I thank Deputy Moynihan for raising this really important issue of eye care services in line with emerging trends. I am taking this on behalf of the Minister for Health, Deputy Carroll MacNeill. There are measures either in place or being progressed to address the emerging trends in eye care services, such as those due to an ageing demographic or an increase in the prevalence of myopia. The Health Service Executive provides optical services free of charge to children referred from child health and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate service for treatment. Under the community ophthalmic services scheme, COSS, medical card holders and their dependants aged over 12 can be seen by ophthalmologists, optometrists or dispensing opticians. They can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances. In 2017, the HSE published two important documents, the Primary Care Eye Services Review Group Report and the national clinical programme for ophthalmology. The review report set out how a significant proportion of eye services could be delivered in a primary care setting. A key recommendation was that children aged between eight and 12 with routine eye care needs should be transferred to the care of local optometrists. These would receive an annual eye exam under the COSS, irrespective of their medical card eligibility. This remains a priority and work is ongoing to implement this recommendation. The clinical programme set out a model of care regarding how the realignment of eye services from an acute hospital setting to the community would be undertaken. The HSE has been developing multidisciplinary integrated eye care teams in accordance with this model of care. These teams facilitate assessment, diagnoses, management and treatment, enabling most patients to be seen in their own locality. Where necessary, patients can be referred onwards to acute ophthalmology services to receive the necessary specialist input. Significant investment has been made in developing and strengthening these integrated eye care teams. There are ten across the six health regions. These teams are also facilitating the large-scale transfer of care from hospital outpatient departments to community settings, with a substantial proportion of referrals assessed, treated and discharged outside the acute system. This has reduced pressure on hospital ophthalmology clinics, enabling acute services to prioritise complex, surgical and high-risk patients, and has improved patient experience through earlier assessment, shorter waiting times and care delivered closer to home. Work is also under way to ensure Ireland has enough trained eye care professionals to deal with increasing demand: The South East Technological University, SETU, is progressing work to establish a bachelor of science honours degree in optometry, with a first intake of students expected in September 2027. I have been working closely with Professor John Nolan and Dr. Fraser Horn, who have done phenomenal work in the last couple of years to embed this into the new technological university. They were very supportive of this "one health" approach. You have to have the eye care professionals in place to deliver an awful lot of the services. I am really struck by what the Deputy said as well about optometrists being able to take that step in regard to dealing with children especially. We have seen how the Minister and the previous Minister have moved in relation to pharmacists now being able to prescribe up to 12 different medications, which is really important. The Department of Enterprise, Tourism and Employment also recently announced that the ophthalmic optician is now an eligible occupation for the critical skills employment permit. Finally, the Department is also considering ways to expend the scope of practice for optometrists to ensure that the eye care needs of people, especially children and older persons, can be met.

Sentiment score: 0.33

It is great to have the opportunity to discuss the reform of eye care services in line with emerging trends across the country. Deputy Michael Murphy, who is sitting in front of Deputy Moynihan, has discussed with me several times the issue of getting the right clinicians into the job. We have been really challenged, for example, in south Tipperary in getting a consultant optometrist in there to fill that post. That is why it is really important we have the training skills across the country. We do not have enough positions at the moment. I am strongly of that opinion and we are trying to change that. That is really important. The Deputy talked about eye care. Often when we think of eyes, we think about the glasses or the contact lenses but eye care is very important. There is a huge amount of work done with older people with dementia, macular degeneration and cataracts. It is very important that the quality of life of a person can be so much improved if they have the correct eye care. Myopia - short-sightedness or nearsightedness - is increasing among children both globally and in Ireland. Research indicates that daily outdoor activities and managing children's screen time and sleep time may be beneficial for slowing the progress of myopia. Children discovered to have sight problems, including myopia, during HSE screenings get free treatment from their local HSE integrated eye care team, but I am conscious of waiting lists and where a young child is waiting. I am conscious again of the situation in south Tipperary, which has been raised. We failed over the past two years to get a consultant in post, and that ends up creating very long waiting lists for children. As we all know, regardless of what health issue it is, early intervention is key. I will raise with the Minister again the prescribing element of it, because the more services we can move away from the acute hospital setting and into the community, the better. I thank the Deputy again for raising this.

Sentiment score: 0.28

I thank Deputy Murphy for raising this very important issue. I am taking this Topical Issue on behalf of the Minister of State with responsibility for older people and housing, Deputy Kieran O'Donnell, who sends his apologies for not being able to be here tonight. The Deputy is quite right. I was a Minister of State in the previous Dáil for four and a half years, and one of the areas where we made a lot of progress was dementia. Every day in Ireland, there are 30 new cases of dementia. There were 30 yesterday, there are 30 today and there will be another 30 tomorrow. I was delighted to welcome the Minister of State, Deputy O'Donnell, to Cappoquin in Waterford last Friday, where we opened a new dementia day service. It is something I worked on while I was in the role and it was great to get it over the line, because bringing services to people in the community, especially those with dementia, is really important. You can live well with dementia in your community with the correct wraparound supports of home care, day care, meals on wheels and the like of the memory clinics. When I was asked to take this Topical Issue debate tonight, I was disappointed to hear that one of the 25 memory clinics that I worked so hard to open across the country after Covid had been "paused". I do not like seeing that word at all. Memory clinics are so important. They are a specialist service to support people with memory loss, changes in cognitive formation or dementia. As the Deputy knows, it is located in St. Patrick's Hospital in Cashel in south Tipperary. I appreciate the impact that this is having on people who are awaiting dementia services. The HSE has advised me that the memory clinic in Cashel has been paused since January this year due to staffing and resourcing issues. I have spoken to the integrated healthcare area manager for south Tipperary this evening. I rang her and she assured me that the HSE was working both locally and nationally to resume the clinic as soon as possible. I am very conscious of the waiting list that the Deputy called out of 450 patients, 168 of whom have had the initial appointment. That is a significant waiting list. Currently, people are referred to the memory clinic either by their general practitioner or through acute hospitals or community specialist teams. Increasing service demand, combined with staffing challenges, has led to longer waiting lists in the memory clinic, as the Deputy alluded to. The HSE has approved the appointment of a full-time administrative post to support the current clinical administrative systems and allow for their further development. In addition, the current clinic staff are exploring new ways of working to address the waiting lists and resume the provision of a memory clinic service in south Tipperary. As the Deputy quite rightly said, the programme for Government includes a commitment to roll out more memory assessment and support services. I had the honour of being able to write that into the programme for Government. I feel strongly about dementia supports, regardless of where people live. I am disappointed to see that this is the current situation. I have been told that referrals can be made to the south Tipperary integrated care programme for older persons, ICPOP, team in Thurles, which provides specialist secondary care for people with cognitive decline, falls and frailty. I am conscious that the current situation in south Tipperary is difficult. I will give the Deputy a commitment tonight. I have already spoken to the Minister of State, Deputy O'Donnell's office this evening. We will follow this up rigorously because it is really important. We came from a situation where we did not have many dementia supports. We have 25 memory clinics open. They are vital, the length and breadth of the country. I will work with the Deputy and the Minister of State with responsibility for older people to make sure that we get this up and running again.

Sentiment score: 0.21

I thank the Deputy. Many of the memory clinics evolved organically over many years. I am aware that there is a memory technology resource room in Clonmel, which supports people with technology when, for example, they are living well at home with dementia, but it is important that we get the memory clinic back up and running. These clinics are a vital cog in the wheel. There is an excellent dementia adviser in south Tipperary. I have met her many times. She is fantastic. There is a great partnership with the Alzheimer Society of Ireland. I commend it on the work it does. The opening of the new service in Cappoquin last Friday brought to 62 the number of dementia day services across the country. I commend the Minister of State, Deputy O'Donnell, for following on and making sure that dementia in general remains a key part of the work that he does every day of the week. We always talk about the prevalence of early onset dementia. We are seeing more and more younger people with it. As the Deputy knows, we had the two fantastic Adams brothers in Ireland only recently. They ran 33 marathons in 33 days. I had the honour of meeting them with the Minister of State, Deputy O'Donnell, and others. We had a very good conversation. I am delighted to say that they will be coming back to Ireland early in July. We will have statements on dementia in the House and the brothers will be present. I thank the Deputy for putting the spotlight on dementia today, specifically with regard to Cashel and the memory clinic. I will speak with the Minister of State in the next week or so and try to make sure that we get traction and get this service back open as quickly as possible.

Sentiment score: 0.33