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Monday, October 12, 1998 Published at 10:58 GMT 11:58 UK


Eye care by postcode

The institute surveyed two trusts in each region

James Westhead reports
A patient in need of a sight-restoring operation who lives in Sussex could wait three times as long as someone who lives in Aberdeen.

The operation to fix a cataract is straightforward, but the longer someone waits for one, the worse their eyesight will get.

A Royal National Institute for the Blind (RNIB) study found that there were massive discrepancies in waiting times across the UK.

But health officials have called into question the data on which the survey is based and say it is "sensationalist".

The RNIB's findings come soon after doctors called on the government to focus on waiting times instead of waiting list numbers.

Regional variation

The study found that people in the catchment area for the Worthing and Southlands Hospital Trust in Sussex or for Kings Healthcare Trust in south London could expect to wait up to 18 months for a cataract operation.

Sue Grindley of the RNIB and Stephen Thornton of the NHS Confederation discuss the issue
Patients in the care of Aberdeen Royal Hospitals Trust wait between five and seven months while those in Newcastle wait 11 months, the institute said.

The Department of Health says it is trying to stamp out regional variations in waiting times.

The government had invested an extra £737m over 1998-99 to tackle waiting lists, a spokesman said.

[ image: Cataracts can lead to sight loss]
Cataracts can lead to sight loss
A cataract is a clouding of the lens of the eye. Vision becomes blurred or dim because light cannot reach the retina at the back of the eye properly.

Fifty per cent of all people over 60 develop one, and by the age of 80 nine out of 10 people will suffer some form of cataract.

Patients waiting for treatment suffer increasing loss of sight and this leads to social isolation, the RNIB said.

They are also at increased risk of accidents but do not have access to support from social services, the institute added.

'Shocking results'

Sue Grindley is manager of the RNIB's Eye Health Programme.

Beryl Douglas: waiting 18 months for operation
She said: "Although the government is investing in the short term to reduce cataract waiting lists, we are alarmed at the length of time people are still having to wait and at the local and regional variations in waiting times."

The institute spoke to two trusts in each health region for their study.

A spokesman for King's College Hospital said this did not represent scientific data.

"It appears to be sensationalist and is not scientific. Ringing two hospitals in each region is hardly comprehensive."

He said the trust had been asked what the maximum wait was likely to be for an operation.

The trust had responded that 18 months was the maximum under the Patient's Charter.

However, the spokesman said no patients were currently waiting 18 months and 94% of patients were treated within a year, with urgent cases having priority.

Dr Peter Black, an eye surgeon at the James Paget Hospital in East Anglia, said demand for cataract operations was "bottomless" and regional variation in waiting times was unsurprising.

He said some areas had staffing problems while others, like his own, had a higher proportion of elderly residents.

Waiting times could also vary according to whether a patient was prepared to undergo day surgery, which involves only a local anaesthetic, or if they wanted a general anaesthetic, he said.

This requires a longer wait as a stay in hospital is necessary.

Long-term gains

Dr Black said waiting times could also be governed by the will of individual doctors and managers.

He said that the government's short-term initiatives could have long-term benefits in certain instances.

He said: "We had until recently waiting lists of a year for day case surgery and inpatients and most of our cataract surgery was done as day cases.

"We were then asked as a trust to do an additional number of cases a year which actually amounted to the annual workload of one consultant.

"We said we only do provided they recruited a fourth consultant.

"So in the short-term the politicians will gain because we will do the extra work, but the population will gain because we can recruit a consultant."

This was not the case everywhere, however.

Dr Black said: "But there are some units where they will do the work but not recruit permanent staff so it solves a short-term political problem but does not solve the issue in the long term."

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