Orders of the Day — Health Services and Public Health Bill

Part of the debate – in the House of Commons at 12:00 am on 7 December 1967.

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Photo of Mr Ronald Russell Mr Ronald Russell , Wembley South 12:00, 7 December 1967

All three back benchers who have preceded me have spoken with some experience of their own of the National Health Service, or of administering it. My only reason for making a short intervention is that I am one of the lay members of the General Optical Council. I have frequent contact with members of the optical profession, and representations have been made to me about parts of the Bill which affect opticians.

I am speaking only on behalf of myself. My hon. Friend the Member for Farnham (Mr. Maurice Macmillan) rightly dealt with the general principles of the Bill. He said that this was the proper thing to do on Second Reading, and that the details should be left to the Committee stage. He hoped that adequate time would be allowed between now and the Committee stage for consultations between various interests. I think that it is worth while warning the Minister of some of the points which may be brought forward in Committee if consultations do not satisfy the opticians.

The first point is one on which there is disagreement between the branches of the optical profession, the ophthalmic opticians who test sight and dispense prescriptions and the purely dispensing opticians. It concerns representation of opticians on the executive councils. In Schedule 1, it is laid down that there shall be one ophthalmic optician and one dispensing optician in addition to an ophthalmic medical practitioner.

The ophthalmic opticians think that this is wrong, bearing in mind the difference in numbers. As there are roughly 5,000 of them compared with 1,000 dispensing opticians, they would like to have two ophthalmic opticians on each executive council. That is partly justified by the representation of the two branches of the profession on the General Optical Council, which is on the basis of five elected ophthalmic opticians and two elected dispensing opticians.

Ophthalmic opticians also point out in some areas that there are no dispensing opticians who will be available to serve on executive councils. On the other hand, I make clear that dispensing opticians think the Minister's proposals in the Schedule are right because it is not so much a question of votes as of advice being given on behalf of each branch of the profession and, therefore, only one from each is required. I should like to know whether the Minister has considered the point about areas where there are no dispensing opticians available to serve on an executive council.

Other points are being put forward on behalf of the two branches of ophthalmic opticians, the Association of Optical Practitioners and the Society of Opticians, and the two branches of the dispensing opticians, the Association of Dispensing Opticians and the Guild of British Dispensing Opticians. All these bodies consider that parts of the Bill are a serious threat to the future of optical practice. For example, Clause 17(3) appears to be designed to enable the Minister, as distinct from an optician, to determine not only the price at which optical appliances are sold but the type of style of frames sold at health centres. Hitherto, these have been matters decided purely be- tween the optician and the patient. A change in the way suggested in the Clause may be a threat to the private sector of ophthalmic services.

There is also the question of employment of opticians at health centres. It is possible that local authorities could offer higher salaries and other inducements to attract employed opticians into the Health Service. The majority, of course, would come from present private practices. Instead of paying a realistic fee for National Health Service ophthalmic services, the Minister could seek to close private individual practices by employing opticians at health centres. He could also offer private and hybrid frames at prices which he determined. I hope that we shall have an assurance that that is not his intention.

I have been given a letter written by one of the right hon. Gentleman's officers to the Registrar of the General Optical Council yesterday in which this is said: You will see that the provisions we had in mind would in the main be permissive ones subject to the Minister's approval and not mandatory. We envisage that he would agree to opticians going into the health centres only in cases where local consultations between Executive Council, local health authority and the local professional representative bodies suggested this to be the right thing to do in the local circumstances. I hope that the Minister will repeat that assurance through his hon. Friend at the end of the debate so that it may be quite clear to all concerned.

There is a further point in the same direction of uneasiness. It was mentioned by my hon. Friend the Member for Farnham and is contained in Clause 62, which allows the Minister to store and supply goods needed by local health authorities and executive councils to discharge their responsibilities. This could lead to the Minister, as the major consumer, so to speak, of the optical industry from frame and lens manufacturers, virtually nationalising the industry by having a monopoly and to stifle such practice as remains outside health centres. I hope that we shall have further assurance that that is not his intention.

Then there is the question of representation on the Central Health Services Council. Every profession providing Part IV services under the Act except the optical profession is already represented on this important Council, but the Bill does not provide for the inclusion of opticians. I wonder why. I wonder whether the Minister will put this right in Committee. Opticians are not included in the National Health Service Superannuation Scheme. I hope that can be considered and perhaps remedied in Committee.

I hope that there will be time for consultation, because I am sure that all these points can be ironed out by consultation between the Ministry and the various bodies of the optical profession, as happened for example, in the case of the Opticians Bill, 10 years ago. If that can be done I am sure that it would be to the advantage of all. I should be grateful if all these points can be examined.