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Dail Éireann · 2022-12-08

Health Strategies

GP Steven Matthews · Wicklow

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Summary of this debate

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I raised the issue of the community ophthalmic services medical treatment scheme with the Minister previously with regard to reviewing the reimbursement to medical professionals in this sector. As the Deputy said, the community ophthalmic medical services treatment scheme was established as a pilot quite some time ago in 2004. The HSE's 2017 primary care eye services review group report outlines a blueprint for the future development of services in accordance with population needs.

It calls for the establishment of primary eye care teams that would include primary ophthalmic physicians, orthoptists, nurses, technicians and administrative staff. A priority for this year has been the development of the primary care teams in CHO 6, CHO 7 and CHO 9.

Built by scoring every sentence in the debate on how distinctive its language is, then quoting the highest-scoring ones back word for word and in the order spoken. Nothing is paraphrased or invented — if a sentence appears here, it was said in the chamber. Drawn from 355 words across 5 contributions by 2 speakers.

Most used terms in this debate

How often each word appears across the whole debate, ranked by how distinctive it is to this debate rather than common to all parliamentary language.

ophthalmic 4
eye 7
treatments 4
service 9
care 7
primary 6
fees 4
cho 3
medical 5
practitioners 3
scheme 6
community 6

The full debate

All 5 contributions, start to finish, in the order they were made. The one you came here for is highlighted.

GP Steven Matthews this contribution

I raised the issue of the community ophthalmic services medical treatment scheme with the Minister previously with regard to reviewing the reimbursement to medical professionals in this sector. I asked whether that is under consideration. My understanding is that the reimbursement paid to them has not kept pace with the costs of delivering that service. This is an extremely important community-based eye medical service.

FF Stephen Donnelly

I thank Deputy Matthews for the question. One of the locations in which the ophthalmic service is provided is in our own constituency in the Deputy's home town of Bray. I value the important role that community ophthalmologists play. I am fully committed to the development of the community service to facilitate the integrated provision of eye care in local communities.

As the Deputy said, the community ophthalmic medical services treatment scheme was established as a pilot quite some time ago in 2004. There are four practices across seven locations providing medical and minor surgical care to patients outside of hospitals, which is important because it frees hospitals up to do the more complex work.

The treatments and fees payable were agreed nine years ago in 2013. The HSE has advised that a detailed evaluation of the operation of the scheme would be needed to see whether we extend it further. I am very happy to tell the Deputy that I am asking the agency to conduct this review in 2023, which I know is something people have sought for quite some time.

The HSE's 2017 primary care eye services review group report outlines a blueprint for the future development of services in accordance with population needs. It calls for the establishment of primary eye care teams that would include primary ophthalmic physicians, orthoptists, nurses, technicians and administrative staff. A priority for this year has been the development of the primary care teams in CHO 6, CHO 7 and CHO 9. I have asked my officials to review the current fees payable under the scheme as raised by the Deputy.

GP Steven Matthews

I thank the Minister. It is welcome news to hear he has requested an evaluation to be carried out on the expansion of the scheme. I hope it will also include the payments that are made under the scheme to the practitioners. As the Minister outlined, it is a very valuable service and one I recently experienced. The Minister might have noticed the black eye I have at the moment. Many people have been asking me about it. I have had to tell them I underwent a small eye procedure recently. It really brought home the value of having practitioners, such as the one to which the Minister referred in our constituency of Wicklow, available to the community.

The Minister quite rightly stated that people do not have to go into a hospital setting to have a procedure carried out. If we could expand this service across the country, it would fit very well with the primary healthcare model he has been so successfully implementing whereby services that are suitable and appropriate take place in the community setting. There are far better outcomes from it. It is far better for the practitioners and people working in those services and for the patients, which is our primary concern.

FF Stephen Donnelly

It is a valuable service. I hope the Deputy got taken care of. Areas covered include acute treatments such as inflammatory or infectious eye conditions, chronic treatments such as cataracts, pre- and post-op care, age-related macular degeneration, surgical treatments such as corneal ulcer surgery and eyelid injuries.

The treatment fees are set out in schedule 3 of SI 274 from 2013. The fees are set at either €59.51 or €75.76 depending on the service. The payments were reduced in 2009 and they were reduced again in 2013. Those reductions were not reversed after the financial emergency measures in the public interest, FEMPI, period came to an end. As the Deputy said, they are considered by the IMO and some of the contractors not to be sustainable. To that end, we will do a review next year to see whether there is an argument for a change in the fee.

GP Steven Matthews

I welcome that news. I will leave it in the Minister's capable hands to look at that. I know he understands the importance of this service. I am glad to receive that response this morning.