Surveys carried out by the optical profession show that after an initial drop, 12·43 million sight tests were carried out in the financial year ending 1991. This exceeds the 12·21 million sight tests in 1987—the last typical year before the changes to the system were announced.
I am grateful to my hon. Friend for those figures, which I shall study carefully. In view of the fact that eye testing is important in picking up illness in the elderly and that we are in the business of preventive medicine rather than treating illnesses when they occur, will my hon. Friend keep an open mind? Should the figures for the number of eye tests show an adverse trend compared with those of the past, will my hon. Friend consider the possibility of reintroducing free eye testing for the over-60s?
My hon. Friend is right to emphasise the importance of prevention. That is why the work of general practitioners is important in terms of the regular checks that they carry out on their patients, in particular those patients aged over 75. I can tell my hon. Friend that four out of five of those elderly patients have accepted their check-ups and that nine out of 10 found them useful.
For 40 years the policy has been that some contribution should be made towards the cost of sight and dental charges—that was agreed by both parties. People pay 13p a week towards the cost of a sight test every two years—less than the cost of a second-class stamp.
Is the Minister's very carefully worded reply an attempt to distract from the fact that the proportion of the elderly in the population is increasing and will continue to do so? Therefore, the potential demand for eye tests from the over-60s will increase exponentially. We have received clear evidence from opticians in our constituencies that the imposition of charges runs contrary to the concept of preventive medicine. That move was further encouraged by the increases in prescription charges last week, which were above average when set against inflation. Should not the costs of check-up tests and the associated costs be scrapped?
The hon. Gentleman, when discussing the increase in prescription charges, did not, of course, mention the above-average increase in optical vouchers—a 9·5 per cent. increase. As the population becomes older, it also becomes wealthier and I draw the hon. Gentleman's attention to the fact that the average pensioner has increased his or her income by 33 per cent. That contrasts with the time when Labour was in power when pensioners' incomes increased by a modest 3 per cent.
The importance of prevention has been emphasised time and again. That is why, only last year, we were involved in the eye awareness campaign with the profession to draw attention to the importance of people ensuring that their eyesight is checked.
Is my hon. Friend aware that there was a serious fall-off in the number of people presenting themselves for eye tests for a considerable period after the charges were introduced and that the current figures show that we have not yet made up that gap? If that is not so, why have so many ophthalmologists gone out of business?
I regret that I disagree with my hon. Friend, but I assure her that the levels have returned to those of 1987. That is agreed by the professions, with which I shall be having further discussion shortly. It is important to note that we have greatly increased the number of professionals providing services on a wide range of fronts. For example, there are an extra 22 per cent. ophthalmologists and an extra 22 per cent. optometrists registered with family health service authorities over and above the 1979 figure. They are all providing an excellent service. I am also pleased to inform my hon. Friend that ophthalmology waiting lists have fallen substantially during the past year.
Is the Minister aware that the number of eye tests in the Oldham area dropped by one third last year? Is he aware that even when people are examined, are found to have cataracts and wait a long time for the operation, some of them—such as a 91-year-old constituent of mine—are told that Royal Oldham hospital, which has been granted trust status, does not have the money to provide the necessary medicines and has money to help only the elderly?
I am extremely surprised to hear what the hon. Gentleman says, for opthalmology waiting lists between March 1990 and March 1991 almost halved for long waiters. There is in the patients charter a clear commitment that patients should be seen within a maximum of two years. I shall look into the circumstances that the hon. Gentleman describes. Free NHS sight tests are available to those on low incomes, children and those especially at risk of eye disease, such as glaucoma sufferers. About 40 per cent. of people are entitled to free tests.