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In Finland, the length of waiting lists for eye healthcare services has reached alarming proportions, with nearly 29,000 individuals awaiting treatment. This situation has underscored a significant challenge within the Finnish healthcare system, particularly in addressing non-urgent specialized medical care, which, by law, should commence no later than six months after the need for care has been identified.

Unfortunately, this standard is not being met in the realm of eye health, leading to over 1,800 people in so-called illegal queues, waiting for more than six months for their turn to receive care. The issue is especially acute in the case of cataract queues, where nearly 13,000 patients are in limbo.

To tackle this issue head-on, the Social and Health Care Licensing and Supervision Authority (Valvira) issued a directive on March 21, 2024, ordering fourteen wellbeing areas and the HUS consortium to ensure access to non-urgent specialized medical care complies with the law by March 31, 2025. Furthermore, Valvira has urged wellbeing areas in South Savo (Eloisa) and Kymenlaakso to organize access to non-urgent specialized medical care in accordance with the law as swiftly as possible.

The crux of the problem lies in the outdated regulatory frameworks and the inefficient use of available healthcare resources. For example, a regulation from the 1960s mandates that individuals who have previously undergone any form of eye surgery must seek care from ophthalmologists, even for routine visits that could otherwise be handled by optometrists. This requirement funnels a significant number of individuals with healthy eyes towards ophthalmologists, resulting in unnecessary visits estimated at 150,000 annually for the renewal of eyeglasses alone.

Addressing this issue, *Näkeminen ja silmäterveys NÄE ry* (Vision and Eye Health NÄE Association), led by CEO Panu Tast, has proposed innovative solutions aimed at dismantling the backlog in eye healthcare and achieving significant cost savings. The association suggests integrating the services of optical stores into the public healthcare system through service vouchers and removing the clause from the professional regulation that restricts the role of optometrists. These measures would not only expedite the clearing of queues but also enable a more efficient allocation of resources.

NÄE ry's proposals include leveraging the capabilities of optical stores for tasks such as glaucoma monitoring, post-cataract surgery check-ups, and screenings for diabetic eye diseases through multidisciplinary collaboration with eye health professionals. By eliminating the outdated clause in the professional regulation, optometrists could assume greater responsibility for all basic vision examinations, freeing up ophthalmologists to focus on patients requiring specialist-level care.

Moreover, the association advises the government to swiftly implement targeted measures to alleviate restrictions on subcontracting by wellbeing areas and to permit procedures performed under anesthesia to be outsourced to private service providers. Such changes, according to NÄE ry, would not only address the immediate backlog but also lay the foundation for a more responsive and efficient eye healthcare system in Finland.

HT

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