THOUSANDS of patients with serious sight-threatening eye conditions, including glaucoma and macular disease, are facing delays to see specialists while private “non urgent” cases are being treated on hospital grounds, it has emerged.

Patients have been admitted to University Hospital Ayr for procedures including laser capsulotomy, which is used to improve vision after cataract surgery, while NHS patients are largely being managed with telephone and video consultations. 

Around 2,000 new referrals are on the waiting list to be seen by ophthalmologists at that hospital and also Crosshouse in Kilmarnock, while there are some 5,000 patients with conditions including, diabetic retinopathy and macular disease who are being managed almost entirely by phone, though the safe management of those conditions is said to be dependent on vision and pressure measurements.

Some are said to be more than a year late for a review date set by a consultant.

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The health board said in an official statement that “no private patients are being seen on NHS Ayrshire and Arran premises. " However, The Herald has seen an email trail that confirms appointments and invoices during the pandemic involving at least
two specialists and the board later ammended its statement.

Another recent email, sent Brian Little, associate medical director at University Hospital Ayr, warns doctors that “private patients should not be booked preferentially to NHS patients, either to clinic or to theatre”. 

The Herald has evidence of at least three private patients being seen during the pandemic, with one seen in the last couple of weeks.

Health sources say there are likely to be more, as private patients are often brought in out-of-hours when there are no receptionists and few other staff present.

Around eight to 10 patients are being seen every day at University Hospital Ayr due to social distancing restrictions while others are being sent to NHS Louisa Jordan in Glasgow.

A health source said consultants choose which patients are offered face-to-face appointments and said “very few patients do”.

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Labour’s health spokeswoman Monica Lennon said the private cases would be a “slap in the face” to patients “languishing on waiting lists”.

Many NHS consultants double up in private practice and the NHS has long been allowed to boost its revenue by charging the patient or insurance provider if medics carry out private work, such as consultations, tests or procedures, within NHS facilities. 

It carries the strict caveat that there should be no adverse effect on NHS patients, such as exacerbating waiting times delays or bed shortages but research suggests the practice is not as closely monitored as it should be.

A spokesman for the British Medical Association (BMA), which represents doctors, said consultants would have to adhere to “clear guidance” if they were using NHS facilities for private work.

Labour’s health spokeswoman Monica Lennon said: “People have been very understanding of the decisions taken by the Scottish Government, however, this will feel like a massive slap in the face.

“NHS patients who are languishing on waiting lists will feel let down that private patients are being prioritised.

“The Scottish Government must explain why private treatment is being carried on NHS property and if this is happening elsewhere.

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“Patients are desperate to know when paused NHS services, including chronic pain clinics, will be reinstated.

In 2018 The Herald told how NHS Ayrshire was earning around £100,000 a year from private patients paying to undergo eye operations on the NHS.

The health board came under fire from patients and opticians after it tightened its criteria for cataract surgery.

After The Herald made the health board aware that we had documentary proof that private patients were being seen, they ammended their statement to say: "We can confirm that since the introduction of national and organisational guidelines on this issue, no private patients have been seen on NHS Ayrshire & Arran premises."

A spokeswoman added: “As a result of the coronavirus pandemic, NHS Ayrshire & Arran cancelled routine outpatient appointments to allow clinicians to focus on the immediate response to the pandemic, as well as free up clinical areas. 

“Near Me video consultations and telephone consultations have proved vital in delivering health and social care during the pandemic. 

“While we have now restarted some routine ophthalmology appointments, we have had to look at how we deliver these services.

"This is not only to ensure patients get the treatment they need, but also to ensure staff and patients are safe.

“Those attending for an appointment will see that we have a reduced number of rooms and recovery space available, and we can’t see as many patients every day. 

“We will, therefore, continue to use Near Me video consultations and telephone consultations, where clinically appropriate. 

“I would like to reassure members of the public that we are doing everything we can to work as efficiently as possible, and I would like to thank them for their patience and understanding during this time as we aim to keep everyone safe.”

In relation to private patients being treated at NHS hospitals, a spokesman from BMA Scotland, said: “We haven’t seen any evidence of this happening, but both NHS Boards and all staff engaged would have to adhere to clear guidance if they deliver private work using NHS facilities.”

Previous data obtained under freedom of information shows that NHS Ayrshire and Arran earned around £400,000 from providing inpatient, outpatient and day case treatment to private patients between April 2016 and July 2018. 

More than half - £228,365 - had come from day case ophthalmology procedures, the vast majority cataracts removal.