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Chamber and committees

Meeting date: Tuesday, September 20, 2016

Meeting of the Parliament 20 September 2016

Agenda: Time for Reflection, Topical Question Time, Economy (EU Referendum), Decision Time, Eye Health Week


Eye Health Week

The final item of business is a members’ business debate on motion S5M-00578, in the name of Stuart McMillan, on eye health week. The debate will be concluded without any question being put.

Motion debated,

That the Parliament marks Eye Health Week, which runs from 19 to 25 September 2016; believes that, since the World Health Organization has suggested that 50% of sight loss is preventable, a greater sense of urgency is needed with regard to eye health; is concerned that an ageing population, increases in diabetes and poor diet might contribute to a doubling of the number of visually impaired people in Scotland over the next 20 years; welcomes the continuation of free eye health checks; further welcomes what it believes is vital Scottish Government planning and investment for the long-term to contain sight-threatening diseases and the government’s commitment to public eye health campaigns, especially among vulnerable groups where there are reports of low awareness about free eye health checks; understands that these include the lower socio-economic groups, ethnic minority groups and people at high risk through associated health conditions, and thanks the country’s eye health professionals, RNIB Scotland, Optometry Scotland, the Scottish Council on Visual Impairment, community-based societies for blind people, Guide Dogs and other third sector organisations for the hard work that they do to support people with sight loss in Greenock and Inverclyde and across Scotland.


I thank all members who signed the motion so that we could have this members’ business debate, and I thank and welcome the members of the Royal National Institute of Blind People Scotland who are in the public gallery.

Last week, we had the first meeting of the new session of the cross-party group in the Scottish Parliament on visual impairment, and it was certainly very interesting. A host of issues was discussed and debated, and we tried to plan ahead for this year and the coming parliamentary session. A number of members who are in the chamber were at that meeting, and I look forward to listening to their contributions.

I am very pleased to open this debate and to bring to the Parliament the issue of eye health week. Eye health certainly became a more serious issue over the previous session of Parliament and, without any action, it will only get more serious over this session.

This week is national eye health week, which is an opportunity for us all to reflect on one of our senses. We may sometimes take that sense for granted. Life without sight is almost unimaginable, but how many of us give our eyes the care and attention that are required to protect this valued sense?

Every day in Scotland, 10 people lose their sight. Every day, in eye clinics across Scotland, ophthalmologists have to tell patients that their sight loss has deteriorated to such an extent that it is not treatable and that, consequently, they are blind or partially sighted. The impact on the individual and their family can be devastating. Questions about whether the individual can keep their job, and questions about driving and getting about, socialising, going to sport, and seeing their wife, husband, children or grandchildren race through their mind before the reality of living with sight loss sets in.

There are challenges on the horizon for Scotland’s eye health. Our ageing population brings with it associated eye disease; the rise of diabetes is driving up the number of Scots with diabetic retinopathy, which can cause blindness if it is not treated; and Scotland’s welcome growing diversity brings with it diverse eye health challenges. The RNIB has stated that, currently, more than 188,000 Scots are living with significant sight loss. It is projected that, by 2030, that figure will more than double to nearly 400,000 people. Given that eye clinics are already the busiest part of out-patient services in the national health service, I do not have to go into detail about the pressures that increased sight loss will bring if we do not take further action.

There are bright spots. Around 50 per cent of sight loss is avoidable if it is detected early, and there are new technologies, through drug treatment and NHS efficiency, but we still need to do more. The gain to the individual, who need not lose their sight, is incalculable. The cost to the public purse can be all too predictable.

I am privileged to be the convener of the cross-party group in the Scottish Parliament on visual impairment; I was its convener in the previous parliamentary session, too. I know that our cross-party group has been well run for many years, even before I became its convener.

It is important to realise and highlight that, where the visual impairment sector comes together to have detailed, effective and vibrant discussion about the future of eye care and the provision of services for blind and partially sighted people, from newly born babies with sight loss through people at school and work to people in retirement and old age, it supports people with sight loss across the generations. That is what our cross-party group manages to do.

Despite these uncertain times and against the backdrop of financial pressures, there are certainly some positive policy developments. Eye health has been on the Government’s agenda and radar for some time, and the sector is coming together and speaking with one voice to an extent that has not been seen before. Key developments in recent years, including the Scottish vision strategy, the see hear strategy, and the getting it right for every child approach, have made a positive difference.

The Scottish vision strategy is a cross-sector framework to improve provision for eye health and sight loss, which aims to ensure that

“Everyone in Scotland knows how to look after their eyes”,


“Everyone with an eye condition receives timely treatment and, if permanent sight loss occurs, there are early and appropriate services and support”

and that Scotland is

“A society where people with sight loss can fully participate.”

The see hear strategy, which was launched by the Scottish Government in 2014, raised the profile of sensory impairments. Most notably, the strategy called for consistency in how services are planned and commissioned across Scotland’s 32 local authorities, each of which had to set up local implementation groups. It also called for a move towards joint sensory services for those who are experiencing sight and/or hearing loss.

Then there is the GIRFEC approach, which was enshrined in law by the Children and Young People (Scotland) Act 2014 and which states that all children, including those with a visual impairment, should be supported to address their wellbeing needs throughout their lives. The GIRFEC principles were built upon in the 2012 Doran review, which examined learning provision for children with complex additional support needs, including visual impairment. In recent years, there has been a presumption that these children should be educated in mainstream schools except under exceptional circumstances.

There are organisations that work tirelessly to fight for blind and partially sighted people, to prevent avoidable blindness and to ensure the best outcomes for those with visual impairments. I put on record my particular thanks to third sector organisations such as RNIB Scotland, Guide Dogs Scotland, the Royal Blind charity and the many local societies, from Sight Action in Inverness to North East Sensory Services—NESS—in the north-east, Vision PK in Perth and Kinross and Visibility. Their work to bring to our attention the cause of blind and partially sighted people is second to none and, as a Parliament, we are fortunate to have such persistent advocates.

Although the Scottish Government has ensured investment in eye health, has retained provision of free eye health checks and is committed to tackling the rise in sight loss, we certainly can always do more.

Yesterday, I helped at the RNIB Scotland stand in Greenock’s Oak Mall shopping centre. My thanks go to the Oak Mall centre’s management for allowing the stall and to RNIB Scotland for agreeing to come again to Greenock. We spoke to a large number of people locally and raised the importance of having regular eye tests. The reception on the whole was good and many people informed us that they get regular check-ups, which was heartening to hear. However, promoting free eye tests to wider society is vital, especially among vulnerable groups, where awareness has been found to be lower.

Scottish Government public eye health campaigns have proved useful, and I look forward to seeing the results of the community optometry service review as we seek to improve eye health across Scotland.

In promoting the motion, I hope to bring greater focus and resulting action from our NHS and the Scottish Government on sight loss, to the benefit of us all.

Thank you very much, Mr McMillan. We now have time in hand, so I can give other members an extra minute. I know that that is exciting.


I congratulate Stuart McMillan on his motion, which is allowing us to debate an important subject.

Sight is but one of our senses, of course, and they all add to life’s richness. When we hear music it moves us, when we taste food it satisfies us, and when we see light it inspires us. Each sensory perception is extraordinary and each is an instrument of life. However, senses are a great deal more than that. They are valuable for their functions, but also as indicators of our general health. If it is protected, the resulting good health will yield encouraging social and economic benefits.

The primary issue tonight is a discussion around health; our sensory faculties directly affect, and are affected by, our health. Much like our senses, health is central to our experience. Of all life’s gifts, health bestows the greatest benefit. Wealth is, by a long way, secondary to health.

We now live in a country that is ageing; I shall be 70 next month myself, and I suffer from five sight defects: myopia, hypermetropia, astigmatism, presbyopia and—the one that cannot be corrected by my spectacles—low-light myopia, as the cells in my eyes deteriorate. None of those is unusual, and we will all experience them to some degree as we get older.

Of course, from looking into the eye, we can see more than simply optical defects or the deterioration of the cells in the eye. Diabetes is a sight-threatening condition, so the substantial increase in the incidence of diabetes creates vulnerability in the eye health of the country. More than ever, we need effective access to treatment. Of course, the gateway to treatment is eye examinations, which is why the NHS examinations are a necessary and very intelligent tool.

The examinations test much more now than they did when my astigmatism was first diagnosed when I was in my 20s. However, the tool is of no value if people do not actually use it. We need more people to go for eye tests and we need to make more people aware of the option of eye tests. Some people do not go because they do not realise that they can have a free eye test, whereas others do not realise the wider health benefits that may accrue from detecting, through an eye test, another condition that may exist. Testing can, of course, prevent the slow process of visual impairment, but it can also be a window on systemic problems.

Eye health week is therefore a huge opportunity for health in Scotland and it is an opportunity, through debates such as this and wider activity across Scotland, to create a new baseline for eye health and, through that, a baseline for overall health. The testing is an indicator of health problems and can be used to prevent them, and eye health is a key element in our general wellbeing.

We all kind of know the importance of our eyes. We rely on them and take them for granted, but not all of us look after them as we should. Early treatment of conditions that can be seen through the eyes means that there are wider community and economic benefits, but it will also make people healthier and happier. We limit treatment cost and minimise loss by preventative measures and through being proactive. We want people to know about the availability of eye tests and we want them to benefit their personal health by taking them. Apparently, one in four people in Scotland does not know that eye exams are free.

We have heard from Stuart McMillan about the many organisations that work on the subject. As, I am sure, other members will, I indicate my support for the work that they do. I was previously a deputy convener of the cross-party group on visual impairment, so I know from experience about the important work that is done.

There are social and economic benefits from good eyesight and from testing eyesight. I hope that all members will continue to press on this important issue.


I, too, congratulate Stuart McMillan on bringing forward this members’ business debate, and I pay tribute to the work that he is doing in Parliament on the issue. As one of the new members on the cross-party group on visual impairment, I look forward to working with colleagues from across the chamber on helping to make progress on the issue. I apologise in advance for being unable to stay for the full debate.

I welcome the opportunity to pay tribute to our eye health professionals across Scotland—especially our optometrists and ophthalmologists—for their excellent work, and to commend the charities and associations that work to support people with sight loss in our communities, including national organisations such as RNIB Scotland, Optometry Scotland and Guide Dogs, as well as many local groups across the Lothian region that I represent.

At a time when we are seeing growing demand on our health services, it is worth reflecting that eye health professionals play a big part in reducing the burden on general practitioners and secondary care. Stuart McMillan’s motion is right to refer to the need to increase awareness of eye health and eye health checks through effective and focused public information campaigns. Take-up rates of free eye health examinations among people on low incomes and among ethnic minorities across Scotland are too low, so we need innovative ways of reaching those groups. Type 2 diabetes is more than six times more common among people of south Asian descent and three times more common among people of African and African-Caribbean origin, so we need new approaches to target those at-risk groups.

It is clear that many groups that are failing to be reached and are not responding to traditional health advice, so public advertising campaigns need to be addressed. I would welcome a debate on how we can address those issues—for example, we could consider the number of opticians who are available in deprived communities throughout Scotland, and we could develop a mobile eye screening service for the many Highland and rural communities where people perhaps also do not go as regularly as they should to have their eyes tested.

Private and third sector initiatives also have important roles to play. I note that RNIB Scotland has established a good working partnership with Specsavers, under which they work together to encourage everyone to have eye checks at least every two years. Given that as much as 50 per cent of sight loss is preventable, early diagnosis is clearly vital. As we have already heard, eye health check-ups can also help to detect a range of other conditions, including some that could be fatal, if left untreated.

Scotland enjoys some excellent-quality eye health care, but there is still more to be done and much work to be carried out. The number of Scots with visual impairment is projected to double to more than 400,000 people between now and 2030, as our elderly population increases. Forward planning based on accurate and up-to-date information is critical, and I share the concern of RNIB Scotland and others that the Scottish Government has not in recent years published registration figures for blind and partially sighted people in Scotland. The most recent figures that are available relate to 2010. I ask the Minister for Public Health and Sport to commit in her closing speech to resuming publication of information that local authorities provide, and to updating the registration process in order to increase registration and to provide additional categories of information so that we can have a truly national picture of sight loss in order that we can best focus limited resources.

I welcome the debate and look forward to further progress being made, building on much of the positive work that is already being done to ensure awareness of good eye health care and access to examinations and treatment. I also look forward to work being done to ensure that we have the robust data that we need to inform future planning and delivery of services.


I thank my colleague and constituency neighbour, Stuart McMillan, for bringing this important matter to the chamber and congratulate him on doing so. Sight is undoubtedly the most developed of the human senses and it provides us with our most reliable perceptions. More than half the information that the human brain receives is visual. The brain receives and interprets that information and produces the images that we see. Sight is also a fertile source for imagination and creativity. It is therefore of the utmost importance that we take care of it throughout our lives.

Eye health week serves as a reminder to those of us in Parliament and beyond of how crucial screenings and diagnostics are in the delivery of eye health care. Nearly 2 million people in the UK live with some sight loss and more than half those incidences of sight loss are preventable or can be avoided. Sight loss is also associated with significant health inequalities, and its silent nature means that symptoms often go unrecognised among people in vulnerable socioeconomic groups, who are therefore more prone to it.

There can also be a matter of pride. My grandmother was completely blind in one eye through having cataracts for seven years before letting on. It was only when she kept turning her head 90° that her daughter realised that something was wrong with her eye. Bizarrely, my grandmother thought that sight loss was shameful.

Mr Gibson knows someone in Greenock—John Crowther—who, this morning, underwent an operation to have a cataract removed. I am sure that Mr Gibson would like to wish Mr Crowther a good recovery.

It is handy that Mr Gibson and Mr McMillan are side by side.

I certainly would like to wish Mr Crowther a good recovery. A cataract operation can transform a person’s life and Stuart McMillan made an important intervention.

Ethnicity can be a factor in some conditions. For example, Europeans are more susceptible to age-related macular degeneration, whereas south Asian and African-Caribbean ethnic groups are at greater risk of developing diabetes—of course, sight loss is one of the most common complications of diabetes.

In Scotland, diabetes affects more than one in 25 people—that is more than 228,000 folk who are potentially exposed to sight loss and ophthalmologic disorders. In the detection of diabetic retinopathy, only an eye check will ascertain potential sight loss, which can in the worst cases lead to blindness.

In his motion, Stuart McMillan noted that there is an obvious link between eye health and wider public health issues. Diabetes is a case in point, but it is also true that cardiovascular disease and high blood pressure are likely to have a significant effect on eye health. Infectious diseases, such as shingles of the eye, affect up to a quarter of all cases and can have a devastating impact on eye health. Regular eye check-ups detect not only potential eye trouble but many other potential diseases or infections.

Free eye health checks for all—a policy that the SNP Government implemented—are likely to be instrumental in preventing avoidable loss of sight and in improving the cost efficiency of eye care services and, more generally, healthcare services. Not having universal free eye tests would be a penny wise, pound foolish measure and I am pleased that we in Scotland will not go down that road, unlike those south of the border.

In relation to my constituency of Cunninghame North, a 10-year sensory plan was launched in 2014 to improve the lives of people who suffer sensory difficulties by finding a new approach to sensory service provision across NHS Ayrshire and Arran. Sight loss is one of the key elements of the plan and I am pleased to see the innovations and improvements that have been made since 2014. Today, there are more practices across mainland Ayrshire, Arran and Cumbrae; 60 optometry practices provide services and seven of them provide care in people’s homes.

I am also pleased to note that eye health is evolving and that new practices are being adopted. For example, Ayrshire, Arran and Cumbrae have a digital referral system, which is an innovative development in the eye care sector that makes it easier to deliver patient care and improves the quality of the service. The use and applicability of that information should be further explored in improving research and developing preventative approaches.

It is interesting to see how eye health care can be successfully co-ordinated nationally and locally. Our Government must continue to work in that direction.

Eye health week gives us the opportunity to inform ourselves about ophthalmology issues through diverse events in Scotland and to take advantage of a free sight test, which I encourage people to take if they have not done so recently. I warmly thank all the organisations that are involved in eye health week and hope that it will be greatly successful in achieving its aims.


Presiding Officer, I thank you for allowing time for the debate, and I thank Stuart McMillan for lodging the motion. I congratulate him on his re-election as the convener of the cross-party group on visual impairment. As a new member, I look forward to working with all members of that group.

It is 10 years since the introduction of free eye health checks by my colleague Lewis Macdonald, who was the responsible minister at the time. The move brought about a step change in the eye health care pathway in Scotland and, since then, the number of eye examinations has increased by 29 per cent. Optometry Scotland reports that, last year, a total of 2.2 million eye examinations were provided by community optometrists, and less than 7 per cent resulted in a referral to GPs or hospitals. That covered more than 1 million eye disorders that were managed by Scottish optometrists, which included an estimated 200,000 eye emergencies.

However, we cannot be complacent, which is why I welcome the current review of community optometry services. We need to maximise the front-line role that optometrists play in detecting and treating eye conditions, not only to make best use of their undoubted expertise but to ease the pressures on our GPs and secondary health services.

Over the next 20 years, the number of people with sight loss is due to more than double—going from 188,000 to nearly 400,000. Eye patients now account for around 18 per cent of all out-patient appointments. Factors that include the ageing population, the increase in the ethnic minority population, Scotland’s health challenges, such as diabetes, and the availability of new treatments show that the need to support front-line ophthalmic care is more important than ever before.

It is also clear that we need to develop a strategy to engage hard-to-reach groups, such as those who live in deprived communities, to ensure that everyone benefits from a free eye health examination. I therefore ask the minister whether there are any plans to run a public health campaign to highlight eye health and increase the uptake of free eye health checks.

In the meantime, this week—eye health week—provides us all with an opportunity to play our part in raising awareness of free eye health checks and to take action ourselves. We should all take advantage of our free eye health check. It is not just distance vision that is tested, but eye pressure, peripheral vision and the condition of the retinas, which makes it possible to flag up a host of other conditions, such as diabetes, glaucoma, and—particularly important for some members in the Parliament—high blood pressure.

I am sure that members will be delighted to know that, thanks to RNIB Scotland, Optometry Scotland and Boots Opticians, I had those checks just yesterday, when I visited Boots Opticians in Dumfries. As members can see, I am in perfect health. Free eye health checks are a tremendous asset for us all and we must encourage everyone to use them.

Successive Scottish Governments have recognised the importance of investing in eye health checks. Another building block is investment in the digital referral scheme, which links high street optometrists to hospital eye clinics. I appreciate the difficulties of complex information technology projects and of the practical application of technology, but I hope that the minister can update Parliament on progress.

I touch on the opportunity that we have through health and social care integration. It is important that each integration joint board works to develop a specific eye health plan and I ask the minister to give assurances that that will happen.

Like Miles Briggs, I put on record my appreciation of the tremendous work that is undertaken by professionals in the sector, of whom I met a number yesterday. Nurses, optometrists and ophthalmologists all make a tremendous contribution to dealing with the increase in sight loss in the population. Like Stuart McMillan, I thank the third sector, which works hard to promote the interests of people with sight loss, runs vital services and works closely with the Government. Third sector bodies range from RNIB Scotland, Guide Dogs Scotland and Royal Blind to local societies such as Visibility, which runs services in Dumfries in my constituency.

I urge all colleagues to have their eyes tested and to support the work of so many across Scotland who ensure that eye health is on the radar of our health and social care priorities. I commend the motion.


I thank Stuart McMillan for bringing this issue to Parliament’s attention, given the importance that should be placed on maintaining good eye health. I put on record my support for the campaign.

We are now on day 2 of eye health week and the vision matters campaign, which focuses on promoting children’s eye health. As the campaign notes, some of the biggest contributors to poor eye health in later life include not attending an eye test at least once a year, poor diet, lack of exercise, overconsumption of alcohol, smoking and not protecting one’s eyes from the sun. That is basic information and it is vital that our children are made aware of it from a young age, not only to protect their vision but to avoid a series of other health complications in later life. Taking children for regular eye tests and promoting a healthy and active lifestyle go hand in hand.

As Stuart McMillan and others have noted, according to the RNIB, more than 180,000 people living in Scotland have a form of sight loss. Importantly, more than 90,000 of those cases of sight loss could have been prevented by people having a regular eye test. It is vital that we ensure that everyone across Scotland has easy and reliable access to community ophthalmic services. In my Highlands and Islands region, that can be particularly challenging, given the sparsity of the population over a large geographic area.

According to the RNIB, the average waiting time for patients to receive in-patient or day-case ophthalmic treatment is 52 days. In the Highlands and Islands, however, it takes 62 days on average, which is significantly higher. That is unacceptable and more needs to be done to ensure that there are sufficient community-based ophthalmic and optometry options for patients across the Highlands and Islands and other remote and rural areas.

With cases of sight loss estimated to more than double to 400,000 by 2030, charities—including the RNIB—have made clear calls for a new and coherent strategy to improve eye health across Scotland. The Government’s Scottish vision strategy paper stated that the clear aim was to eliminate avoidable sight loss by 2020. However, with cataract surgeries up by 80 per cent since 2000 and conditions such as diabetic retinopathy and age-related macular degeneration expected to become more prevalent, action is required sooner rather than later. When members of the Health and Sport Committee recently visited the Golden Jubilee hospital, I was astonished to learn about the number of cataract operations that are undertaken and that they account for such a large proportion of operations.

Sight charities agree that a large part of tackling the issue is through publicising the fact that eye tests in Scotland are free. A recent YouGov survey stated that one in four Scots are still not aware of that so, given that that has been the case for a decade, more needs to be done to promote it.

We face major challenges with eye health care. I applaud the vision matters campaign for raising awareness of the issue so that we in Parliament can work to find and implement the right solutions to meet the vision strategy target of eliminating avoidable sight loss by 2030 and of ensuring that people have greater access to eye health care facilities at a community level wherever they live.

I commend Stuart McMillan for his motion.


I congratulate my colleague Stuart McMillan on securing a debate on such an important matter. It has been mentioned that we are not just talking about eyes because so much can be told about health from an eye test. As someone who has recently had to admit to the fact that they now need glasses to read—although I have forgotten them today—I know how important it is for us to have our eyes tested regularly.

I welcome the work of Glasgow Caledonian University’s vision centre in my constituency and I congratulate it on that work. In Glasgow, we call GCU Glasgow Caley so, if I revert to that instead of the full title, members will know what I am talking about. I welcome the fantastic work that it does, raising awareness of the importance of eye health in Glasgow and beyond. GCU trains over 300 students each year in vision-related professions and it is the only university in the UK to train—I have to get my tongue around this—optometrists and dispensing opticians. I hope that that was the correct word. It is no mean feat to be the only university to train those professionals in the whole of the UK.

I welcome GCU’s unique vision sciences research expertise and I understand that members of the public who visit the GCU vision centre are examined by students under the direct supervision of experienced and qualified clinical staff, and that over 5,000 patient consultations are provided every year.

I also welcome the work of the qualified optometry students at the Hunter Street health centre in Glasgow who deliver eye care for homeless people and asylum seekers. Other members, including Miles Briggs, have touched on the issue of reaching out to the hard-to-reach people in the community, because homeless people and asylum seekers are not always aware that they can get their eyes tested. I would like to give a special mention to the Glasgow Caledonian University vision centre for reaching out, making people aware and giving free eye care to homeless people and asylum seekers. We should be looking at that issue and—as Miles Briggs said—perhaps we should have a special debate to highlight those particular groups of hard-to-reach people. Is the minister looking to develop a project to capture hard-to-reach people such as homeless people and asylum seekers? Will she take on board the service provided by the Glasgow Caledonian University vision centre when considering any future Scottish Government projects?

Finally, I again congratulate Stuart McMillan on a very good debate and a worthwhile motion that we should all tell our constituents about.

I think that “optometrist” is easier to pronounce than “ophthalmologist”. Members have done well with both.


I concur with the point about the pronunciation of some of the professions—I hope that I do not get too tongue-tied.

I add my thanks to those of colleagues to Stuart McMillan for giving us the opportunity to mark eye health week and discuss eye care in Scotland. I also echo the thanks of other members to all the country’s eye health professionals, as set out in Stuart McMillan’s motion, and I welcome representatives of RNIB Scotland to the public gallery.

I am sure that most members would agree that general ophthalmic services are among the true success stories of the NHS in Scotland. The introduction in 2006 of free eye examinations set Scotland apart from the rest of the UK. For the first time, everyone in Scotland, regardless of their personal situation, had access to an eye examination free of charge. Uptake has risen steadily: in 2015-16, more than 2 million people had their eyes examined, which was the highest number ever. However, we recognise that more needs to be done to reach out to the whole of society—a point that was well made by Kenneth Gibson, Colin Smyth, Donald Cameron and Sandra White.

Clearly, people recognise the benefits of having their eyes examined regularly, and we need to ensure that that continues. Regular examinations help us to look after a crucial sense that, as Stuart McMillan, Stewart Stevenson and Kenneth Gibson pointed out, we often take for granted. However, there can be consequences if our sight deteriorates.

We are committed to ensuring that the best community eye care is accessible to everyone, providing a full health check of the patient’s eye, with specific procedures dependent on the patient’s age or condition.

On 25 August, the Cabinet Secretary for Health and Sport announced a review of community eye care services. I was glad to hear Colin Smyth welcome that review—and to hear him say that he is in tip-top condition. I reassure him and Donald Cameron that we will consider raising awareness of eye tests as part of the review. We will also take on board the points that Sandra White raised about good practice at Glasgow Caledonian University.

Before I discuss the review further, I will take the opportunity to mention the eye care services that are provided in the community and talk about the position of strength that Scotland is in.

In Scotland, the optometrist is the first port of call for any eye problem. Evidence shows that more patients now know to go directly to their optometrist, rather than their GP, if they have any problems with their eyes. Community optometrists are taking on an extended role, demonstrating the growing capacity, capability and competency of the profession. Optometrists are doing more work in the community, reducing the burden on secondary care and ensuring that patients remain in a primary care setting.

A key enabler has been the decision in 2013 to allow optometrists to undergo training so that they can independently prescribe medicines. Since then, the number of those trained has increased steadily and now more than 120 optometrists have become fully trained independent prescribers, with another 30 in hospitals. They make up one third of all independent prescribing optometrists in the UK, and I believe that we should continue to grow their number. I take this opportunity to thank each and every optometrist who has taken the time to carry out the training, and I encourage others to take up the opportunity.

In my area, there is an excellent example of how prescribing can be used to improve the patient experience. The Lanarkshire eye network scheme, or LENS, was set up in 2010 to reduce the burden on secondary care by allowing optometrists to prescribe medications for certain eye conditions. That move has been welcomed by optometrists and ophthalmologists, and has improved the patient experience, as patients do not have to travel to hospital unnecessarily.

The scheme has been a huge success. It has made optometrists feel more empowered by allowing them to decide how to treat patients. It has reduced the burden on secondary care, freeing up the hospital eye service to treat those who need treatment most. It has seen optometrists and ophthalmologists work together to improve patient care, which we can all agree is of the utmost importance. It has a high level of patient satisfaction, as patients do not have to travel far or sign on to waiting lists to receive treatment, which is particularly important in the treatment of eye diseases. That is good news, and is entirely consistent with the Scottish Government’s 2020 vision of health and social care treating more patients in their local community.

I am sure that we would all agree that the possibility of losing one’s sight is worrying, and it is important that the potential for any loss of sight is identified early. One of the major causes of sight loss is glaucoma, which is of particular interest to me as my mum suffers from the condition, which has a hereditary element.

Glaucoma can affect a person’s sight due to the build-up of pressure in their eyes. Early diagnosis is important, and community optometrists are in the ideal place to recognise the condition early on. That is why, earlier this year, as part of the primary care transformation fund, the Government provided every optometry practice in Scotland with a pachymeter. That hand-held instrument measures the thickness of a patient’s cornea, having been placed directly on the surface of their eye—I am told that it is absolutely painless—and helps to identify whether the patient is suffering from glaucoma.

Optometrists and ophthalmologists also work together when patients need referral to secondary care. Eye care integration is a programme that allows optometrists to send patient referrals to secondary care electronically—Kenneth Gibson mentioned that. Previously, if an optometrist decided to refer a patient to hospital, they had to send the forms by post, which took time. In addition, the optometrist rarely knew whether the referral had been received. Now optometrists can send the referral electronically and can attach pictures and scans of the patient’s eyes. That allows the ophthalmologist to assess and triage the referral, with an appropriate appointment being offered sooner if required. In time, we hope that that will mean that optometrists get meaningful feedback and that the number of unnecessary referrals to secondary care will reduce.

As I said, the Scottish Government announced a review of community eye care services in August. The aim of the review is to look at good practice across Scotland to see whether more can be done to ensure that people from all backgrounds take advantage of free eye examinations. RNIB and Optometry Scotland representatives are members of the review group, and patients are also involved to ensure that we capture their views. The review will work alongside other Scottish Government initiatives, such as the see hear strategy, which focuses on sensory impairment in children and adults, and it will report to ministers by the end of the year. I look forward to seeing what recommendations are presented.

I turn to some of the other issues that members have raised. Stuart McMillan raised concerns about ensuring that other key pillars of Government policy, such as GIRFEC, are part of the review, and that point was well made. Similarly, Colin Smyth made a good point about the changed landscape of social and health integration, and the review will take cognisance of it.

Stewart Stevenson outlined the challenges that eye care services are facing because of our ageing population. Again, the review will be able to unpick some of those challenges. In response to Miles Briggs’s point about blind registration, I note that the Government is carrying out a review to gather information from professionals, including examples of good practice. Stewart Stevenson and Kenneth Gibson also demonstrated how the condition of our eyes is a useful barometer of our health and wellbeing.

I will be mindful of all the points that have been raised this evening and take them to the review that the cabinet secretary announced.

I am pleased to have been involved in the debate, and I am sure that Parliament will continue to support eye health week in the years to come. The fact that we are conducting our review and that there has been such a great interest in the work that we are undertaking means that we can promise to continue to work with colleagues to ensure that we create a service across the country that is fit for purpose and meets the needs of our population.

Meeting closed at 17:48.