Clause 34 - Provision of primary ophthalmic services
Health Bill
10:35 am
Stephen Williams (Shadow Minister, Health; Bristol West, Liberal Democrat)
I beg to move amendment No. 79, in clause 34, page 28, line 41, leave out from 'all' to end of line 11 on page 29 and insert 'persons'.
Good morning, Mr. Illsley and may I wish you and all members of the Committee a happy new year. There is a very fraternal atmosphere in my party at the moment, as I am sure you will realise. I did a quick calculation this morning and discovered that we had 47 clauses, four new clauses and five schedules to get through today. I therefore intend to be brief and I hope that other hon. Members will be brief too. The purpose of the amendment is to provoke a discussion on the disparities in access to eye health services for different groups of the population within England, particularly compared with the much enhanced access in Scotland and the different system in Wales under the new devolved arrangements.
The amendment deletes all references to the groups of the population in new section 16CD(2) who currently receive free eye tests: those who are under 16; those who are over 16 but in full-time education; various people who are in receipt of means-tested benefits; and the over–60s. The clauses in this chapter of the Bill deal with the general ophthalmic services contracts and what we would normally describe as eye tests. The significant part of GOS is certainly eye tests.
I had a most useful meeting with optometrists and ophthalmic dispensers in my constituency back in November. I learned a great deal about how the existing service operates. I was quite shocked to discover that the NHS eye test fee is currently only £18.39, which for a visit to a well-qualified professional person seems very small. That is rather less than one would expect to pay for a visit to the local garage to have one's car repaired, let alone various other medical services. I was staggered to discover how low the eye test fee is. However, 66 per cent. of the tests currently offered by optometrists are funded by the NHS, albeit at a low rate. The second part of the GOS contract is the voucher system, which contributes towards the cost of children's spectacles.
The purpose of the amendment is to provoke a discussion on access to eye care for all sections of the population of England. The major worry that the eye care profession has about chapter 2 of the Bill relates to the provisions for the existing GOS contract in England. The management will be devolved from the central NHS to the primary care trusts that operate in all our constituencies. They will have discretion over the management of contracts. Several amendments to later clauses will deal with that, so I shall not dwell on the matter now. However, it will be worth hearing from the Minister why in England only the groups specified in new section 16CD(2) in clause 34 have access to a free eye test and eye care, when the devolved Administrations have seen the value of giving all sections of the population free and easy access to an optometrist, not only to detect a defect in natural sight but to look for other health concerns that only a qualified optometrist can identify.
There is an analogy here with dental services. I went to a most useful presentation before Christmas about mouth cancer—I am sure that the Under-Secretary attended it too—where I learnt that, as part of their standard contract with the health service, dentists look for early signs of mouth cancer. The analogy is that, as well as doing the obvious thing of testing somebody's vision, a qualified optometrist will look for other potential defects. The issue involves more than the standard eye test.