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Chamber and committees

Meeting date: Tuesday, September 25, 2018

Meeting of the Parliament 25 September 2018

Agenda: Time for Reflection, Topical Question Time, Mental Health Strategy: 2018 Annual Report, UK Trade Arrangements: Scotland’s Role, Business Motion, Decision Time, Eye Health Week 2018


Eye Health Week 2018

The Deputy Presiding Officer (Linda Fabiani)

The final item of business is a members’ business debate on motion S5M-13553, in the name of Stuart McMillan, on eye health week 2018. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes that Eye Health Week takes place between 24 and 30 September 2018; welcomes the progress that has been made with eye health and the hugely important eye examinations; notes that, in the last financial year, 1,923,926 over 16s and 288,258 under 16s received a free eye test, which is the highest annual level on record; commends all organisations involved in promoting eye health and care, and notes the calls for the public to get their eyes tested on a regular basis by utilising the free eye examination.


Stuart McMillan (Greenock and Inverclyde) (SNP)

I am delighted to lead the debate and grateful to all the members who signed the motion and who will speak today. I thank all the organisations that provided briefings for the debate.

I hosted a Royal National Institute of Blind People Scotland stall in the Parliament last week, and I appreciate the time that members took to visit it. The team who staffed the stall were delighted by the number of MSPs who visited it to learn about eye health, the services that RNIB Scotland offers and the many and varied conditions that exist. I thank everyone very much.

Since 2011, I have chaired the cross-party group on visual impairment; I became a member of the CPG after being elected in 2007. I am always keen to raise awareness of eye health week, as I recognise that we must continue to highlight the importance of eye health, the progress that has been made and the challenges that still exist.

I celebrate the success of the free eye test policy in Scotland. Since 2007, the policy has been backed by £775 million of funding, following its introduction by the previous Labour-Liberal Democrat Executive in 2006. In the initiative’s first year, 1,349,979 people obtained free eye tests. In the most recent full year—2017-18—the figure rose to almost 2 million people. I am sure that those who were ministers pre-2007 will be delighted with the growth in the number of people obtaining free eye tests; I am also sure that every health minister since 2007 will be delighted with the continued annual increase. Overall, more than 21 million tests have been conducted since the policy came into effect.

The national average for uptake of sight tests across all health boards sits just below one in three people, at 31.8 per cent, but I am pleased that my health board—NHS Greater Glasgow and Clyde—is bucking the trend with uptake of 33.1 per cent. By comparison, NHS Orkney has the lowest rate at 24.1 per cent. That emphasises that more work needs to be done to encourage everyone in Scotland to access free eye health checks.

Like many conditions, sight loss can affect anyone, which is why it is important to realise that eye tests do not just test sight but can detect symptoms of serious health conditions such as diabetes, high blood pressure, stroke and cancer. If an eye health check identifies changes in the eyes before vision is affected, the condition can be treated before it reaches an advanced stage. That is in the best interests of patients and our national health service, as it is cost effective and more efficient than meeting the medical and social costs that arise if people lose their vision or suffer ill health unnecessarily.

Every survey shows that sight is the sense that people fear losing most, yet we can be surprisingly negligent about our eye health. We tend to think of eye tests as being only for people who need contact lenses or glasses, but we should all get our eyes checked every two years or so to keep healthy.

Last year, alongside Cate Vallis from RNIB Scotland, I was on a stall outside Specsavers in the Oak Mall in Greenock, making shoppers aware of free eye tests. It certainly was a hard shift; I will not lie—I have had easier shifts distributing political material. I accept that that might have been because a politician was trying to give something out, but the issue has been raised before in the cross-party group and I have discussed it with others.

At the cross-party group meeting in May, Dr Alexandros Zangelidis from the University of Aberdeen gave a presentation entitled “Eye Care Services in Scotland: Did the Scots Get It Right?”, in which he discussed his research into the introduction of the free eye examination. His analysis concluded that, overall, the policy has been a success and is to be welcomed. However, when it comes to looking after our eyes, he highlighted challenges that face communities such as mine that have areas of poverty and deprivation.

Although more people are getting their eyes tested, there is a small but growing gap between the less well-off and the more affluent in society. There are various theories as to why those from more deprived Scottish index of multiple deprivation areas are less inclined than others to get their eyes tested. One theory is that people worry that, if an eye test indicates that they need glasses, they will not be able to afford them. That could lead to the gap increasing, even though—I stress this—more people are getting their eyes tested.

Dr Zangelidis’s research also refers to people’s lack of understanding about eye health, which could explain the hard shift that Cate Vallis and I faced last year in trying to make people aware of the free eye tests.

How do we fix that? I would like the Scottish Government to consider a few actions. I would like a refreshed public information campaign to make people aware of the free eye examination, with a targeted approach to communities with economic challenges. I would be quite content for parts of my Greenock and Inverclyde constituency to be used in any such pilot scheme.

Four of the most common causes of sight loss are age-related macular degeneration, cataracts, glaucoma and diabetic retinopathy, which is now the single biggest cause of sight loss among Scots of working age. Some of my constituents live with those conditions. Earlier this year, I visited the Jenny’s Well facility in Paisley, which is one of only two specialist residential care homes in Scotland for visually impaired older people and which is run by Royal Blind. I went across the road to Scottish War Blinded’s Hawkhead centre, which provides free support to ex-service personnel who are living with sight loss. Although some of my constituents use those services, many more people could benefit from them. That is why I am keen to highlight such facilities at every opportunity.

It is not just older people or veterans who are affected by visual impairment. As the Scottish Government’s school census figures indicate, the number of pupils with visual impairment has more than doubled since 2010. When we consider that more than 180,000 people live with sight loss in Scotland, that the figure is expected to double over the next 20 years, and that 50 per cent of sight loss is preventable, it is evident that free eye health checks are an important measure to help keep our nation healthy and that they can make a real difference to people’s lives.

In its briefing, Optometry Scotland highlights the National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006, which have revolutionised the delivery of community eye care in Scotland. Most notably, they have led to a shift in the balance of care away from general practitioners and hospitals, which has freed up vital resources. In 2016-17, optometry services indicated that the regulations saved the NHS £71 million, with community optometry preventing more than 370,000 people from having to attend hospital for eye issues every year. Further, more than 80 per cent of acute eye conditions are now managed by optometrists, up from 25 per cent before the introduction of the GOS regulations 12 years ago.

Although Scottish optometry is leading the world in the design and delivery of community eye care, Optometry Scotland states that a concerted focus on forward planning for an increasing older population is needed, along with a Scottish Government-supported strategy to encourage people to consider a career in the optical sector. In Scotland, the number of registered blind and partially sighted people is around 34,500, and every seven minutes someone in the United Kingdom will be diagnosed with macular disease, which is the biggest cause of blindness in the UK.

It is pertinent that, to increase the number of people who benefit from the policy, we as MSPs do all that we can to make our constituents aware of free eye tests in Scotland. That should mean that the rate of preventable sight loss will decrease and that as many people as possible can live life seeing the full picture.


Brian Whittle (South Scotland) (Con)

I congratulate Stuart McMillan on securing this important debate. I welcome the opportunity to pay tribute to our eye health professionals and the organisations that are involved with promoting eye health and care. National eye health week gives us an important opportunity to increase understanding of eye health and to educate people on the importance of eye examinations in identifying sight loss and other health conditions.

As has been said, since April 2006, all people residing in Scotland have been entitled to free NHS eye examinations every two years. The aim of the policy change was to increase demand for eye examinations and, as a result, improve the visual health of Scotland’s population through the early detection of eye health issues.

I am looking at the figures for the past financial year. As Stuart McMillan said, nearly 2 million over-16s and nearly 300,000 under-16s received a free eye test—the highest annual level on record. It is clear that uptake is increasing, which is extremely encouraging. However, there is still scope to do more. The number of Scottish people with sight loss is still projected to double to almost 400,000 by 2030, so we must continue to encourage and promote greater utilisation of existing eye care services.

Eye examinations ensure that people receive early support or treatment for vision impairment, but they also identify other health conditions such as high blood pressure, arteriosclerosis, tumours and diabetes. Those aged under 16 or over 60, individuals with glaucoma, those aged over 40 with a close family history of glaucoma, and patients with ocular hypertension or diabetes are entitled to free examinations each year rather than the standard two-year period. As co-convener of the cross-party group on diabetes, I say that such checks are important for the 290,000 people in Scotland who currently live with diabetes, as they are vital in picking up early signs of diabetic retinopathy, which is a complication of diabetes caused by high blood sugar levels damaging the back of the eye. Diabetic retinopathy is now the single biggest cause of sight loss among working-age adults in Scotland and can cause blindness if left undiagnosed and untreated. It is estimated that nearly all people with type 1 diabetes will have diabetic eye disease 20 years after diagnosis, and that as many as 60 per cent of those with type 2 diabetes will show signs of the condition. A comprehensive eye exam once a year ensures that if diabetic retinopathy is detected it can be treated before it reaches an advanced stage and significantly damages sight. The importance of such checks cannot be emphasised enough.

Eye health week is also vital in raising awareness of what people can do to reduce their risk of developing a condition that leads to vision impairment. While paying particular attention to type 2 diabetes, which is suffered by about 87 per cent of diabetics in Scotland, we must address lifestyle factors such as obesity, low levels of physical activity, excessive alcohol intake, poor diet and smoking. Research has shown that smoking in particular not only makes people 30 to 40 per cent more likely to develop type 2 diabetes, but doubles the probability of sight loss. Repeated exposure to tobacco smoke speeds up the body’s natural ageing process, including that of the eyes, and increases the risk of developing cataracts and complications that are linked to diabetes.

Worryingly, of the 21 per cent of people in Scotland who smoke, 56 per cent are unaware of the link between smoking and eye disease. I therefore commend ASH Scotland for teaming up with RNIB Scotland, the Association of Optometrists and NHS inform to design a stop smoking advice card that communicates the implications that smoking can have for sight. I hope that we can make further progress in informing people of such dangers. According to RNIB Scotland, by 2050, nearly 4 million people in the UK will be living with significant sight loss, despite more than 50 per cent of that it being avoidable.

It would be remiss of me not to take the opportunity to say, once again, that when we talk about tackling eye health we are talking about health in general. By encouraging an active, healthy lifestyle we can have an impact on the health of our eyes just as much as we can have an impact on the health of our hearts, lungs or any other organ. Preventing people from losing their sight unnecessarily must be a key priority. I welcome the platform that the debate gives us not only to educate people about the importance of eye health but to raise the necessary awareness of how to reduce the risk of sight-threatening conditions.


Emma Harper (South Scotland) (SNP)

I am pleased to speak in this afternoon’s debate, and I congratulate my colleague Stuart McMillan on securing it. He covered very well the facts and stats about eye health conditions that are highlighted by this week’s being national eye health week, and I agree with what he explained.

However, I would like to pick up on the related point about eye examinations. I note that Stuart McMillan’s motion

“calls for the public to get their eyes tested on a regular basis by utilising the free eye examination”.

As a nurse, I have been able to use my experience to inform myself for the debate; I learned that a vision test during a visit to the optometrist is not just a way to check whether one’s eyesight needs help with a corrective prescription. While the main purpose of such an examination is to detect and diagnose vision problems, as has been described, it can also help to detect signs of other health issues that may affect other parts of the body. When I spoke in the debate during last year’s eye health week, the focus was on diabetic retinopathy.

According to Diabetes UK, about 750,000 people across the UK have undiagnosed diabetes. This week, I had a discussion with an ophthalmic nurse specialist, who happens to be my wee sister, Buffy. She conveyed that many diagnoses of type 2 diabetes are made when an eye examination is performed—when people describe their symptoms and when retinal photographs are taken.

Many people dismiss their symptoms of gradual visual impairment as part of growing old, or even put the symptoms down to tiredness. However, the high blood-glucose levels that are associated with poorly controlled type 2 diabetes can mean that the tiny wee blood vessels in the eye can be damaged by high levels of blood glucose, which can lead to diabetic eye disease—retinopathy. If type 2 diabetes is picked up, diagnosed and treated early, visual impairment complications can be detected and treated, and the person’s sight can be protected.

High blood pressure has been mentioned. It is a disease that has far-reaching complications not just for the eyes, because blood flow affects every part of the body. Fortunately, high blood pressure is another example of a health condition that may be detected during an eye examination.

One disease that has not been mentioned is rheumatoid arthritis. Most people do not know that rheumatoid arthritis, which is an inflammatory process, can affect the eyes as well as the joints. I was quite surprised to learn that. If rheumatoid arthritis is affecting a person’s eyes, they may have dry eyes, eye pain and other vision problems. The news is that early treatment can prevent permanent vision damage.

I would like to thank Royal Blind for its briefing ahead of the debate. We need to highlight the importance of vision testing, as Royal Blind has said, and we must seek to get the message out that most people should have a sight test once every two years, and identified groups should have one every year.

The symptoms that an eye health professional might detect include spots in the retina, bleeding in the back of the eye and constricted blood vessels, among others. Again, having one or more of those symptoms does not necessarily mean that a person has high blood pressure, but they might need further consultation to determine what is causing the symptoms.

My sister also told me that a young 30-year-old woman showed up in her clinic one day with a sudden visual impairment, which led to a diagnosis of multiple sclerosis.

It is really important to raise awareness, and to remind people that they should schedule eye examinations and follow the advice of healthcare professionals and doctors on recommendations for suitable follow-up tests and treatments.

I echo Stuart McMillan’s call for the Government to support and promote a refreshed national eye check campaign. Following an eye exam, glasses might not be the only thing that is required; other medical issues can be assessed, diagnosed and treated ahead of complications developing.


Anas Sarwar (Glasgow) (Lab)

I congratulate Stuart McMillan on securing this important debate. I pay tribute to the RNIB and Royal Blind—to all their staff and, in particular, to all their volunteers, for the amazing work that they do all year round, and not just during eye health week. They are not just lobbying parliamentarians but, as Stuart McMillan outlined, are out there on the streets campaigning to give people better support.

I want to touch on something briefly before I speak about eye tests. I had the great pleasure of speaking at an event a couple of weeks ago in this Parliament—“The Sound of Vision” event, which was organised by the RNIB and was kindly sponsored by our own Presiding Officer. That event taught me—genuinely taught me—about many of the additional challenges for people who have problems with their sight. It is not just about access to services; it is also about employability. People want to go on living normal lives. It is about the impact on them, their families, their friends, their relationships and their daily interactions, including the simple things such as going to the shops, going to post a letter in a letter box, working out what is on the television and what shows they might watch or how they might socialise with their friends.

The stark reality of all those issues was brought home at the event in some of the fantastic contributions that we heard from people who were blind or partially sighted, and who had got support from the Glasgow Speakers Club to learn about public speaking to help to build their confidence. I can honestly say that the speeches that were made by those really inspiring individuals were better than those that we hear most of the time in the Scottish Parliament, excluding the speeches that we have heard in this debate, and I think that there were some future parliamentarians in that group. I congratulate the Presiding Officer on allowing the group to have the event here in Parliament. I also congratulate the project funders—in particular, Steven Sutherland, who is the driving force behind the project. He is an inspiring young man who we might see in the Parliament at some point in the future.

Why is this debate so important? We have talked about the 170,000 people in Scotland who have significant sight loss and about the impact on their families. There has been praise—rightly—for the policy on entitlement to a free eye test every two years. I will make a confession: I cannot remember the last time I went for an eye check, but given that I now sit closer and closer to the television and that I have to bring my notes closer and closer to my eyes, I must be due an eye test very soon. I am very happy to support a public information campaign, as suggested by Stuart McMillan, and I hope that the minister will give a positive response to that.

It is welcome that almost one third of people in Scotland take advantage of the free eye check every two years, but we can drive up the figure for testing rates, particularly in the most vulnerable communities and among people who are more likely to experience health inequalities. We can spend to save so that future issues for our national health service are addressed. We have already heard that eye checks can pick up conditions or problems that do not yet affect the vision, including blood pressure issues, refractive errors, kidney problems, brain tumours and problems in blood vessels in the eyes. Early checks can help to pick up all those things.

I thank, in particular, all the charities that are involved in the fantastic work and I thank Stuart McMillan for securing this important debate. To the chair of the RNIB, who spent two days last week sitting in Parliament and lobbying parliamentarians, I apologise that members did not all go to his stand instantly, but I hope that he had a positive interaction with parliamentarians.

Eye health is an issue on which our Parliament can unite and make a significant intervention that will have an impact for generations to come.


Rona Mackay (Strathkelvin and Bearsden) (SNP)

I am delighted to speak in this debate to mark eye health week, and I thank Stuart McMillan for bringing it to the chamber.

Eye health affects us all. Most of us, at some point in our lives, will wear glasses or contact lenses, or have laser eye treatment, but what if glasses are not enough and our eyesight starts failing so badly that our lives are irrevocably changed? That why it is important to go for regular eye tests to detect early if problems are looming. As Stuart McMillan’s motion says, great progress has been made with eye health and we have the highest annual level of people receiving eye tests on record. It is also important that eye examinations are free in Scotland, which is a huge boost for public health.

There are things that we can do to preserve our eye health, such as taking regular screen breaks, reading in the correct light and, most important, not smoking. We all know that smoking is harmful to general health, but ASH Scotland tells us that there are particular implications for eyesight. Tobacco smoke is composed of thousands of active chemicals, most of which are toxic. As a result, smoking greatly increases the chances of losing sight. As many as one in five cases of age-related macular degeneration are caused by smoking, which is also linked to cataract development.

I am extremely fortunate to have the wonderful organisation Deafblind Scotland in my constituency and, earlier this month, I hosted an event in Parliament to highlight the fantastic and progressive work that it does. Stuart McMillan was present at the event, so he can back me up on that. It was not about what they could not do, but about what they could do, which included trekking in the Himalayas, climbing Kilimanjaro, playing the taiko drums and much more. One young man—Ryan—who has Usher syndrome, which is a condition that affects both hearing and vision, gave an inspirational speech that told of how he had not let that terrible condition hold him back. He was incredible.

Early diagnosis and treatment can prevent up to 98 per cent of severe sight loss and, as for most health conditions, the earlier the treatment, the more likely it is to be effective. National eye health week seeks to get the message across that most people should have a sight test once every two years. We know that a sight test can also detect high blood pressure, diabetes and other serious health conditions.

There are around 188,000 people with significant sight loss living in Scotland today, and the number of people with sight loss is projected to double over the next two decades in Scotland to almost 400,000 by 2030. The number of registered blind and partially-sighted people in Scotland now stands at around 34,500, but research indicates that as few as 23 to 38 per cent of eligible people are actually registered blind and partially sighted.

Civic society and local authorities have a large part to play in helping people who have sight loss. In Kirkintilloch in my constituency, the local authority introduced a shared space scheme, which has proved to be disastrous for people living with visual impairment or sight loss. They are simply unable to access their own town centre—which raises huge issues of equality—because of the removal of traffic signals, kerbs that guide dogs recognise, and thundering lorries and buses clogging up a busy junction. It is simply not safe. I urge local authorities and developers to think carefully about the effect that such streetscapes can have on the less able.

We should all remember that eye health is precious, go for regular free eye tests and detect problems early. We owe it to ourselves and our families.


Annie Wells (Glasgow) (Con)

The importance of eye health and the need for regular tests must not be underestimated. According to leading bodies, sight is the sense that we most fear losing and, for many, simple lifestyle changes can be the key to ensuring long-term eye health.

Eye health week is about promoting such changes and encouraging everyone to get their eyes tested regularly. In doing so, we can reinforce the message that vision really matters.

As many members have already done, I commend the work that has been done so far in promoting eye health and care.

Many of us are risking future sight loss by failing to look after our eyes. Routine eye appointments are recommended every two years, even if our eyesight has always been healthy, so that an optometrist can check that we are seeing clearly and spot signs of common eye problems.

Poor eyesight can affect anyone at any age. A seven-year-old might be struggling to read the board at school. A 45-year-old might not be able to see the ball during the Friday night five-a-side game. A 67-year-old might be finding it difficult to carry out daily tasks, such as making a cup of tea.

Eye health week seeks to reinforce the message that, regardless of circumstance, it is best to get our eyes checked regularly. As Stuart McMillan said, huge progress has been made in raising the number of those who are getting tested regularly. As Brian Whittle stated, almost 2 million over 16s and 300,000 under 16s received their free eye tests in the past year. Campaigns such as eye health week will no doubt contribute to the rising figures, and I commend all the organisations involved.

Last year’s campaign to raise awareness saw collaboration between Eye Health UK, RNIB and Channel 4 to create a special ad break giving viewers the chance to watch TV as if through the eyes of somebody who is living with sight loss. The Royal Mail also teamed up with Eye Health UK to promote the importance of good eye health by placing a special national eye health week postmark on all stamped mail.

Every year, national eye health week teams up with the Central Optical Fund to publish Vista, a lifestyle magazine that is available online, and is designed to raise awareness of how lifestyle choices can affect eye health. Raising awareness is about more than promoting regular eye tests. Certain lifestyle choices make poor eye health more likely and thus preventable. For example, smokers are four times more likely to suffer from age-related macular degeneration, which is the UK’s leading cause of blindness. Despite that, in surveys, more than half of smokers indicate that they are unaware of the link between smoking and sight loss, equating to half a million people in Scotland.

Obesity and the links it has with diabetes, also doubles the risk of AMD and increases the chances of developing cataracts. Over-exposure to the sun can also increase the chances of cataracts. Eye-friendly nutrients can be found in many fruits, vegetables and cold-water fish such as sardines and tuna and they can protect against AMD.

To be perfectly honest, although I knew vaguely about the links between certain lifestyle choices and eye health, it was only when I read around the topic prior to today’s debate that I came to understand just how strong the link is. I am pleased that I am now 11 weeks off the cigarettes; that is me cutting my risk even more. It is just about losing the weight now.

I had no idea that eye tests can indicate other health conditions, such as hypertension and raised cholesterol, so they can help to prevent more serious health problems such as heart disease and stroke. If eye health week can improve my knowledge of eye health and the factors that contribute towards greater risk, it is imperative that we politicians give it further weight and promote awareness.

I thank Stuart McMillan for bringing the debate to the chamber. We can all agree how important it is to raise awareness of and promote eye health and care.


The Minister for Public Health, Sport and Wellbeing (Joe FitzPatrick)

This has been a really good debate, and I, too, thank Stuart McMillan for giving us this opportunity to mark eye health week and discuss eye care in Scotland.

I know that, across the chamber, we agree that general ophthalmic services represent one of the many NHS success stories in Scotland. The introduction in 2006 of free NHS-funded eye examinations set Scotland apart from the rest of the United Kingdom. This Parliament has been able to come together to continue to support that, despite changes in Government, which shows the strength of the policy. For the first time, everyone in Scotland, regardless of their personal situation, had access to an eye examination free of charge.

A routine primary eye examination provides a full health check of the patient’s eye as well as a normal sight test, helping to detect eye diseases early. A number of members mentioned particular health issues that an eye examination can identify. Rona Mackay mentioned high blood pressure; Emma Harper mentioned rheumatoid arthritis, which I confess that I did know could be detected through an eye test; and Brian Whittle and a number of other members mentioned diabetes. Brian Whittle also mentioned that an active lifestyle is an important tool for improving our overall health—we cannot make that point often enough. Annie Wells talked about the importance of a healthy diet. All those are good points to make. Anas Sarwar mentioned a number of health issues, but the list was so long that I was not able to keep up. The point that he, like others, made is that eye examinations are important for people’s health in general, not just their eye health.

The uptake of free NHS-funded eye examinations has increased by 43 per cent since they were introduced in 2006. As someone mentioned, in 2017, more than 2.2 million people had their eyes examined, which is the highest number ever.

To pick up on the points that were raised by Stuart McMillan, Anas Sarwar, Emma Harper and others, we are not complacent. As well as continuing to raise awareness among the general population through initiatives such as NHS 24’s campaign, know who to turn to, we plan to run targeted awareness-raising campaigns for specific patient groups among whom take-up of free eye examinations is lower, including those living in more disadvantaged communities.

The Scottish Government remains committed to ensuring that the best community eye care is accessible to everyone. That is why we commissioned a review of community eye care services in Scotland in 2016, 10 years on from the introduction of free eye tests in 2006.

Before I talk about the review, I want to take the opportunity to mention the current eye care services that are provided in the community. In Scotland, the optometrist is the first port of call for any eye problem. It can be frightening when something happens to our vision, but this support, in the community, close to where people live, provides the high-quality care that people need. Emergency eye presentations can often be managed and treated in the community. Evidence shows that more patients now know to go directly to an optometrist if they have any problem with their eyes, rather than to their GP. Clearly, community optometrists have increasingly been taking on that extended role for some time, demonstrating the growing capacity, capability and competency of the profession. They are doing more work in the community, which reduces the burden on secondary care and general practitioners and ensures that patients remain in a primary care setting.

The service is enhanced by those optometrists who have undergone training on independent prescribing of medicines, which is facilitated by NHS Education for Scotland. More than 250 community optometrists have become fully trained independent prescribers, which amounts to one third of all such fully trained prescribers across the UK. However, we think that more can be done and that the service should grow.

Optometrists and ophthalmologists work together when patients need referral to secondary care. The eye care integration programme that is under way seeks, among other things, to increase the number of optometrists who send patient referrals to secondary care electronically. As well as being much quicker, that means that the optometrist can attach pictures and scans of the patient’s eye, which allows the ophthalmologist to assess and triage the referral with an appropriate appointment. Really good progress has been made on that, and we will continue to work with health boards to reach a position in the near future where all referrals are submitted electronically.

We are also in the early stages of commissioning our once for Scotland ophthalmology electronic patient record, which will be a real game changer for the delivery of eye care services in Scotland. It will mean that ophthalmologists can provide meaningful feedback to optometrists, which will reduce the number of unnecessary referrals to secondary care.

As I mentioned, in 2016, the Government announced a review of community eye care services. Representatives of the Scottish Council on Visual Impairment and Optometry Scotland were members of the review group, and patients were involved to ensure that their views were captured. The review published its report in April 2017 and highlighted the successes of the service as well as identifying areas for improvement. Since then, the Government has been working with a range of stakeholders, including Optometry Scotland and NHS boards, to deliver on the report’s recommendations.

As a result of that work, a number of significant and positive changes will be made to general ophthalmic services from 1 October. Among other things, the changes include further support for community optometry as the first port of call for all eye health problems in Scotland and revised arrangements for tests and procedures. All general ophthalmic services practitioners will be required to complete mandatory annual training provided by NHS Education for Scotland, which will further upskill the optometry profession and provide a baseline standard of education and care. To pick up on a point that Emma Harper made, patients who are sight impaired or severely sight impaired will, for the first time, be entitled to an annual primary eye examination rather than one every two years, as at present.

This has been a really good debate, and I am pleased to have been involved in it. I am sure that the Parliament will continue to support eye health week in the years to come.

Meeting closed at 17:43.