TENS OF thousands of people at the greatest risk of irreversible sight loss are languishing on waiting lists for too long, with services woefully under-resourced, a committee heard.

The Senedd’s health committee took evidence from clinicians, charities and patients as part of a short inquiry into ophthalmology in Wales on March 20.

More than 80,000 patient “pathways” – which include those waiting for multiple treatments – were waiting too long for sight-saving treatment in January, according to the latest data.

Russell George, who chairs the health committee, asked about prevention given half of all sight loss is avoidable with early detection and timely treatment.

Ansley Workman, director of the Royal National Institute of Blind People (RNIB) Cymru, welcomed a new national clinical strategy but warned of a lack of commitment.

“There’s no investment, there’s no timeline,” she said: “And that timeline needs to be at pace and the reason for that is people are going blind in Wales now, so it is a matter of urgency.”

In its written evidence, RNIB Cymru voiced concerns about the lack of a significant investment and direction from ministers in Cardiff Bay.

The charity warned: “Without this, Wales’ eye care waiting lists will continue to rise as will the number of patients … needlessly losing their sight while waiting for NHS treatment.”

Ms Workman raised underreporting of the scale of harm befalling patients in Wales, with “shockingly low” reports despite 80,000 patient pathways being over their clinical target.

Senedd Members heard powerful stories from patients who shared their frightening experiences of living in constant fear of losing their sight.

Rhianon Reynolds, clinical lead for ophthalmology within the NHS Wales Executive, pointed to the development of the national strategy but warned of a lack of support to drive change.

The consultant ophthalmologist said: “We can put the blueprint in place but without investment … it’s going to be difficult to show significant change.”

Ms Reynolds, who is president of the Royal College of Ophthalmologists in Wales, told Senedd Members that ophthalmology is the biggest outpatient speciality in the NHS.

But she said: “We are often perceived as a small speciality because we don’t have inpatients, so … we’re often not overly prioritised in terms of how we are funded.”

Ms Reynolds warned: “In terms of consultant ophthalmologists we are woefully under-resourced in Wales right across the board. Some areas are like a desert.”

She added: “Even if we had more secondary care clinicians, we don’t have the space.”

Ms Reynolds, who works at Aneurin Bevan health board, raised “fundamental problems” with the estate, citing examples of ceilings falling in and plants growing through the walls.

On the £8.5m roll-out of the OpenEyes patient record system, which began in 2021, she explained that Digital Health and Care Wales (DHCW) is responsible for the project.

She told the committee: “We don’t have it across all the health boards, it’s available in Cardiff, it’s potentially being rolled out to other health boards.”

Last week, health secretary Jeremy Miles escalated intervention arrangements at DHCW due to serious concerns about its ability to deliver major programmes.

Asked if roll-out of OpenEyes is being prioritised, Ms Reynolds said: “No, I don’t think it is.”

She told the committee a digital transformation is required, saying: “It’s a huge area of frustration for us,” with services still receiving letters rather than digital referrals.

Ms Reynolds said Wales is well below the Royal College’s recommendation of 3.2 ophthalmologists per 100,000 people, with around 1.9.

“In terms of the consultant workforce, we’re extremely under-resourced,” she warned, adding that there is not a much-needed workforce plan in place.

Wales has the lowest numbers of consultant ophthalmologists of any part of the UK and, across Europe, only North Macedonia has fewer, according to the RNIB’s evidence.

Owain Mealing, chair of Optometry Wales, warned of “clunky” integration between primary optometry and hospital services, with fax machines and paper records still in use.

Andrew Pyott, a consultant ophthalmologist at NHS Highland, undertook a 2021 review on eye care services in Wales which described the situation as serious and fragile.

He said: “The biggest driver is for cataracts services, that’s what patients often see as a priority for them – many who are languishing on long waiting lists, with an impact on their daily lives because they can no longer drive or, in some cases, keep down employment.”

Asked about agreements for patients to be treated in England, he told the committee that Welsh taxpayers are effectively subsidising Bristol’s training programme.

Prof Pyott said: “It would be much better for the Welsh taxpayer to be preparing the next generation of vitreoretinal surgeons for your country.”

A PEMBROKESHIRE solar farm scheme, which would provide power for nearly 3,300 homes, has been put on hold once again, after previously being deferred for a site visit.

In an application listed at Pembrokeshire County Council’s planning committee meeting of March 18, members were recommended to approve a scheme by Wessex Solar Energy (WSE Pembrokeshire Ltd) for a 9.99MW solar farm and associated works at Lower Nash Farm, near Pembroke Dock.

The proposed scheme would be spread over three fields, amounting to approximately 14 hectares with some 25,000 PV panels on site, some 120 metres from the national park.

The scheme was previously deferred from the February meeting so members could visit the site after concerns were raised about the loss of the most valuable agricultural land.

The development, some of it on Best and Most Versatile (BMV) Agricultural land, would provide approximately 3,296 households with renewable energy annually, members have previously heard.

A larger 22MW scheme covering 34.25ha was previously refused in 2021 due to the effect on BMV land.

Planning Policy Wales (PPW) requires that BMV agricultural land “should be conserved as a finite resource for the future with considerable weight given to protecting it from development,” adding: “Such land should only be developed if there is an overriding need for the scheme and either previously developed land or land in lower agricultural grades are unavailable.”

Welsh Government Soil Policy & Agricultural Land Use Planning Unit has objected to the latest scheme on BMV grounds, saying the return to agriculture as BMV agricultural land is “…seldom practicable”.

Four objections to the scheme were received, with local community council Cosheston raising concerns about the use of BMV land.

At the February meeting, agent Charlotte Peacock was questioned about the use of the BMV land by committee chair Cllr Simon Hancock, who said: “Farming and agriculture are fundamental to the security of this country; the way that the population is increasing we really need to ensure farmland is protected.”

The agent said the farmer landowner would receive a guaranteed income which would be more reliable than crop values, adding: “The greatest threat to future security is climate change, the single biggest threat to our output of crops.”

Local member Cllr Tessa Hodgson, as a public speaker, successfully called for a site visit before any decision was made saying it was “surely better to use poorer land and brownfield sites” for such developments,” adding: “Does the permanent loss of prime agricultural land outweigh the benefit of renewable energy?”

At the start of the March meeting, members were told the scheme had been temporarily withdrawn due to issue with the publicity of an environmental statement accompanying the application; the proposal expected to now be considered at the April meeting.

THE SENEDD rejected Conservative calls for the UK Government to compensate charities for the increasing cost of employer national insurance (NI) contributions from April.

Mark Isherwood called for Welsh charities, not-for-profits and voluntary organisations, which play a crucial role in delivering public services, to be reimbursed for the extra costs.

The Conservative criticised Rachel Reeves’ “debt-driving, tax-hiking and job-destroying” first budget as UK chancellor and Labour’s “cruel” decision to increase NI contributions.

Mr Isherwood warned of false economies, with the UK tax set to rise from 13.8% to 15%, “swallowing up” increases in funding through the Welsh budget.

“This is dumb economics,” he told the Senedd.

The north Walian raised concerns from the Wales Council for Voluntary Action (WCVA), an umbrella organisation for the sector, about the impact of NI increases across the country.

Mr Isherwood said the WCVA has warned many voluntary organisations already face significant financial pressures, with the extra strain jeopardising vital services.

He pointed to comments from cancer care charity Tenovus which described the rise as devastating and urged the Welsh Government to mitigate the impact.

Adferiad, a mental health and addiction charity, told the North Wales representative that the rise will cost £600,000 a year, potentially leading to reduced services and staff being let go.

Mr Isherwood warned that the 16 charitable hospices in Wales are all facing deficits and having to consider “significant” cuts which would lead to “huge gaps”.

He said: “They provide essential care to over 20,000 children and adults in Wales affected by terminal and life-limiting illnesses each year, and provide a huge cost saving to the NHS.”

Leading a Tory debate on March 19, Mr Isherwood stated hospices urgently need £5.9m to cover the impact of NHS pay rises and safeguard the immediate future of services.

The motion urged Welsh ministers to call on their UK counterparts to ensure charities are included in the ONS definition of public sector employer and reimbursed NI costs as a result.

Heledd Fychan, Plaid Cymru’s shadow finance secretary, argued the cost of increases to employer NI contributions to core public services should be fully covered by Westminster.

The UK treasury intends to use the Barnett formula to calculate funding for Wales based on the costs in England, which could leave public bodies facing a shortfall.

Conservative Tom Giffard warned the uplift in NI contributions could cost the voluntary sector across the UK a “whopping” £1.4bn a year, according to estimates.

Labour’s Lee Waters described the Tory motion as “breathtakingly cynical, incoherent and opportunistic”, questioning where the opposition would find extra money for public services.

But he said: “I do have some sympathy with the arguments about NI contributions, I think it is the wrong tax to be raising and I regret the fact that other taxes have been ruled out…. I don’t think it’s the right call but there is a significant deficit in public spending.”

Mr Waters, a former minister, cautioned that the Labour UK Government inherited “threadbare” public services and a “rotten” economy from the Conservatives.

Responding for the Welsh Government, Jane Hutt recognised concerns about the impact of NI rises on public bodies which commission services from the third sector.

Ms Hutt, who is responsible for the voluntary sector in Wales, said the UK Government more than doubled the employment allowance to protect the smallest businesses and charities.

The social justice secretary stressed that NI is non-devolved, adding that Welsh ministers will continue to make representations to their counterparts in Westminster.

She told Senedd Members: “The UK Government has confirmed it will provide funding to public sector employers to cover the increased cost of NI contributions.”

Ms Hutt said the Welsh Government has initially estimated the additional NI cost to devolved public sector employers in Wales at £253m.

Senedd Members voted 36-14 against the Tory motion before a version amended by Plaid Cymru and the Welsh Government was agreed by the same margin.