New campaign for greater choice for NHS cataract patients

03/06/2008

The fight to let cataract patients pay to upgrade their treatment may be a step closer to victory thanks to Dr David Allen, consultant at the Sunderland Eye Infirmary, who has argued for years that cataract patients should be allowed to contribute towards their treatment, so that they can have a better standard of lens fitted than is available on the NHS.

 

There have been many developments in eye surgery over the past fifteen years which allow people to have good vision without glasses

- the best known being refractive surgery (treatment with lasers). 

But although this so-called ‘lifestyle’ choice is not available at public cost via the NHS - cataract surgery IS. Cataract surgery is the commonest surgical procedure performed in the UK and is freely available as standard NHS treatment. It involves taking out the patient’s own clouded lens and replacing it with a brand new plastic implant lens, and the implant gives clear vision in only one place - usually the distance.

 

But recent technical advances mean that there are now implants available that allow some patients to be able to dispense with glasses altogether - because they allow the patient to see in the distance and also at close quarters. In other words, treatment using these implants combines therapeutic surgery (NHS eligible) and refractive surgery (NHS non-eligible). However they cannot be split into two procedures, and must be done simultaneously - which is where the problem lies.

 

Current NHS rules do not allow a patient to have both NHS treatment and private treatment in the same episode. Therefore if NHS patients want to have the added convenience of being able to dispense with glasses altogether, they have to go outside the NHS for the whole of their treatment. But David Allen hopes to bring such pioneering treatments within the reach of NHS cataract patients

 

His proposal, backed by TV’s Loose Women presenter Jane McDonald, is that cataract surgery NHS patients should be allowed to opt to have one of the new refractive implants, and pay a fee just for the refractive element of their care - not the whole operation. And they emphasise that their proposal is NOT about patients 'topping up' to have better treatment than the NHS can afford.

 

David Allen said: "In my view, this proposal permits a patient to choose when having cataract surgery to go on using glasses after the procedure and to pay for them. Or to pay an additional amount, around £500 per eye, to have the multiple-focus lens implanted. It won't affect waiting times for other patients, and the surgical procedure takes the same time and involves the same technique."

 

Jane McDonald, who has had groundbreaking replacement lens surgery to save her sight urged politicians to find a way to allow everyone the chance of recovering their sight by giving them access to the best technology. Speaking at a private House of Commons function she said: 

“This is a wonderful operation and I am absolutely delighted with my new eyes. I think it would be wonderful if this technology was available through the NHS - because our sight is priceless.”

 

Mr Allen, a former consultant adviser to the chief medical officer of England, made a detailed presentation in Westminster in March to health chiefs, MPs and members of the Lords. He said: “What we are about is trying to extend the availability of this new technology to more patients. I believe patients who choose this option will have a better quality of life.”

 

Those supportive of the proposal currently include Shadow Health Minister Mike Penning MP, Baroness Knight, Sunderland South MP Chris Mullin and the House of Lords Shadow Health spokesman Earl Frederick Howe. MP Kevin Barron, chairman of the all-party parliamentary Health Select Committee, said David Allen’s proposal merited a ‘proof-of- concept’ pilot study to be set up possibly in the north of England.