Clause 36 - Persons performing primary ophthalmic services
Health Bill
4:45 pm
Andrew Murrison (Shadow Minister, Health; Westbury, Conservative)
The clause should not detain us for too long. I know that I have said that before, but I really mean it this time.
I am very grateful for the Minister's lengthy exposition of the list held by the PCTs. She said that members of the Committee needed to be educated about the list, and I am very grateful for her attempts to do so. I believe, however, that we are really talking about two lists—I refer to the lists suggested in new subsection (2A).
Lists are obviously important to the clause. The first is a list of practitioners who are qualified, and the second is a list of contractors. Given the importance that the Minister places on lists, it would be useful if she outlined what she means by a list, how one becomes a member of that list, and whether there are indeed two lists, one of which is of contractors who may not be qualified to provide ophthalmic services in the way that I understand the Minister to mean, and the other of which is of persons who are qualified to provide those services as dispensing opticians, as ophthalmic medical practitioners and so on. That is important, because we have spent some time discussing how one might become a member of that list and how one might be disqualified from it, and we need to know which list we are dealing with.
In that context, it would also be useful to have the Minister's clarification of what is driving all this, as she seems to be concerned about the current level of opportunity for dispensing opticians and what she calls lay members to provide those services. Apart from the fraud issue, which we discussed earlier, much of this part of the legislation appears to be driven by the need to enhance the opportunity for the category of people who are lay members or dispensing opticians.
In the context of our discussion on the possibility of opening up the provision of enhanced and additional services to a range of providers, it seems that the Minister is exercised about potential providers that do not have someone who is currently qualified to provide primary ophthalmic services.
If that is the case, the Minister should say so categorically. Perhaps she should also say what representations she has received from organisations that have a lay member or a dispensing optician who may wish to apply for contracts. The whole thing has been driven by their needs rather than by those of the rest of the professions who might deliver primary ophthalmic contracts or by those of patients in particular.
The clause makes reference to medical practitioners who might apply for inclusion in a list and to the fact that regulations may prescribe their qualifications and experience. I could find no reference to regulations that may prescribe the qualifications and experience of dispensing opticians and optometrists; none of that is laid out in the clause or elsewhere in the Bill.
That is strange and I wonder why ophthalmic medical practitioners, which I would understand to mean doctors who are qualified in ophthalmology and who are qualified to carry out primary ophthalmic services, are singled out to have their experience and qualifications defined whereas other professionals in the field are not. I am not making a judgment about whether that is a good or bad thing; I am merely intrigued to know why a difference is being established between those two groups: the ophthalmic medical practitioner, who is essentially a doctor who is additionally qualified, and dispensing opticians, optometrists and so on. It would be interesting to hear the Minister's rationale for that. I am sure that there is a good explanation in addition to her comments about the list.