2. Will the Minister make a statement on the warning by Dr Gwyn Williams, of the Royal College of Ophthalmologists, that a tide of avoidable blindness could sweep Wales if eye care services are not reformed? TQ647

Diolch yn fawr. Llywydd, Gwyn Williams, who is our ophthalmology clinical lead, along with the Royal College of Ophthalmologists, has worked with us to develop an eye care strategy, which we are now implementing. Over the past 12 months, eye care services have implemented considerable innovations to ensure that patients at risk of sight loss are seen and are treated. 

Thank you, Minister, for that response. The waiting times are horrendous for eye treatments anywhere in Wales. And there are difficulties across the United Kingdom; I accept that, Minister. Dr Williams highlights three points that he believes need dramatic intervention on behalf of the Government, working with health boards. The first is, obviously, changing working practices and actually using a wider base of professionals to, obviously, deal with eye care services; the second is the recruitment of people into the service to increase the capacity of the service; and the third is to create three eye care centres of excellence across Wales and actually look at what optometrists can do in their high street locations to, obviously, increase the service level that may be available for people with eye conditions.

Nothing could be considered worse, I would suggest, than actually losing your sight over a given period of time, when you know an intervention could stop that deterioration in your eyesight and going into a world of darkness. How confident are you, Minister, that the plan that you've put in place will meet the three objectives that Dr Williams has highlighted as of critical concern if we are to expand the service here in Wales and that in 12 months' time we will not be here still debating, still discussing, large waiting times for eye care treatment in Wales, and, regrettably, many people having the lights going off in their eyesight and darkness prevailing in their lives?

Thanks very much, Andrew. I absolutely am very aware of the fact that there are certain conditions where we have to move fast, and this is one of them, which is why what we've done is to ask clinicians to sort out priorities, to put people into categories so that we are really getting to the people who need the most urgent help fastest. Of course, what we are doing is implementing the recommendations of the Pyott report, and one of those is now being implemented. So, we've got two new surgical mobile theatres dedicated to cataract treatment. They're in operation in Cardiff and the Vale, and that was funded by £1.4 million of funding from the Welsh Government.

In terms of working practices, we are looking to change the rules. So, the rules currently say that high street optometrists, for example, can only check eyesight, but their skills go way beyond that, and we need to change the rules to allow them to do that. So, the process is not as straightforward as it seems to change the rules, but we are absolutely in the process of seeing how far and how quickly we can do that. 

When it comes to recruitment, of course, we're working with Health Education and Improvement Wales in terms of specialising and making sure we've got the right people to do the right things in the right place. And certainly, when it comes to high streets, we are very, very keen to make sure that they are a part of the solution to this problem. 

Since 2018, the policy in Wales is that eye care and the kind of care that is provided is based on the level of risk. It was innovative in that regard, with patients being seen according to how much risk they face. And the highest risk factor is for those who face the risk of irreversible harm. And for people with eye problems, that means the risk of losing their sight. Now, in order for a system like that to work, people have to be seen within a specific time frame. It’s as simple as that, and that’s why the target notes that 95 per cent of patients need to be seen within that time frame. It should be 100 per cent as far as I’m concerned, but that 95 per cent is statistically quite close. But we hear now that 65,000 people aren’t being seen within that specific time frame: 65,000 people facing losing their sight. 

I drew attention to this in the middle of the dark months of the pandemic, in February of last year. I was concerned about the impact of the pandemic, but we’re hopefully moving out of the pandemic now and the problems are intensifying. It’s bad enough when people are waiting in pain for orthopaedic treatment, perhaps, but we’re talking here about people who are losing their sight. 

We’ve heard about the NHS starting to receive post-COVID targets, therefore, may I ask the Minister, very simply, when does she commit not to decreasing the number of people who are waiting longer than they should, but to getting rid of these waiting times entirely? There’s no point having a system that is based on risk measures if you then leave tens of thousands of people open to the highest level of risk. 

Thank you. As you’re aware, I was pleased to see, for the first time, that those waiting for two years and longer, that those lists are coming down for the first time since the beginning of the pandemic. So, we’re travelling in the right direction, but, of course, we’re not travelling quickly enough. You must bear in mind in terms of the figures that we’re dealing with at the moment, that we published our plan in April, and it's April’s figures that we have. So, it does take time to put systems in place, and what we have now, for example, is the NHS Wales university eye-care centre. They are developing a workforce that can provide that sophisticated care and provide those opportunities for optometrists across Wales to work.

So, I am pleased to see that those structures in terms of risk are in place, but what we’re endeavouring to do now is to get through the list as quickly as possible, and that’s why having these places that stand alone and aren’t going to be knocked out for reasons such as urgent care and so on is so important. So, what we’re likely to see is that those lists will reduce far more quickly than we’ve seen in the past. If you look, for example, at Swansea, there's the new modular theatre there. We hope to see some 200 operations per month in addition to what happened previously.