It's a timely debate because of the recent publication of the new performance measures, especially as sight loss is a subject that will impact many of us, either directly or indirectly, throughout our lives. I want to begin by actually thanking the Minister and the Welsh Government for listening to users and experts, and for introducing the new performance measures for eye care patients. It is great that Wales is the first part of the UK to introduce these new outcome-focused measures, and it should help health boards to prioritise patients according to their clinical needs. The challenge that we now face is ensuring that this new way of measuring does not deflect away from delivery, and that patients most urgently in need of surgery or assistance receive it before irreversible damage is done to their sight.

As our motion sets out, the number of people with sight loss is predicted to increase by, to be frank, a staggering 32 per cent by 2030, and double by 2050. Currently, there are approximately 111,000 people living with sight loss in Wales, and in the two counties that I represent, over 13,500 people are living with some form of sight loss, and approximately 1,500 people are registered blind. Let us just pause and consider what this means. In 30 years' time, around 7 per cent of the Welsh population will have sight loss. This means that they'll be living with the loss of one of the most important of our senses. Now, many of us in the Chamber, myself included, wear glasses to correct our vision, and isn't it frustrating when we misplace or lose them for a short while, and we can't see very clearly? Just think what that must be like on a permanent basis, and often with no prospect of being able to see clearly again, or in the worst case, at all. Think then of the long-term impact to a patient's mental health of having to accept that they're losing their sight, and then consider the cost to the NHS and the state of supporting a person with impaired vision or sight loss.

These indirect costs associated with sight loss cost the Welsh economy around £268 million every year, and according to the Access Economics figures produced in 2017 by Deloitte, the associated reduction in well-being and health due to living with sight loss totals £1 billion every year in Wales. And I've just talked money here. We've got to remember the personal cost to the individual. And the RNIB put it very clearly: the barriers people with sight loss face every day already create deep inequality, and it will become a national catastrophe unless we do something radical. The current situation shows that ophthalmology waiting lists have spiraled out of control, and one in three patients are deemed to be at high risk of losing their sight or waiting longer than their target waiting times. In Cardiff and Vale, this figure is far worse—almost 50 per cent of people—and across Wales ophthalmology is the second worst of all disciplines for waiting times.

I've met with a number of people via my constituency work and through the RNIB patients group, some of them sitting here, as I've already said, and I want to reinforce the message that none of these patients are criticising the hard-working doctors, the clinicians, the healthcare staff. When they get the treatment, it's great; it's getting the treatment that so difficult. They want to make sure that this is a better service for other people. And, Minister, it is these lives, these people, who are impacted by the decisions that your Government takes, and one of the key concerns is around appointments. There are waiting lists. And, of course, we all accept that waiting lists will exist for certain conditions. And, of course, success creates waiting lists. I thought it was interesting to read over the weekend that the procedure that exists to repair cataracts is now the most successful and the most popular and most universal of any operation carried out by the NHS in the UK. But this success comes with a price—that of more people being referred, longer waiting lists without necessarily the extra budget. Imagine the frustration; a world-class solution that is so universal that specialists can be dropped into countries with poor medical facilities and deliver sight-saving surgery, whilst in our comparatively wealthy nation access to cataract surgery is rationed in an inconsistent manner.

A similar Government initiative, again very welcome, in the fourth Assembly concerning glaucoma was very successful, but led to extra pressure being placed on clinics. And I've heard it's not unusual for patients to be left waiting for over four hours when attending their appointments. And it's not just the waiting time for appointments that was raised, but the issue of cancellation of appointments. A freedom of information request to Betsi Cadwaladr highlighted that, over the last five years, that health board has cancelled close to 40,000 ophthalmology appointments; 7,900-odd were in the last financial year. And I've heard patients say things like, 'I've had enough cancellation letters to wallpaper my bedroom.' We've been told about how people were actually standing there in the queue waiting to be seen and they've heard the receptionist on the phone to a parent or to a spouse back in their home saying, 'Oh, please do tell him he can't come in', and they're standing in front of the receptionist, waiting to be checked in.

We need to do something about it. Minister, I'm asking you to do something about it, because this is absolutely vital. Patients speak about how the loss and deterioration of sight has a huge impact on their mental health. It leads to isolation, anger, loss of friends. People have to give up their driving licences, which has a massive impact, especially if you live in a rural community. I was told by one patient, who used his local leisure centre to swim, that once it was obvious he was losing his sight, he was told he couldn't make use of the centre because he was a health and safety hazard. Unfortunately, sight loss is something that has a huge amount of stigma.

And I'd also like to point out, Minister, that not all patients are born with eye problems or have problems that are linked to the ageing process. I'm concerned that not enough understanding or support is given to those who experience sudden sight loss due to brain injury or other causes of rapid sight loss. I'd like, Minister, for you to have a look at your vision strategy and urgently address the situation. I'm going to stop right now; I'm not going to have enough room to basically conclude. I'm looking forward to hearing what everybody else says. Minister, you're doing well; we could do better. Please listen very carefully to us.