Edinburgh's Eye Pavilion: Government's eyecare plans branded 'reckless'

Scottish Government plans not to replace Edinburgh's Princess Alexandra Eye Pavilion are "reckless" and would "destroy" a centre of excellence, its former director has warned.

Celebrated eye surgeon Dr Hector Chawla said the plan to increase the use of community optometrists would mean more need for an eye hospital not less, because they would produce more patients requiring help.

The government told NHS Lothian in December it would not fund a new hospital at Little France to replace the Eye Pavilion despite signing up to the project in 2018. It said services should be dispersed across the region, including to a new elective care centre to be built in Livingston.

But Dr Chawla, who was director of the Eye Pavilion for ten years and was awarded an OBE in 2001, said: “Eight thousand people undergo surgery at the Eye Pavilion every year. The delivery of this service under one roof has stood the test of time. To replace them with an untested theoretical model is hazardous. Not to replace them at all is reckless – but that is what the Scottish Government proposes. The promised new hospital at Little France is to be cancelled and NHS Lothian has been ordered to see what it can do with existing buildings elsewhere.

The Scottish Government is refusing to fund a replacement for the Princess Alexandra Eye Pavilion

“We are asked to believe that a new surgical facility for some branches of surgery at Livingston, yet to be built, can be used for complex ophthalmic procedures as well, in a way as yet unexplained.”

He said adopting a more “regional” model was a move in the wrong direction. "A quality eye service requires more, not less centralisation. In the Eye Pavilion, there are nine sub-speciality interests, all dependent on more than 200 doctors, nurses and technicians. They run the service of today and teach the new staff for the service of tomorrow.

“Expertise shared with each other and concentrated in one building is how the Edinburgh centre has acquired its international reputation.”

He said in the past, equipment was relatively simple and all eye surgeons would undertake all kinds of eye surgery. “Those days are now gone but the new loose proposals seem to have forgotten that. The closely integrated staff work with increasingly complex equipment that can’t just be trundled about in a van.”

Dr Chawla said the government’s “regional” model was based on increasing the use of community optometrists, which it touted as an innovation. But he said: “In Edinburgh, that is already what happens because it was started here. Their special knowledge is, very sensibly, employed in the management of stable conditions and some external eye disorders, within their scope of practice.

“Unfortunately, the belief that the deployment of optometrists will eliminate the need for an eye hospital is wrong. It will increase the need because the very existence of their practice will produce more patients who require the services of the full ophthalmic system.”

And he questioned the value for money of the government’s plan. “If the Eye Pavilion, with its annual 84,000 outpatients, were a business, the present arrangement with its economy of resources would surely be the chosen model.

“Why destroy a centre of excellence for a one off saving of £45m which is of no great significance against the overall Scottish Governmental spending?”

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