Health Bill

moved Amendment No. 95:"Page 33, line 24, at end insert—" ““(   )   services such as a glaucoma referral refinement service within or outside the Primary Care Trust”” The noble Baroness said: This amendment returns to a subject that I raised in the previous group of amendments about glaucoma. It also reflects the transfer of services away from acute hospitals that is already beginning to happen throughout the NHS. It is not often talked about in relation to these matters; principally people talk about decreasing the number of acute beds and so on. However, for some conditions and services with high numbers of out-patient appointments—for example, podiatry or audiology—there is an increasing tendency to move services away from acute hospitals, which are sometimes awkward and expensive to get to. There is also a move, which Ministers have spoken about frequently, to skill-up allied health professions to release the time and skills of those who are qualified to provide particular services. That is the spirit that lies behind this amendment. It seeks to remove the contractual restraints on optometrists who wish to provide a referral refinement service for glaucoma—a chronic condition that requires a number of appointments to provide long-term follow-up. It is estimated that between 25 and 40 per cent of out-patient appointments in ophthalmology are related to glaucoma alone. Those patients will always be ongoing cases. They will never be discharged from the list. The aim of the amendment is to remove the restrictions to enable optometrists to carry out the ongoing tests needed by people with glaucoma to monitor their condition and enable accurate decisions to be made about their care. If the restriction were removed, it is proposed that up to 40 per cent of hospital eye appointments could cease, which would free those times for other patients who need more complex diagnosis or treatment. The amendment reflects a pilot scheme in Manchester which did exactly that. Eighteen optometrists saw approximately 1,200 new referrals for glaucoma each year. I hope that the Minister will see this as being in the interests of patients with glaucoma and that the Government are in favour of it becoming more widespread throughout the NHS. I hope that she will accept the amendment. I beg to move.