the payment of interim compensation. I now want to make it equally clear on the Floor of the House. The Government recognise that the scheme utilised must be collaborative and sympathetic, and as user-friendly, supportive and free of stress as possible, while being consistent with the Government’s approach to protect against fraud. The Government will ensure those principles are adopted.

We have significant work to do to ensure we are ready for Sir Brian’s report. For example, Sir Robert makes detailed findings and recommendations about the delivery of the scheme, which must be worked through in discussion with the devolved Administrations. Work will need to be undertaken to ensure, in line with his recommendation, that final compensation can be made free of tax and disregarded for benefits purposes.

We know, too, that the inquiry will make recommendations in relation to bereaved parents and children. In his interim report, Sir Brian made clear his view that the moral case for their compensation is beyond doubt. Sir Brian recognised that the approach to compensating this group of people is complex and the Government must be ready to quickly address recommendations relating to them. The work in consideration of the study will ensure that the Government are prepared to act swiftly in response to Sir Brian Langstaff’s final recommendations relating to compensation.

Those infected and affected have suffered enough. Having commissioned both the inquiry and the report, the Government have further shown their commitment in our actions by the payment of interim compensation. Sir Brian and Sir Robert have both ensured that the voices of those infected and affected are front and centre of their work, and I, too, hope to be able to meet and hear from people directly affected as our work progresses. We have much to do, but I wish to assure the House—this is why I wished to be here today—that this is a priority for the Government and we will continue to progress it. I commend this statement to the House.

17/12/2022
Neil O’Brien – 2022 Speech on Eye Health

The speech made by Neil O’Brien, the Parliamentary Under-Secretary of State for Health and Social Care, in Westminster Hall, the House of Commons on 15 December 2022.

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important debate. He has been a strong advocate for eye health for a long time. He speaks from huge knowledge and personal experience, and I listened to his speech with great interest. Given that health is a devolved matter, a lot of my response will focus on England, as he suggested. I understand that the devolved nations are facing similar challenges. We are always interested in sharing ideas and working with our counterparts, in answer to the question asked by the hon. Member for Motherwell and Wishaw (Marion Fellows).

There are 2 million people living with sight loss, and that is predicted to double to 4 million by 2050 as a result of an ageing society. Sight loss is often preventable, and that is why prevention and early detection, along with access to diagnosis and timely treatment, are key. One of the best ways to protect our sight is to have regular sight tests. The hon. Member for Strangford rightly underlined why that is so important with his powerful story about the tennis ball-sized tumour that his constituent had taken out.

When combined with early treatment, sight tests can prevent people from losing their sight. That is why we continue to fund free NHS sight tests for many, including those on income-related benefits, those aged 60 and over, and those at risk of glaucoma and diabetic retinopathy —two of the main causes of preventable sight loss. More than 12 million NHS sight tests were provided to eligible groups in 2021-22. We also provide help with the cost of glasses and contact lenses through NHS optical vouchers. Eligible groups include children and those on income-related benefits. The NHS invests over £500 million annually to provide sight tests and optical vouchers.

The risk factors for sight loss include ageing, medical conditions such as diabetes, and lifestyle factors such as smoking and obesity. We are taking action to reduce obesity and smoking. Smoking rates in England are already the lowest in history, and we remain committed to going further to be smoke free by 2030. We are working to drive down the number of people who take up smoking, and we are supporting those who wish to quit. We are also working with the food industry to ensure that it is easier for people to make healthy choices, and we are supporting adults and children living with obesity to achieve and maintain a healthier weight.

Turning to the medical conditions that lead to sight loss, diabetic retinopathy—a common complication of diabetes—is a potentially sight-threatening condition. The diabetic retinopathy screening programme now provides screening to over 80% of those living with diabetes annually. Between 2010 and 2019-20, the number of adults aged between 16 and 64 who are registered annually as visually impaired due to diabetic retinopathy has fallen by 20%, meaning that it is no longer the main cause of sight loss in adults of working age. The screening programme has played a major role in that.

Jim Shannon

I thank the Minister for his helpful response. The target of providing retinopathy screening to 80% of those living with diabetes has been achieved. Are there any plans to try to reach the other 20%? I am diabetic. I had my retinopathy test about four weeks ago; I get it every year. I know the encouragement and confidence that testing gives people once they know they are okay. Are there any ideas for how we can get to the other 20%?

Neil O’Brien

Absolutely. As the hon. Gentleman says, we are keen to constantly drive that rate up, and we can talk more offline about the different things that we can potentially do to drive it up even further. The healthy child programme recommends eye examinations at birth, six weeks and age two, and school vision screening is also recommended for reception-age children.

The hon. Member for Strangford raised a question about a special school, which I will address specifically. The NHS long-term plan made a commitment to ensure that children and young people with a learning disability, autism or both who are in special residential schools have access to sight tests. NHS England’s proof of concept programme has been testing an NHS sight-testing model in both day and residential schools, and it is currently evaluating its proof of concept as part of programme development, which we expect to conclude towards the start of 2023. The evaluation will then inform decisions about the scope, funding and delivery of any future sight-testing model. I reassure the hon. Gentleman that, at present, absolutely no decisions have been made; we are waiting for the evidence that that programme is generating.

I turn to secondary care. Once an issue with eye health is detected, it is vital that individuals have access to timely diagnosis and any necessary treatment. The NHS continued to prioritise those with urgent eye care needs throughout covid-19. However, we acknowledge the impact that the pandemic has had on our ophthalmology services, as it has had on other care pathways. Our fantastic NHS eye care teams are working hard to increase capacity and provide care as quickly as possible. We have set ambitious targets to recover services through the elective recovery plan, supported by more than £8 billion over the next two years, in addition to the £2 billion elective recovery fund and the £700 million targeted investment fund announced last year.

Marsha De Cordova (Battersea) (Lab)

Will the Minister give way?

Neil O’Brien

I give way with pleasure to the hon. Lady, who has been hot-footing it from a funeral to attend the debate. I will seamlessly fill in, so she can catch her breath. I congratulate her on making it here.

Marsha De Cordova

I honestly thank the Minister for giving way. I have just got here from the funeral of a dear friend, Roger Lewis, who, as a totally blind man, was also a strong advocate for a national plan for eye care in England and the devolved nations. I congratulate my dear and honourable friend, the hon. Member for Strangford (Jim Shannon), on securing this very important debate.

As many Members will know, I currently have a Bill calling for a national strategy for eye health in England. We need to ensure that eye care provision is joined up across England to reduce avoidable sight loss but also, more importantly, to end the fragmentation of services. Is the Minister willing to meet me to discuss some of the provisions in the Bill, to ensure that we can create an eye care pathway that ensures that nobody who is losing their sight—or has already lost it—will go through the pathway without the right support and timely treatment?

Neil O’Brien

I am grateful for the hon. Lady’s intervention, and I will be happy to meet her. It sounds like there is an important connection between where she has just been and this debate. I am extremely happy to meet her to talk about that.

I will continue setting out our strategy. I have already talked about screening in primary care, and I was setting out the sums of money that we are investing—the £8 billion plus the £2 billion—in elective recovery following the pandemic. NHS England has been supporting NHS trusts to increase capacity in surgical hubs, and the independent sector has also been used to increase the delivery of cataract surgery, in particular. In 2021-22, nearly half a million cataract procedures were provided on the NHS, which is actually more than before the pandemic, so that is recovering.

Beyond recovering from the pandemic and looking to the future, hospital eye care services are facing increasing demand. As a number of hon. Members have pointed out, ophthalmology is already the busiest out-patient speciality, and the predictions are that the demand for services will increase by 30% to 40% over the next 20 years as the result of an ageing society.

To help address these challenges, NHS England’s transformation programme is looking at how technology could allow more patients to be managed in the community and supported virtually through image sharing with specialists in NHS trusts. Current pilots for cataracts and glaucoma are allowing primary care practices to care for these patients and refer only those who need to be seen by specialists. The learning from these pilots will feed into any possible future service model. That could allow us to use the primary care workforce to alleviate some of the secondary care pressures.

I am delighted that the NHSE has appointed the first national clinical director for eye care, Louisa Wickham, who will oversee this work programme. I am aware that the APPG on eye health and visual impairment has called for there to be one Minister responsible for primary and secondary care services. I can confirm that my portfolio covers both those areas, so I will be taking an active interest in the development of that transformation programme and strategy.

A number of hon. Members have raised questions about the workforce, and we acknowledge that there are challenges across the system, including in ophthalmology. NHS England is developing a long-term workforce plan that will consider the number of staff and roles required and will set out the actions and reforms needed to improve workforce supply and retention. We have already invested in growing the ophthalmology workforce with more training places in 2022, but there is more to do. We are also improving training for existing staff so that they can work at the top of their licence.

Research is an area that the hon. Member for Strangford is interested in, and I was extremely sorry to hear from the hon. Member for Tooting (Dr Allin-Khan) about her keratoconus. That is one area where, fortunately, research and new treatments are coming online, so research is hugely important. While we have effective treatments, particularly for macular disease, we absolutely cannot rest on our laurels because medicine continues to evolve. We recognise that research and innovation are crucial to driving improvements in clinical care and improved outcomes for people living with sight-threatening conditions. The £5 billion investment in health-related research and development announced in the 2021 spending review reflects the Government’s commitment to supporting research into the most pressing challenges of our time, including sight loss.

Over the past five financial years, the National Institute for Health and Care Research has invested more than £100 million in funding and support for eye conditions research, and many of the studies focus specifically on sight loss. The NIHR Moorfields Biomedical Research Centre has recently been awarded £20 million from the NIHR for another five years of vision research, allowing it to continue its mission of preserving sight and driving equity through innovation. Through the NIHR, England, Scotland, Wales and Northern Ireland work together on a range of research topics, and the devolved Administrations co-fund several research programmes.

To assess how well interventions are achieving their intended aims, it is important that we track their impact, which hon. Members have mentioned. The public health outcomes framework’s preventable sight loss indicator tracks the rate of sight loss per 100,000 population for three of the most common causes of preventable sight loss: age-related macular degeneration, glaucoma and diabetic retinopathy.

We are making progress. The indicator shows the impact that the new treatments have had on the rate of sight loss due to age-related macular degeneration. Despite an ageing population, the rate of sight loss in 2019-20 was 105.4 cases per 100,000, down from 114 per 100,000 in 2015-16, so there has been an improvement on macular degeneration. The open availability of this data provides a valuable resource for integrated care boards to draw on in identifying what is needed in their areas and for local democratic accountability for any variation in performance against public health outcomes.

Jim Shannon

The answers are very helpful. One thing that all three Members referred to was the waiting list, and those who lose their eyesight just because they have been on a waiting list for diagnosis, examination and investigation. I know the pandemic created lots of problems in relation to the waiting list. Does the Department intend to have a strategy that will reduce the number of people on waiting lists to ensure that those waiting for a diagnosis retain their eyesight?

Neil O’Brien

I mentioned earlier that one of the main goals of the huge £8 billion plus £2 billion investment is in elective recovery because, as the hon. Gentleman said, the pandemic has had a huge impact. We have already cleared the number of people waiting for two years. The next milestone is to clear those waiting 18 months and then to work through the plan and bring down the numbers using that additional money over time, reducing those waiting the longest first and then steadily reducing the number of people waiting in total.

I acknowledge the importance of good vision throughout life, and especially as we get older. I hope that what I have outlined today provides some reassurance that we acknowledge the ongoing challenges faced by eye care services and are taking action to address them.

16/12/2022
Rosena Allin-Khan – 2022 Speech on Eye Health

The speech made by Rosena Allin-Khan, the Labour MP for Tooting, in Westminster Hall, in the House of Commons on 15 December 2022.

It is a pleasure to serve under your chairmanship, Mr Sharma, and to respond on behalf of the shadow Health and Social Care team. I pay tribute to the hon. Member for Strangford (Jim Shannon) for securing this important debate and for his continued advocacy on this issue. I particularly liked his description of the experience of walking with a guide dog, and how that lived experience has helped him become a campaigner. The hon. Member is a voice for issues that often do not get enough time in this place.

More than 2 million people live with sight loss in the UK, and by 2050 the number will reach 4 million. Ophthalmology is the NHS’s busiest outpatient service, with 7.5 million hospital attendees last year. With demand for eye care services set to soar by 40% over the next 20 years, it is vital that we get this right. The Government must have a plan.

We have all been sharing our personal experiences with eye services, and I am no stranger to them, having something quite unusual called keratoconus—it is particularly bad in my right eye. I understand how worrying it can be when one discovers that they have eye pathology.

I pay tribute to the continued campaigning work of the Association of Optometrists, the Royal National Institute of Blind People and so many others for their work on eye health. I also pay tribute to my hon. Friend the Member for Battersea (Marsha De Cordova), who is a fantastic advocate on this issue. It is very welcome that NHS England has appointed the first ever national clinical director for eye care, a role that aims to put ophthalmology on a par with other major specialties and that will lead to the development of a national strategy.

As we have heard today, NHS eye services are not keeping pace with demand. Waiting lists for ophthalmology treatments have increased by more than 130% over the last 10 years. Over 650,000 patients are stuck on NHS ophthalmology waiting lists in England, with tens of thousands of patients waiting longer than a year. That is unacceptable. Those waiting lists have been longstanding; even pre-pandemic, the system was in trouble.

In 2018, the APPG on eye health and visual impairment found that the current system of eye care was failing patients on a “grand scale”. Waiting lists have increased every year since 2010. For years, there have been calls for the Government to act, but those calls have fallen on deaf ears. It is 12 years of Conservative Government failure that have caused waiting lists to grow and left ophthalmology services in the state they are in now. Patients simply deserve better.

Increased staffing pressures compound the issue. More than three quarters of units in the UK reported unfilled consultant posts, with over two thirds of hospital eye units using locum doctors to fill those vacancies. Many eye units rely, to a large extent, on non-medical clinical staff working in extended roles, or doing work traditionally performed by an ophthalmologist. I ask the Minister, what assessment has the Department made of the impact the current ophthalmologist workforce shortages are having on patient care? Will the upcoming workforce strategy include a commitment to fund the workforce that is identified as being needed to meet patient demand?

I am pleased that the debate as also focused on the devolved nations. In Northern Ireland, at the Western Health and Social Care Trust, the average wait for routine cataract surgery is more than six years. These are grandparents who cannot see their grandchildren properly; these are people who have to give up work because they cannot see. Patients are suffering. The stress and anxiety that long waits such as those have on patients cannot and should not be ignored. There is a huge personal cost. Here is yet another example of Government decisions costing people a full and healthy life.

Along with tackling the workforce challenges, enabling the effective integration of primary and secondary eye care services is key to the plan for eye health. The Labour-run Welsh Government are leading the way in ophthalmology data and referrals and in reform of the general ophthalmic services contract. Wales is ensuring that there is more detailed data on ophthalmology waiting lists. It is also developing a comprehensive, interoperable electronic patient record system, as recommended by the Royal College of Ophthalmologists. When will the Government be serious about eye health and do the same?

The next Labour Government will take eye health seriously. We will pull every available lever to get ophthalmology patients treated sooner. Sticking plasters are not enough. We need a Government that will grasp the root causes of the staffing crisis in the NHS. That is why Labour will end tax breaks for non-doms and use the money raised to expand our NHS workforce. The next Labour Government will train a new generation of doctors, nurses and midwives to treat patients on time again. We will double the number of medical school places to ensure we have the workforce that we need across different specialties, including ophthalmology.

Labour has a plan. I would be grateful if the Minister set out the Government’s position and explained to patients why they continue to wait so long for treatment. They cannot afford to wait any longer.

16/12/2022
Marion Fellows – 2022 Speech on Eye Health

The speech made by Marion Fellows, the SNP MP for Motherwell and Wishaw, in Westminster Hall, the House of Commons, on 15 December 2022.

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for the nice things he said about me and congratulate him on securing this important debate. He is right: people would have been present if it had been possible, but weather, transport and other emergencies intervened.

Eye problems can affect anyone at any age. It is important that people get their eyes tested regularly. In Scotland, we feel that that should be by having a free NHS-funded eye examination. It is easy for us to neglect our eyes, because often they do not hurt when there is a problem. Having our eyes examined regularly can help to detect early signs of sight-threating conditions and other serious health conditions such as diabetes, cardiovascular disease and high blood pressure, in addition to the conditions that the hon. Member for Strangford told us about a moment ago.

In Scotland, community optometrists are the first contact point for any eye problems. They can diagnose and treat a number of conditions without the patient requiring an appointment with their GP or an ophthalmologist. An increasing number of community optometrists are registered independent prescribers and can issue patients with an NHS prescription to treat their eye problem.

The Scottish Government intend to expand further the range of eye care services delivered in the community by investing in a shared electronic patient record and in accredited practitioner training. That will include the management of stable glaucoma and treated ocular hypertension patients, and a national low vision service for visually impaired people. The Minister should probably have a look at that.

The Scottish Government also have a national ophthalmology workstream on hospital eye services, which sets out how they manage the delivery of hospital eye care services to provide timely care for patients. Patients with ophthalmic conditions are often vulnerable and must be supported by a responsive health service. Their care should primarily be safe and timely.

In Scotland, the Government are committed to improving services for sensory impaired people through their See Hear strategy. Adults and children with a sensory impairment should expect seamless provision of assessment, care and support, and the same access to employment, education, leisure, healthcare and social care as anyone else. In 2017, NHS Education for Scotland carried out an independent review of low vision service provision across Scotland.

In contrast to England and Wales, the Scottish Government provide free, universal, NHS-funded eye examinations, which is really important, especially given the cost of living. Universal access to healthcare is one of the Scottish Government’s key priorities, which is why free eye examinations for all were introduced in Scotland in 2006. Anyone, from any background, is able to access free eye care to help reduce the risk of sight loss. That includes all people in Scotland who are UK resident, refugees, asylum seekers and some eligible overseas visitors. Appointments are available every two years, and people are able to attend an optometrist for an NHS-funded examination of any eye problem that arises between times, including emergencies.

I was a beneficiary of that system. My eye started to fail and I found it very difficult to carry on my work, especially here in Westminster Hall, when I could not read the screens properly unless I was sitting very close to them. I went to my local optometrist. She checked my eyes and discovered cataracts, and immediately put me on a path for treatment, which really helped. When the same thing happened in my other eye, I was able to go back between appointments and say, “Look, I think there’s a problem. Can you help?” Again, I was put on a treatment path. I now have two artificial lenses—one in each eye, as my late father would have said. I have really benefited from that system, as have many people in Scotland.

If someone is unable to travel unaccompanied because of a physical or mental illness or disability, they can arrange to have a home visit quite easily. In fact, I walk from my house to my son’s house every week, and there are posters on railings across the roundabout that I have to go by, telling people that they can have that service. That is hugely important because, often, it is as people get older and more vulnerable—I put myself in that category some days—that they benefit from free eye care.

Those on benefits such as employment and support allowance, jobseeker’s allowance, pension credit, universal credit, working tax credit or child tax credit, and children under 16 years old, are entitled to help with the cost of glasses or contact lenses, and the repair or replacement of glasses or contact lenses, in the form of an NHS optical voucher.

In Scotland, before a child starts primary school, they will be offered a vision screening appointment as part of the See4School programme. That helps children begin school with the best possible vision and helps provide for any long-term visual problems. My daughter only discovered she had eye issues when she was learning to play a musical instrument and could not read the music from where she had to stand. If she had been screened earlier, it is possible that she would not have needed glasses for her whole life, as she does now.

In Scotland, we believe that socioeconomic inequalities drive health inequalities. That is why the Scottish Government are acting to mitigate the impact of austerity and reduce inequality. Where we have public health issues, Scottish Government public health efforts are complemented by wide-ranging cross-Government action. That is where Scotland benefits from being a small country. It is much easier to work in partnership and get cross-governmental things done.

We know that the worst health outcomes are driven to a significant extent by deprivation. That is why the Scottish Government are committed to addressing the underlying causes of health inequalities and to ending poverty; increasing access to fair employment, education and training; and improving our physical and social environments. That whole-systems approach and cross-Government action is needed to improve equity for Scotland’s people and communities. I believe that is true right across the four nations of the United Kingdom. That will be achieved by focusing efforts on the determinants of health inequalities and working more effectively in partnership. Reducing poverty and inequality sits at the heart of the SNP Scottish Government’s investment across all portfolios, and is a key driver of their development of a wellbeing economy that will have the needs of each individual at its core. The wellbeing economy is now becoming a recognised way of improving not just health, but everything around health and the lives of a nation’s people.

We believe that prescription charges are a tax on ill health and a barrier to better health for many. Charging for prescriptions would mean that many people with chronic conditions, or even those receiving treatment for cancer, could be liable. The Scottish Government continue to demonstrate their commitment to the provision of free healthcare advice and treatment when needed, with the introduction of the NHS Pharmacy First service, which is available in all community pharmacies to everyone registered with a GP or ordinarily resident in Scotland.

The Scottish Government are keen to support people to make healthier lifestyle choices that help take care of their eyes. I do not think many people realise that giving up smoking helps, because smokers are much more likely to develop age-related macular degeneration— the most common cause of sight loss in the UK—and cataracts than non-smokers. Given that smoking is more prevalent in the most deprived communities, the Scottish Government have set specific targets for cessation services focused on those communities. They provide £9.1 million a year to health boards to fund smoking cessation services targeted at achieving successful 12-week quits for 1.5% of the adult population in the most deprived areas. Through all of that, the Scottish Government will ensure a “done by communities, for communities” approach, making sure that lived experience is central to their work.

The Scottish Government are also keen that people drink within the recommended limits, because heavy alcohol consumption may increase the risk of developing early age-related macular degeneration. The alcohol framework sets out the priorities for preventing alcohol-related harm. We consulted on potential restrictions on alcohol advertising and promotion in 2022 to protect children and young people. The Scottish Government have twice run their “count 14” campaign work to raise awareness of the UK chief medical officer’s lower-risk drinking guidelines of 14 units per week. It was run for four weeks in March 2019 and over six weeks in January to March 2020. They are exploring the evidence around managed alcohol programmes and are delighted to be able to contribute to the running of the model being piloted in Glasgow by Simon Community Scotland and its evaluation. Of course, making alcohol more expensive in Scotland, especially the kinds of drinks that young people in particular used to drink, has also helped. In the end, it will help their eye health as well.

Will the Minister look at what we are doing in Scotland? I am sure he has a very good idea. It is really important. Will he tell us what he hopes will happen in England?

In conclusion, it is really important that there is a blueprint, as the hon. Member for Strangford said. In Scotland we do things differently, but we want everyone to benefit from our experiences and to have the same chance of good eye health. Will the Minister support a national eye health strategy? As has previously been mentioned, the hon. Member for Battersea (Marsha De Cordova) cannot be here today, but she recently introduced the National Eye Health Strategy Bill. Will the Minister support the Bill on Second Reading on Friday 3 March? Everyone here wants the best for people in their communities. The best way forward—and I would say this—is to look at the Scottish example and put aside the barriers that prevent people from having their eyes tested regularly.

16/12/2022