1834. Deputy Michael Lowry asked the Minister for Health the reason for the disparity in discretionary payments under the primary care community services (PCCS) scheme for children with certain eye conditions and/or additional needs who require spectacles; if her attention has been drawn to some families being required to pay in excess of €400 per pair of glasses for young children in certain Community Healthcare Organisation (CHO) areas, while children with similar conditions are fully funded in other areas, including parts of Dublin; the basis on which such discretionary decisions are made; if national guidance exists to ensure consistency of support; and the steps she will take to eliminate what appears to be an "Eircode lottery" in access to essential prescription eyewear for children with significant clinical need. [19191/26]

The Health Service Executive (HSE) provides optical services to children referred into the HSE community ophthalmic service from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment.

Following referral, the HSE provides eye examinations and glasses, if necessary, to children up to the age of 12, irrespective of medical card eligibility. Children aged 12-16 who have a medical card or are the dependent of a medical card holder can also receive eye examinations and glasses, as needed.

Under the Community Ophthalmic Services Scheme (COSS), medical card holders aged over 12 years can be seen by local ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians. Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.

The HSE’s 2017 Primary Care Eye Services Review Group Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.

The 2017 National Clinical Programme for Ophthalmology developed a model of care detailing how the realignment of eye services from an acute hospital setting to the community would be undertaken.

The HSE has been developing multidisciplinary Integrated Eye Care Teams in accordance with this model of care. These teams facilitate assessment, diagnoses, management and treatment, and, in some cases, pre-op/post-op care, enabling most patients to be seen in their own locality. Where necessary, patients can be referred onwards to acute Ophthalmology services to receive the necessary specialist input.

Transferring the routine care of children aged 8+ years to the care of local private optometrists under the COSS remains a priority.