See Sense: York hope for eye clinic to cut operation queue

Mary Halligan after having her eye operation. "It's as though I had a veil over my eyes for so long," she said Picture: Paul Baker

But they warned today that the scheme was still in the preliminary stages, and will need the backing of North Yorkshire Health Authority.

York District Hospital is desperate to find a solution to problems of overcrowding in the eye unit, which is one of the main causes for a long wait by patients for cataract operations.

An Evening Press investigation revealed that in York cataract patients are waiting an average 17 weeks for their first outpatients appointment - and then almost a year for the operation itself.

This is much longer than many other areas.

Dr Mike Hayward, consultant opthalmologist and director of the hospital's eye department, warned today that the Government's recent scrapping of sight-test fees for the over 60s could ironically make the situation worse, by leading to a rush of new patients as fresh cases of cataracts were spotted.

He said there was potentially a "vast number" of people who had "reduced vision" - many of them probably suffering from cataracts - who simply did not know how bad their eyesight was.

"This is a very, very effective operation. Patients do say it is a miracle. It does seem corny, but that's what it means to them. It's difficult for the staff themselves knowing that patients have to wait this long."

Patients like Mary Halligan, 73, say the simple 20-minute operation transforms their lives.

Speaking after having a cataract removed from her right eye, she said: "It's amazing! The colours look so bright. It's an absolute treat! It's as though I had a veil over my eyes for so long."

Dr Hayward said two possible sites had already been identified for a new clinic.

One option is to build a second floor above the hospital's child development centre, and the other would be for a new building between the ward block and the hospital canteen.

But Dr Hayward admitted: "There is what we need: and there is reality. We have to remember that we are part of a district general hospital and there are other teams here who also have space constraints and financial needs."

The hospital's general manager, Susan Acott, admitted the two sites had been considered for a new clinic.

But she said both schemes would be likely to cost more than £1 million, and would therefore need the approval of regional health chiefs to go ahead.

Miss Acott said: "These are both at the really preliminary planning stages. They are both expensive options and both have problems, and if the costs go over £1 million, we would need authority to build."

More operating theatres could be made available for eye operations under plans for a £7.9 million revamp of the hospital's first floor.

But hospital bosses warn that even if that does go ahead overcrowding in the hospital's outpatient eye clinic could get worse as it becomes a bottleneck for patients.

Morag Cuthbertson, of North Yorkshire Health Authority, said the trust would need to hold discussions with the authority and also primary care groups on drawing up a business case.

See COMMENT 'Focus on fight to save sight'

Sight for sore eyes

Elderly eye patients in York face waits of up to a year for a simple eye operation to remove cataracts that could transform their lives. Health reporter Stephen Lewis spent a day in York District Hospital's eye unit to see for himself the pressures staff face

"IT'S amazing! " Mary Halligan said. "The colours look so bright. It's an absolute treat!"

The day previously, 73-year-old Mary had been sitting in her daughter's garden in Haxby when the telephone rang.

It was the eye unit at York District Hospital, reminding her she was supposed to be having an operation that day to remove a cataract from her right eye.

Her daughter rushed her in, she had a short wait in the eye unit's day case room, and then she was whisked off to theatre for the 20-minute operation.

Mrs Halligan was awake throughout the operation, but says she didn't feel any pain. A local anaesthetic was used to numb her eye before surgeons began work.

She said: "They put a sheet over me with a hole in for the doctor to do the operation. I could hear them chattering all the way through."

That night she was back at her home in The Groves: but it was not until she woke up the next morning that she realised the full value of the gift the hospital had given her.

"What surprised me this morning is just how clearly I can see. The colours are so wonderful. It's as though I've had a veil over my eyes for so long.

"Before, when anyone handed me anything, like a cup of tea, I used to miss. Your eyes deteriorate so gradually and it goes on for so long, you almost forget what it's like."

Doctors and nurses in the hard-pressed eye department are used to this reaction.Cataract operations are hugely effective, quick and easy, and have a high success rate.

And they can transform the quality of a patient's life.

"We don't save lives here," said Sister Katrina Swires. "But we do save the quality of life. We get patients crying, they say it's so wonderful.

"It's the brightness, the colour of things. They've been looking through a murky-coloured window, and all of a sudden it's not murky any more."

That's why it is such a desperate shame that waiting times for this simple operation, here in York at least, are so long.

It's not the fault of staff. They know how priceless the gift of sight is: and they're working flat out to get people through the operation just as quickly as they can.

Last year alone the hospital's surgeons performed about 1,000 cataract operations - and in the three months from October to December last year they blitzed the cataract waiting lists by working evenings and weekends.

But despite all their efforts, here in York patients are still waiting an average of about 16 weeks for an outpatients appointment - and then a further ten months to a year for the operation itself.

If the second eye needs doing as well - and cataracts usually affect both eyes - they face another wait of up to a year.

In other parts of the country, nearby Wakefield included, waiting times are much shorter. Why?

Part of the problem is that demand is increasing all the time. As people live longer, so they tend to develop cataracts. New surgical techniques mean that now the operation is comparatively quick and simple - but ironically, that has simply increased demand, as more and more people become aware of how much their sight could be improved.

That increase in demand is the same everywhere, though. In York there is a further problem - the hospital itself.

Built in the 1970s, it is becoming increasingly cramped. The eye department itself is split over several areas. The ward and day case room is on the second floor. The eye clinic, where patients come for their outpatients appointment, is on the first floor and a brisk walk away - and the theatres are in another part of the hospital.

To be able to make a real inroad into the waiting list, the department really needs to appoint another consultant. But there is simply no room.

The eye clinic itself - the gateway to treatment - is perhaps the worst problem of all.

Little more than a corridor on the first floor lined with chairs, there is literally no room to expand.

At a busy Friday-morning cataract clinic, patients and their relatives fill all the chairs.

Patients who arrive for their appointments are first shown a video, in small groups of three or four. They are then ushered back into the corridor to wait for an appointment with a nurse, who checks their eyes and takes a variety of measurements designed to help surgeons fit the right-sized artificial lens after the operation.

Then it's back to wait in the corridor again until they see the consultant, who will confirm that they do have cataracts, and talk them through the options.

It's a busy, friendly, informal atmosphere: but it is clear, too, that it is working to its maximum limit.

In one of the consulting rooms, consultant opthalmologist and director of the eye unit, Dr Mike Hayward, is examining 86-year-old Henry Miles. He's one of 23 patients he will see that morning.

Dr Hayward confirms that Mr Miles does have cataracts in both eyes which will make it increasingly difficult for him to read. They may also soon make it difficult for Mr Miles to recognise people's faces, he adds.

Mr Miles - who, like many elderly patients, insists there is "'not a lot wrong, considering my age" - is put on the waiting list for an operation to remove the cataract from his right eye.

He will have to wait 11 months, Dr Hayward tells him.

As Mr Miles leaves, Dr Hayward says: "Ten years ago, I wouldn't have countenanced doing an operation in this case. Now the outcomes of cataract surgery are so much better it is worthwhile."

In a sense, he agreed, medical staff struggling to cope with ever-increasing demand for treatment were victims of their own success.

It was thanks to a breakthrough in 1989/90, when surgeons developed techniques to remove cataracts through much smaller incisions in the eye, that surgeons are now able to operate successfully on a day case' basis, where patients don't have to stay in hospital.

But that breakthrough has also led to a surge in demand.

Dr Hayward said: "Now, if people come in with a problem and we think that in a year's time it will be worse than it is at the moment, we offer surgery. I think (Mr Miles) will be very pleased when he's had the cataract removed, and will probably realise then how bad his sight was beforehand.

"But in a sense you could say the success of the techniques we use is adding to the pressures."

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