For people living with sight loss, it can impact on every aspect of life—physical and mental health, the ability to live independently, to find or keep a job, their family and social life. Timely access to support from social services is critical to help mitigate the impact of sight loss. Rehabilitation is a specialist service that helps a person with sight loss to adapt to the world around them. The service supports people to relearn skills they need to live an independent life. It could include emotional support, help with mobility, aids and adaptation, or help to assist with activities of daily living such as laundry, cooking and cleaning.

Now, every year in Wales half of those over 80 will have a fall in their home. Almost half of all falls experienced by blind and partially sighted people have been attributed to their sight loss. What's more, falls have been estimated to directly cost the NHS £67 million per year. The cost of falls in Wales related to vision alone is estimated to be £25 million annually. It's a no-brainer in my view that rehabilitation should be a universal offer to all blind and partially sighted people. The economic value alone of vision rehabilitation per referral is estimated at £4,487.

However, it's unacceptable that when it comes to accessing rehabilitation, too often we see a postcode lottery in Wales. In some areas of the country, some people are having to wait over 12 months to see a specialist rehabilitation officer, during which time their sight condition may be deteriorating and they risk becoming quickly isolated. Forty-three per cent of people who lose their sight will suffer significant and debilitating depression. The problem is further exacerbated by the fact that not enough people are being trained to replace retiring rehabilitation officers. Charities in the sight loss sector are increasingly concerned about the provision of rehabilitation for visually impaired people. In some areas, waiting times are unacceptably long, and in others people are getting screened out of rehabilitation assessments completely, or they're being assessed by unqualified staff. Local authorities and health boards need to develop clear referral routes into rehabilitation and early intervention and preventative services where this is not already happening. It's unacceptable that this profession is not being futureproofed. We need to establish plans for future workforce development and encourage people into the role. Ultimately, we need to make sure that people have timely access to rehabilitation services no matter where they live, to enable them to live as full and independent a life as possible.

Turning to the ability to access information and advice, the majority of people who lose their sight also lose their ability to communicate via standard print. This is vital for anyone to maintain their well-being and have voice, choice and control over their life.

In 2013, the accessible healthcare standards for people with sensory loss in Wales were launched. Wales became the first country in the UK to lay out how NHS services will be delivered accessibly to people who are deaf, hard of hearing, blind, partially sighted or have dual sensory loss. Accessible information might mean receiving information in Braille, in large print, in audio or e-mail—whatever is right for that patient to support them to participate fully in their healthcare, as fully as possible. But it is now five years since we launched those standards. The stark reality is that these have had a limited effect, and people are still facing major barriers to healthcare. Patients are still leaving hospital every day unsure of how much medication they are meant to take, or unsure of what advice they have been given. Yes, there has been tentative progress in some areas, but, overall, charities such as RNIB and Action on Hearing Loss tell us that there has been little demonstrable change for people with sensory loss in Wales. Moreover, we were proud, and rightly, that Wales was the first nation in the UK to implement the standards. Why then are we still in many ways no better than across the border in England? Surely, it's high time that the standards, like the Welsh language standards and others, became mandatory. Why isn't Welsh Government setting annual targets from each health board to monitor the improvements? This is a patient safety issue. Patients need to be able to engage in and fully understand their consultations with healthcare professionals.

The built environment is another area where we can minimise barriers for blind and partially sighted people. RNIB Cymru's Visibly Better programme supports organisations to develop environments that more people feel confident in getting in and around. The design principles help prevent falls and promote confidence by establishing appropriate lighting levels, colour and tonal contrast, and fixtures and fittings that aid way finding. Visibly Better design has been used in the newly refurbished radiology department at the University Hospital of Wales. The whole area is now much easier for patients to navigate confidently and safely. We need to futureproof our environments for our ageing population, and we need a commitment to these principles being applied to other public spaces in the future.

If I can just touch on shared space, the concept of shared space is, on the face of it, a most appealing one. Spaces are deregulated to ensure that no-one has a sense of priority. The space is jointly shared by vehicles, pedestrians and cyclists. It all sounds great, but it relies on the ability to make eye contact and that is not easy if you can't see. That means that that space becomes unsafe and avoided. This situation can be worsened by the removing of any crossings and differentiation between pavement and road. The Active Travel (Wales) Act 2013 was introduced with the primary aim of promoting the increased benefit of walking and cycling. However, blind and partially sighted people risk not feeling these benefits when poor planning of shared space puts them at risk of collision with cyclists, so something that starts off as a good idea can end up with a different consequence. A survey carried out by Guide Dogs showed that 97 per cent of people with sight loss have collided with street clutter such as A-boards. 

Finally, Dirprwy Lywydd, I just want to address the issue of transport. Many blind and partially sighted people are reliant on public transport for most of their everyday journeys. In rural areas where people may feel more isolated and public services are further away, blind and partially sighted people rely on public transport that is often old, with bus stops that have no information. That affects people who are fully sighted as well, so we all appreciate those problems.

Can I end by wishing RNIB a very happy birthday as it marks 150 years of championing the rights of blind and partially sighted people this year? We in Wales need to find new solutions and new ways to build a country where the equal participation of blind and partially sighted people is the norm. These are just some of the barriers that people with sight loss face every day, and I know we can tackle them. We can do things differently, and we can see things differently. Diolch yn fawr.