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.
Royal National Institute of the Blind