Select Committee on Health Written Evidence

Supplementary memorandum submitted by the Association of Optometrists, Association of British Dispensing Opticians and the Federation of Ophthalmic and Dispensing Opticians (CP 26A)

  We would like to thank the Committee for inviting us to give evidence as part of your inquiry into NHS charges. We both enjoyed being part of such a lively discussion. There were a few issues that were raised that we promised we would clarify.


  During the session you asked about the take up of sight tests for children. According to official statistics 21.6% of NHS sight tests are carried out on children under 16. In the year to 31 March 2005 11.7 million NHS sight tests were performed in total, therefore 2.53 million children had a free sight test. This equates to approximately a quarter of the total population of children under 16 in England. According to official statistics the total population of children under 16 in England is 9.75 million (Office of National Statistics). 26.5% of vouchers or approximately half a million vouchers went to children under 16. Given the importance of eye health and also the early detection of visual impairment on the development and wellbeing of children, we strongly recommend as a minimum that all children should have a sight test before the age of eight years old. Ideally all pre-school children should have a sight test to ensure early detection and if necessary, the early treatment of eye disease.


  Our major concern in relation to domiciliary sight tests is that over one million older people live at home or in care, unable to visit a high street optician unaided, yet only 344,000 domiciliary sight tests were carried out in the year ending 31 March 2005. As we mentioned during the session, research carried out by the University of York found that over 189,000 people with visual impairments fall each year at an estimated cost to the NHS of £269 million (York University study, 2003).


  During the discussion about voucher values we pointed out that the voucher value does not cover the cost of spectacles, although two thirds of practices do subsidize this and offer a range of spectacles for that voucher value. We did not have time to raise the point that the level of reimbursement for complex lenses, ie those of a high prescription, is particularly low and does not reflect the cost of these lenses. Generally speaking people who require very high prescriptions and who would qualify for a complex voucher would want to have the best thinnest lenses that they could afford in order to improve the cosmetic appearance of their spectacles. The allowances, which are currently a supplement of £12.40 or £31.30 for single vision and for bifocal lenses are insignificant against the actual retail cost of these expensive lenses and should be increased.

  For accuracy, we would also like to explain to the Committee that eligible patients do make payments when using hospital services, when there is a clinical need for contact lenses. The charge is £48 per lens, and therefore £96 for a pair. This charge is close to the actual cost of the lenses which therefore means that NHS patients are effectively paying for their lenses. This payment is made whether the contact lenses are dispensed at the hospital or elsewhere.


  We would like to stress again the importance of eye health for people of all ages. Increasing public and parents awareness of the importance of having regular sight tests is crucial in reducing the incidences of eye disease and preventing avoidable blindness. That is why the optical bodies have given their support to the RNIB campaign, "Open Your Eyes". We believe that the Government should include eye care in all relevant National Service Frameworks and public health white papers. In particular, we would hope to see a question about eye examinations in the first (self-assessment) part of the new NHS Life Check. We also hope to see the inclusion of eye care and the availability of free domiciliary NHS sight tests for vulnerable people in the forthcoming Next Steps publication under the Older People's National Services Framework. These would be steps in the right direction in the promotion of eye health to the public.

  We enclose a copy of our policy document, "Primary Eye Care in England—A Vision for the Future", which sets out our proposals for a national services framework for improving optical health. We also enclose a copy of a recent report by Professor Nick Bosanquet, "Developing a New Partnership Contract for Community Eye Care in England". We hope that the Committee will find these publications useful.

  Should the committee have any further questions relating to eye care services please do not hesitate to contact us and we will be happy to provide you with any further information you require.

David Cartwright
College of Optometrists

Lynn Hansford
Association of Optometrists

15 February 2006

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