Select Committee on Health Written Evidence

Memorandum submitted by the Royal National Institute of the Blind (CP 30)

  There are around two million people in the UK with sight loss and every day another 100 people start to lose their sight. We are the leading charity working in the UK offering practical support, advice and information for anyone with sight loss. We are also the largest organisation of blind and partially sighted people in the UK. Eighty per cent of our Trustees and Assembly Members are blind or partially sighted and we now have a thriving individual membership scheme with over 10,000 members.

  We welcome the Committee's inquiry into co-payments and charges and have comments relating to a few of the questions outlined in the Committee's press release announcing the inquiry.


  Our main concern in this area relates to the NHS voucher scheme for the Hospital Eye Services and General Ophthalmic Services (GOS). These vouchers are provided to people entitled to help, through the NHS voucher scheme, toward meeting the costs of their spectacles or contact lenses, whether provided by an optometrist in the community or in the Hospital Eye Service. Current free entitlements include people under 16, people in full time education under the age of 19 and people who get income support and a number of other benefits.


  The accessibility and therefore clarity of the voucher is not often of a high standard due to the following factors:

    —  Vouchers can be photocopied repeatedly, therefore causing indistinct and poor quality print.

    —  Vouchers can in the first place be designed in small print.

  These factors can make it impossible or very difficult for a visually impaired person or someone with sight loss, who are after all going to be significant users of Hospital Eye Services facilities, to access information on the voucher. We would like to see measures introduced to ensure that all information produced by the NHS, including vouchers and related information, meets best practice and is produced in at least 12 point print. Clearly this is of vital concern in relation to Hospital Eye Services vouchers, which, by definition, will need to be accessible to people with sight problems.

  This is particularly relevant when taking into account the Disability Equality Duty, within the Disability Discrimination Act, 2005. This duty will require public sector to promote equality of opportunity for disabled people and tackle discrimination. The NHS needs to start looking broadly at the access barriers that it will have to cover in the Disability Equality Schemes that they may have to produce, and we believe that accessibility of printed information will be one key issue, amongst others, that will need to be addressed.


  In some hospitals ophthalmic services are provided by private sector companies that have a contract with the PCT. We are concerned that proper auditing takes place regarding the provision of spectacles and low vision aids within this setting. This is because these companies have the ability to both prescribe and sell spectacles and low vision aids, the former being paid for by the patient with vouchers and perhaps also additional private funds, the latter being paid for by the hospital.

  We believe that charges for these items by private providers must be transparent and therefore open to auditing inspection to establish that costs are similar when either a hospital or a private company is providing the same equipment to patients.

  Review of guidance on "Optical Charges for Hospital Eye Service (HES) Patients" Department of Health regulations relating to the application of the NHS spectacle voucher scheme in the Hospital Eye Service were issued in the circular reference HC(89)12, which was cancelled on 1 April 1993.

  The guidance is yet to be renewed and we are concerned that parity of treatment is maintained in terms of the entitlements under both Hospital Eye Service Vouchers and GOS vouchers. We do not believe that having one system of entitlements for Hospital Eye Service patients and another (under GOS) for people being treated in primary care settings would be beneficial. Therefore we hope the DoH's review of General Ophthalmic Services will take account of the replacement for the HC(89)12 guidance when it is issued and ensure that both voucher systems retain the same entitlement structure.

Dan Scorer

Royal National Institute of the Blind

December 2005

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