In the Department of Health strategy document ‘Future Health’ that was published in November 2012, the Department claim that in the future, the Primary Care setting should “meet 90 – 95% of people’s health and personal social care needs.” (p.30)

Given the financial difficulties facing the State and the comparative expense of treating patients in secondary care settings, this commitment is both timely and necessary. However, despite the much trumpeted claims from the Department, rhetoric and reality do not always align, for while the Department talks, on the one hand, of boosting Primary Care, on the other they take steps to do just the opposite. This dichotomy of approach can be clearly seen in the case of the Community Ophthalmic Physicians.

Community Ophthalmic Physicians are community based independent medical specialists providing a full range of ophthalmic services to the community in which they are based. They are consulted by colleagues in General Practice and also by Hospital based colleagues. Just some of the conditions that are treated by Community Ophthalmic Physicians are:

• Strabismus
• Amblyopia
• Refractive errors
• Ocular inflammation

Given recent advances in specialist training and in the deployment of new technologies, Community Ophthalmic Physicians can treat over ninety percent of their patient caseload without needing referral to the secondary care setting.

In seeking to bolster Primary Care, it would seem clear that the Community Ophthalmic Physician service would be a good place to start, or a good model to follow. In fact, there is even an independent Review of the Service with the HSE. However, the HSE have refused to release, let alone act upon this Review.

Despite repeated efforts to engage with the HSE to explore the potential of the Service, no engagement has been forthcoming. As a consequence, the IMO has written to Mr Alex White TD, Minister for Primary Care, seeking his involvement.

It will be interesting to see Minister White’s response and whether the Government means it when it talks of reform in the health service.