 The final item of business is members' business debate on motion 1, 3, 5, 5, 3, in the name of Stuart McMillan, on iHealth week 2018, and this debate will be concluded without any questions being put. Would those members who wish to speak in the debate please press the request to speak buttons, and I call on Stuart McMillan to open the debate for around seven minutes please. Thank you very much, Presiding Officer. I'm delighted to be leading this debate, and I'm grateful to all the members who have signed the motion, and also those who are going to speak this afternoon. I'd also like to thank all the organisations who have provided briefings for today's debate. I heard of today, I hosted an RNNB Scotland stall in the Parliament last week, and I appreciate the time that members gave to visit the stall. The team staffing the stall was delighted at the number of MSPs who visited and also to learn about iHealth and the services that RNNB Scotland offered, and the many invaded conditions that exist. Thank you very much, everyone. Since 2011, I've chaired the cross-party group on visual impairment, and prior to this, I was a member of the CPG when I was first elected in 2007. I'm always keen to raise awareness of iHealth Week as I recognise how important it is that we continue to highlight the importance of iHealth, the progress that has been made in this area and the challenges that still exist. To begin, I'd like to celebrate the success of the free iTest policy in Scotland, which, since 2007, has been backed by £775 million of funding following its introduction by the previous Labour Liberal Democrat Executive in 2006. In the initiative's first year, 1,349,979 people obtained free iTests, and in the last full year, 2017-18, that figure rose to almost 2 million people. I'm quite sure that ministers, pre-2007, would have been delighted with the growth in people obtaining the free iTests. I'm sure that every health minister since 2007 will be delighted with the continued annual increase, and more than 21 million tests have been conducted since the policy came into effect. While the national average uptake of site tests across all health boards sits just below 1 in 3 people at 31.8 per cent, I'm pleased that my own health board area at NHS Greater Glasgow and Clyde is actually bucking the trend with 33.1 per cent uptake as compared to the lowest at NHS Orkney at 24.1 per cent, which emphasises that more work still needs to be done to encourage everyone in Scotland to access the free iHealth checks. The site loss, like many conditions, can affect anyone, which is why it's important to realise that iTests don't just actually test a site, but they also detect symptoms of other serious health conditions such as diabetes, high blood pressure, stroke and cancer. If an iHealth check can identify changes in the eyes before the effective vision, then the condition can be treated before it reaches an advanced stage. This isn't patients and also our NHS's best interests as it's cost effective and more efficient than meeting the medical and social costs of people who might otherwise go on to lose vision or suffer ill health unnecessarily. Every survey shows that sight is the sense that people fear losing the most, yet we can be surprisingly negligent about our iHealth. We tend to think of our eyes as only being for people who need to go and get their contact lenses or glasses, but the reality is that we should all get our eyes checked regularly, but actually every two years so to keep healthy. Last year, alongside Kate Wallace from RNIB Scotland, we had a stall outside of SpecSavers in the open mall in Greenock to make shoppers aware of the free iTest. It certainly was a hard shift. I've had easier shifts distributing political material—I'm not going to lie—but I accept that it may have been the fact that there was a politician there trying to give something out. It's an issue that I've raised before in the cross-party group, but I've also had discussions with others. At the cross-party group meeting in May, I had a presentation by Dr Alexander Zangaliris from the University of Aberdeen. His talk that night was titled, I care services in Scotland, did the Scots get it right, where he discussed his research regarding the direction of the free i examination in Scotland. His analysis concluded that overall the policy has been a success and it is to be welcomed. I have also highlighted some challenges facing communities, like mine, with areas of poverty and deprivation when it comes to looking after our eyes. Although more people are getting their eyes tested, there is now a small but a growing gap between the less well-off and the more affluent in society. There were various theories as to why those in the SIMD areas are less inclined than others to actually go and get their eyes tested. One theory was that if an eye test indicated to the needed glasses that they couldn't afford, then that leads to the gap even though—I must stress this—people actually are going to get their eyes tested, but it can lead to the gap potentially increasing. Dr Zangaliris' research also mentioned the people's lack of understanding about eye health, which could explain the hardship that Kate and myself faced last year when trying to make people aware of the free eye tests. How could we fix that? I would like the Scottish Government to consider a few actions. Firstly, I refreshed the public information campaign, making people aware of the free eye examination, and secondly, a targeted approach towards communities with economic challenges. I would be quite content for parts of my green or coninverclyde constituency to be used in any such pilot scheme. Four of the most common causes of sight loss are age-related mycola degeneration, catenaps, glaucoma and diabetic retinopathy. That is now the single biggest cause of sight loss among Scots of working age. I have had constituents living with those conditions, which is why I visited the Jenny's Well facility in Paisley earlier on this year. It is one of Scotland's only two specialist residential care homes for visually impaired people, older people, which is run by Royal Blind. I also went across the road to the Scottish War Blinded's Hockhead Centre, which provides free support to ex-servers personnel living with sight loss. Some of my constituents use those services. There are still many more who could benefit, which is why I am keen to highlight those facilities at every single opportunity. However, it is not just older people or veterans who are affected by visual impairment. As the Scottish Government's school census figures indicate, the number of pupils with visual impairment has more than doubled since 2010. When you consider that in Scotland over 180,000 people live with sight loss, this figure is expected to double over the next 20 years. 50 per cent of sight loss is preventable, and it is evident that free eye health checks are an important measure to help keeping our nation healthy. It is also one that can make a real difference to people's lives. In the briefing of Tomatry Scotland, it highlighted the general ophthalmic services that the GOS Scotland regulations 2006 has revolutionised the delivery of community eye care in Scotland. Most notably, leaving to the shift in the balance of care away from GPs and hospitals, freeing up vital resources. In 2016-17, Tomatry service indicated that it saved NHS £71 million, with community optometry stopping over 370,000 people from attending hospital for eye issues every year. In addition, more than 80 per cent of acute eye conditions are now managed by optometrists up from 25 per cent prior to the GOS's introduction 12 years ago. While Scottish optometry is leading the world in design and delivery of community eye care, Optometry Scotland states that a concerted focus on forward planning for an increasing older population is needed, along with the Scottish Government's supportive strategy to encourage people to consider a career into the optical sector. In Scotland today, the number of registered blind and partial sighted people is around 34,500 people. Every seven minutes, somebody in the UK will be diagnosed with macular disease, which is the biggest cause of blindness in the UK. In conclusion, it is pertinent that we as MSPs do all that we can to make our constituents aware of the free eye test in Scotland so that the number of people benefiting from the policy increases, which should mean that preventable sight loss decreases, and as many people as possible can live life seeing the full picture. We move now to the open debate and speeches of around four minutes please. I welcome the opportunity to pay tribute to our eye health professionals and all the organisations involved in promoting eye health and care. National Eye Health Week gives us an important opportunity to increase the understanding of eye health and educate people on the importance of eye examinations and identifying sight loss and other health conditions. Since April 2006, as has already been said, all people residing in Scotland have been entitled to free NHS eye examinations every two years. The aim of the policy was to increase the demand for eye examinations and, as a result, to improve the visual health of Scotland's population through an early detection of eye health issues. From looking at the figures from the last financial year that Stuart McMillan has said, there are nearly 2 million over 16s and nearly 300,000 under 16s received a free eye test, making it the highest annual level on record. It is clear that that uptake is increasing and that is extremely encouraging. However, I think that there is still scope to do more. The number of Scottish people with sight loss is still projected to double to almost 400,000 by 2030, and we must therefore continue to encourage and promote the need for greater utilisation of existing eye care services. Eye examinations ensure that people receive early support or treatment from vision impairment, while also identifying other health conditions such as high blood pressure, artheoscholarosis, tumours and diabetes. Those under 16 or over 60 individuals by glaucoma or those aged over 40 with a close family history of glaucoma, patients with ocular hypertension or with diabetes are entitled to a free examination each year rather than the standard two-year period. As co-convenier of the cross-party group on diabetes, I would particularly like to say that those checks are important for those 290,000 people in Scotland currently living with diabetes, as they are vital in picking up early signs of diabetic retinopathy, a complication of diabetes caused by high blood sugar levels damaging the back of the eye. Diabetic retinopathy is now the single biggest cause of sight loss among working age adults in Scotland and can cause blindness if left undiagnosed and untreated. It is estimated that nearly all people with type 1 diabetes will have diabetic eye disease 20 years after diagnosis, and as many as 60 per cent of those with type 2 diabetes will show signs of the condition. A comprehensive eye exam once a year ensures that if diabetic retinopathy is detected, it can be treated before it reaches an advanced stage and has significantly damaged sight. The importance of those checks can therefore not be emphasised enough. Eye health week is also vital in raising awareness of what people can do to reduce their risk of developing a condition that leads to vision impairment. Paying particular attention to type 2 diabetes, which accounts for about 87 per cent of diabetics in Scotland, we must address lifestyle factors such as obesity, physical activity levels, excessive alcohol intake, poor diet and smoking. Research has shown that smoking in particular not only makes you 30 per cent to 40 per cent more likely to develop type 2 diabetes but also doubles the probability of sight loss. Repeated exposure to tobacco smoke speeds up the body's natural ageing process, including that of the eyes, and increases the risk of developing cataracts and complications linked to diabetes. Warringly enough, of the 21 per cent of people in Scotland who smoke, 56 per cent are unaware of the link between smoking and eye disease, so we have to commend Ask Scotland for teaming up with the RNIB and Association of Tomatrists and NHS-Informed Scotland to design a stop smoking advice card, which communicates the implications that smoking can have on site, and I hope that we can make further progress in informing people of those dangers. According to the RNIB, by 2050, nearly 4 million people in the UK will be living with significant sight loss, despite more than 50 per cent of that being available. It has been very missing me, of course, not to mention just to take the opportunity to once again say that when we are tackling eye health, we are in fact talking just about health. By encouraging an active healthy lifestyle, we cannot impact the health of our eyes just as much as we can impact the health of our hearts. We cannot impact lungs or any other organ. Stopping people from losing their sight unnecessarily must be a key priority, and I welcome the platform that this debate gives us in not only educating about the importance of eye health, but also raising the necessary awareness of how to reduce risk of sight-threatening conditions. Emma Harper, to be followed by Anas Sarwar. I am pleased to speak in this afternoon's debate, and I congratulate my colleague Stuart McMillan for securing this this afternoon. Stuart covered the facts and stats really well regarding eye health conditions during this week, as it is highlighted as National Eye Health Week. I agree with what Mr McMillan has explained. I would like to pick up on the point that he related about obtaining an eye exam. I noted the wording in Stuart McMillan's motion, which calls for the public to get their eyes tested on a regular basis by utilising the free eye examination. As a nurse, I have been able to use my experience to help inform me for this debate. A vision test during a visit to the optometrist is not just a way to check whether one's eyesight needs help with corrective prescription. The main purpose of getting an eye exam is to detect and diagnose vision problems. However, an eye exam, as has been described, can also help to detect signs or other health issues that may affect other parts of the body. Last year, when I spoke in this eye health week debate, the focus was on diabetes and retinopathy. According to Diabetes UK, there are around 750,000 people across the UK who have undiagnosed diabetes. Following a discussion with an ophthalmic nurse specialist this week who happens to be my wee sister, Buffy, she conveyed that many diagnoses of type 2 are often made at the time that an eye examination is performed. When people describe their symptoms and when retinal photographs are taken, many people dismiss their symptoms of gradual visual impairment as grown old or even put it down to tiredness. However, the high blood glucose levels associated with the poor controlled type 2 diabetes can mean that the tiny wee blood vessels in the eye, which can be damaged by high levels of blood glucose, can lead to the diabetic eye disease retinopathy. If type 2 diabetes is picked up, diagnosed and treated early, visual impairment complications can be detected and treated and protection of a person's sight can then be achieved. High blood pressure is being mentioned and it is a disease with far-reaching complications, not just for the eyes but because the blood flow affects every part of the body. Fortunately, high blood pressure is another example of a health condition that may be detected during an eye examination. One disease that has not been mentioned is rheumatoid arthritis and I was quite surprised about that. Most people do not know, however, that rheumatoid arthritis can also affect the eyes as well as the joints and it is an inflammatory process, but if your rheumatoid arthritis has affected your eyes then you may have dry eyes, eye pain and other vision problems. The news is that early treatment can prevent permanent vision damage. Presiding Officer, I would like to thank the Royal Blind for their briefing ahead of this member's debate and highlighting the importance of vision testing. As the Royal Blind have said, seeks to get the message out that most people should have a sight test once every two years and every year for many other identified groups. The symptoms that an eye healthcare professional may detect include spots in the retina, bleeding in the back of the eye and constricted vessels among others. Again, having one or more of those symptoms does not mean that you might have high blood pressure but it means that you may need to find further consultation to determine what is causing the symptoms. Presiding Officer, one of the other issues is that multiple sclerosis in young people, my sister was telling me, was that young 30-year-old women showed up in her clinic one day with a sudden visual impairment and that led to a diagnosis of multiple sclerosis. I think that it is really important that we raise awareness and remind people to schedule an eye examination, follow your healthcare professionals and doctors advice and recommendations on the suitable follow-up test and treatment. I echo Stuart McMillan's call for the Government to support and promote a refreshed national eye check campaign and that, maybe following the eye exam, glasses might not be the only thing that is required but other medical issues can be addressed, diagnosed and treated ahead of any complications developing. I start by paying tribute to both the RNIB and the Royal Blind to all their staff, particularly to all their volunteers for all the amazing work that they do all year round, not just during eye health week but all year round, not just lobbying parliamentarians. As Stuart McMillan outlined out there on the streets campaigning to help support people and give people better support. I want to touch on something briefly before I speak about the issue of eye test. I had the great pleasure of speaking at an event a couple of weeks ago in this Parliament, the sound and vision event that was organised by the RNIB, which was sponsored kindly by our own Presiding Officer. What that generally taught me was a lot of the challenges that go alongside people who have issues with their site. That is not just about access to services but access to employability. People want to get on having normal life, how it impacts on their family, their friends, their relationships, their day-to-day interactions, going to the shops, simple things that go into the shops. Simple things that are going to post a letter in a letterbox. Simple things like what's on the television or what shows they might go and watch or how they might socialise with their friends. All those issues put into stark reality around some of the fantastic contributions that we had from those people who were either blind or partially sighted, who had got support from the Glasgow speakers club to learn about public speaking to help build their conference. I can honestly say, Deputy Presiding Officer, apart from the speeches that we have heard today, there were better speeches that we have most of the time in the Scottish Parliament from those really, really inspiring individuals. I think that there were some future Parliamentarians in that group, so I want to congratulate again, in particular, the Presiding Officer for allowing them to come and have that session here to the RNIB, to the funders of that project. In particular to Stephen Sutherland, who was the driving force behind that project, a very, very inspiring young man and one that I'm sure we may see in this Parliament at some point in the future. Why is this debate so important? We talk about the 170,000 people that have significant loss of sight in Scotland. We talk about the impact on their families. We've rightly had praise of the free eye test policy every two years. I'm going to make a confession. I can't remember the last time I went for an eye check, but given that I'm now sitting closer and closer to the television and having to look closer and closer at my notes, I think I'm doing an eye test very, very soon. However, how do we have a public information campaign? I'm very happy to support shortly milling on, and I hope that the minister can give a positive response to that as well. It is very welcome that we now have almost a third of people across Scotland taking advantage of the free eye checks every two years, but I think that we can drive up that figure, particularly in those most vulnerable communities, particularly those people that are more likely to have issues around health inequalities. If we can drive up the testing rates among those individuals, I think that we can spend to save in terms of future issues that address our national health service. We've already heard about how we can help to pick up on conditions that don't affect the vision yet around blood pressure, refractive errors, kidney problems, brain tumors, blood vessels and the eye that can have issues. All those things that early checking can help to have a support on. I want to say again a particular thank you to all the charities involved in this fantastic work. I want to say thank you to Stuart McMillan again for securing this important debate. I should also say to the chair of the RNIB who spent two days last week sitting in this Parliament, lobbying parliamentarians. I apologise if we didn't all come instantly to the stand. I hope that you've got a very positive interaction with all the parliamentarians. I truly believe that this is an issue that we can unite our Parliament on and have a significant intervention for generations to come. I'm delighted to be able to speak in this debate to mark our health weekend. I thank Stuart McMillan for bringing it to the chamber. Eye health affects us all. Most of us at some point in our lives will wear glasses or contact lenses or have laser eye treatment. But what if glasses weren't enough? What if our eyesight started failing so badly that our lives were irrevocably changed? That's why it's so important to go for regular eye tests to detect early if problems are looming. As Stuart McMillan's motion says, great progress has been made with eye health and we're at the highest annual level on record for people receiving eye tests. It's also so important that in Scotland eye examinations are free. It's a huge boost to public health. Of course there are things we can do to preserve our own eye health, such as taking regular screen breaks, reading in the correct light and most importantly not smoking. We all know that smoking is harmful to general health, but Ash Scotland tells us that there are particular implications for eyesight. Tobacco smoke is composed of thousands of active chemicals, most of them toxic, and as a result smoking greatly increases the chance of losing sight. As many as one in five cases of age-related macular degeneration are caused by smoking, which is also linked to cataract development. I'm extremely fortunate to have the wonderful organisation Deaf Blind Scotland in my constituency. Earlier this month I hosted an event in Parliament to highlight the fantastic and progressive work that they're doing. Stuart McMillan was present at that, so I think that he could back me up here. This wasn't about what they couldn't do, it was about what they could do. From trekking in the Himalayas, climbing Kilimanjaro, playing the taiko drums and much more. One young man, Ryan, who has Usher's syndrome, a condition that affects both hearing and vision, gave an inspirational speech, which highlighted how he'd not let this terrible condition hold him back. He was incredible. Early diagnosis and treatment can prevent up to 98 per cent of severe sight loss. As in most health conditions, the earlier the treatment, the more likely it is to be effective. National Eye Health Week seeks to get the message across that most people should have a sight test once every two years. We know that a sight test can also detect other health conditions such as high blood pressure, diabetes or other serious conditions. There are around 188,000 people living in Scotland today with significant sight loss, and sight loss is projected to double over the next two decades in Scotland to almost 400,000 by 2030. The number of registered blind and partially sighted people in Scotland now stands at around 34,500, but research indicates that as few as 23 to 38 per cent of eligible people are registered blind and partially sighted. Civic society and local authorities have a large part to play in helping people with sight loss. In Kirkntillock, in my constituency, the local authority introduced a shared space scheme, which has proved to be disastrous for people living with visual impairment or sight loss. They are simply unable to access their own town centre, which raises huge issues of equality. This is due to the removal of traffic signals, kerbs, which their guide dogs recognise, and thundering lorries and buses clogging up the busy junction. It simply is not safe. I urge local authorities and developers to think carefully about the effect that those streetscapes can have on the less able. In conclusion, let's all remember that eye health is precious, go for regular eye tests, free eye tests and detect problems early. You owe it to yourself and to your family. The last of the open debate contributions is from Annie Wells. The importance of eye health and the need for regular tests cannot be underestimated. According to leading bodies, sight is the sense that we fear losing most, and for many simple lifestyle changes can be the key to ensuring long-term eye health. Eye health week is about promoting such changes and encouraging everyone to get their eyes tested on a regular basis. In doing so, we can reinforce the message that vision really does matter. As many in the chamber have already done so, I too wish to commend the work that has been done so far in promoting eye health and care. Many of us are risking future sight loss by failing to look after our eyes. Rotein eye appointments are recommended every two years, even if your eyesight has always been healthy, so that an optometrist can check that you are seeing clearly and spot any signs for common eye problems. Importantly, poor eyesight can affect anyone at any age. There might be a seven-year-old boy struggling to read the board at school, a 45-year-old not able to see the ball during a Friday night 5-a-side game, or a six or seven-year-old finding it difficult to carry out daily tasks, like just making a cup of tea. The message that eye health week seeks to reinforce is that, regardless of circumstance, it is better to get your eyes checked out regularly. As Stuart McMillan has mentioned, huge progress has been made in terms of numbers, the number of those getting tested regularly. As Brian Whittle has stated as well, nearly 2 million over 16s received a free eye test and nearly 300,000 under 16s received their free eye test in the last year. Campaigns such as eye health week will no doubt contribute to rising figures, and I, too, would like to commend all the organisations involved. Last year's campaign today's awareness of collaboration between Eye Health UK, RNIB and Channel 4 to create a special ad break, giving viewers the chance to watch TV through the eyes of somebody living with sight loss. The Royal Mail also teamed up with Eye Health UK to promote the importance of good eye health by placing a special and national eye health week postmark on all stamped mail. Every year, National Eye Health Week teams up with Central Optical Fund to publish Vista, a lifestyle magazine available online, designed today's awareness of how lifestyle choices can affect your eye health. Raising awareness is, of course, about more than promoting regular eye tests. Certain lifestyle choices make poor eye health more likely and thus preventable. Smokers, for example, are four times more likely to suffer from age-related macular degeneration, or AMD, the UK's leading cause of blindness. Despite that, however, over half of smokers and surveys indicate that they are unaware of the link between smoking and sight loss, equating to half a million people in Scotland. Obesity and the links that it has with diabetes also doubles your risk of AMD, increasing your chances of developing cataracts has already been stated. Over exposure to the sun can too increase your chances of cataracts. Finally, eye-friendly nutrients can be found in many fruits, vegetables and cold water fish such as sardines and tuna and can protect against AMD. To be perfectly honest, although I vaguely knew about the links between lifestyle choices and eye health, it was only reading about this topic prior to today's debate that I came to understand just how strong a link it is. I am very pleased that I am 11 weeks off the cigarettes now, so that is me cutting my chances even more. It is just losing the weight now, so we do that. For example, I had no idea that eye tests can indicate other health conditions such as hypertension and raised cholesterol, which could prevent more serious health problems such as heart disease and stroke. If eye health week can improve my knowledge of eye health and the factors that contribute towards greater risk, it is imperative that, as politicians, we give it further away and promote awareness. To finish today, I thank Stuart McMillan for bringing this debate to the chamber today. I think that he can all agree how important it is to raise awareness and promote eye health and care. To respond to the debate for around seven minutes, I thank Stuart McMillan for giving us the opportunity to mark eye health week and discuss eye care in Scotland. Across the chamber, we agree that general ophthalmic services are one of the many NHS success stories in Scotland. The introduction in 2006 of free NHS-funded eye examinations set Scotland apart from the rest of the United Kingdom, and it is something that this Parliament has been able to come together to continue supporting in spite of changes to Government. That is another thing that shows the strength of the policy. For the first time, everyone in Scotland, regardless of their personal situation, had access to a number of NHS success stories in Scotland. For the first time, everyone in Scotland, regardless of their personal situation, had access to an eye examination free of charge and a routine primary eye examination provides a full health check of the patient's eye, as well as a normal sight test to help to detect eye disease early on. With a number of members, across the chamber we have mentioned particular health issues that an eye examination can identify. Rona Mackay mentioned high blood pressure, Emma Haddadid did the first shot. Rona Mackay sentiments on the health of Rona Mackay. Rodd Llanff, Ronan Mackay, Hyblod Pressure—Ema rodd Rhyo, Rodd Llanff added rheumatoid arthritis, which I confess I haven't been aware of either, and a number of members have, including Brian Whittle, mentioned diabetes. Brian Whittle also mentioned the importance of an active lifestyle as one of the tools. I don't think that we can ever make that point about an active lifestyle being important to improve our overall health more often and Annie Wells added, at the end, the importance of a healthy diet. Those are all very, very good points. Anna Sarwar also mentioned a number of other health, but it was such a big list that I can't... I apologise, I wasn't able to keep up, but the point was that eye examinations are really important for people's health and not just for your eye health. Eye examinations have increased by 43 per cent since they were first introduced in 2006 to a position where now, I think that someone mentioned the number, over 2.2 million people had their eyes examined in 2017, the highest number ever. To pick up on the points raised by Stuart McMillan, Anna Sarwar, Emma Harper and others, we are not complacent. As well as continuing to raise awareness amongst the general population through initiatives such as NHS 24's Know Who to Turn To campaign, we plan to run targeted awareness-raising campaigns among specific patient groups where take-up of free eye examinations is lower, so that includes those living in more disadvantaged communities. The Scottish Government remains committed to ensuring that the best community eye care is accessible to everyone. That is why we commissioned a review of community eye care services in Scotland in 2016, 10 years after the free eye tests were introduced. Before I talk about the review, I thought that it was probably useful to take the opportunity to mention the current eye care services that are provided in the community. To meet tourists in Scotland is the first port of call for any eye problem. It can be really frightening when something happens to your vision, but the support in the community, close to where you live, provides the high quality of care that people need. Emergency eye prescriptions can often be managed and treated in the community. Evidence shows that more patients now go directly to the optimist if they have a problem, rather than going to their eye to their GP and then being referred on. Clearly, community optimist have increasingly been taken on this extended role for some time now, demonstrating the growing capacity and capability and competency of the profession. They are doing more work in the community of reducing the burden on secondary care and GPs and ensuring that patients remain in a primary care setting. The service is enhanced by those optimist who have undergone training to independently prescribe medicines. That is something that is facilitated by NHS education in Scotland. Over 250 community optimist have become fully trained independent prescribers. That amounts to one third of the total number of such fully trained prescribers across the whole of the UK. However, we think that there is more that can be done there. That is a service that we think should be growing. Optometrists and ophthalmologists are also working together when patients need referral to secondary care. Eye care integration is a programme that is under way that, among other things, seeks to increase the number of optimist. The patient is referred to secondary care electronically, not only much quicker but means that we can also attach pictures and scans of the patient's eyes, allowing the ophthalmologists to assess and triage the referral with an appropriate appointment. That is really good progress that has been made there. We continue to work with health boards to reach a position in the near future where all referrals are submitted electronically. We are also in the early stages of commissioning our once-for-scotland ophthalmology electronic patient record. That will be a real game changer for the delivery of eye care services in Scotland. It will mean that ophthalmologists can provide meaningful feedback to optometrists in reducing the number of unnecessary referrals to secondary care. I mentioned earlier that the Government announced a review of community eye care services in 2016. SCOVI, the Scottish Council on Visual Impairment and Optometry Scotland representatives were both members of the review group and patients were involved to ensure that their views were captured. The review published its report in April 2017 and highlighted the success of the services, as well as identifying areas for improvement. Since then, the Government has been working with a range of stakeholders, including Optometry Scotland and NHS boards, to deliver on the report's recommendation. Among other things, as a result of the work, a number of significant and positive changes will be made to general ophthalmic services from 1 October. Among other things, those changes include further supporting the community to optometry, as the first port of call for all eye health problems in Scotland, revised arrangements for tests and procedures. All general ophthalmic services petitioners will be required to complete mandatory annual training provided by NHS Education Scotland, further upskilling the optometry profession and providing a baseline standard of education and care. To pick up the point that Emma Harper made, patients who are sight impaired or severely sight impaired will, for the first time, be entitled to an annual primary eye examination rather than just every two years as at present. I think that this has been a really good debate. I am very pleased that I have been able to be involved in it and I am sure that the chamber will continue to support eye health week in the years to come. Thank you. That concludes the debate and this meeting is closed.