§ Vice-Admiral Hughes Hallett
I beg to move, in page 24, line 11, to leave out "five" and insert "six".
This Amendment is the first of a series which have the effect of adding a fourth 573 ophthalmic specialist to the General Optical Council. I put down a similar series of Amendments in Committee, but I withdrew them because I found at that time that no agreement had been reached between the British Medical Association and the ophthalmic opticians concerning this matter and it appeared that there was danger that if the Amendments were carried, the ophthalmic opticians would then move for a corresponding addition of their representation and we would have an ever-growing Council.
The point was raised on Second Reading by my hon. Friend the Member for Aberdeenshire, East (Sir R. Boothby), who pointed out that the medical representation on the General Optical Council ought really to be strengthened. I understand also that the British Medical Association has made the point that if there are to be only three ophthalmic specialists, as at present provided in the Bill, one of whom has to come from Scotland, there might be difficulties in ensuring that medical questions were adequately covered. I am not entirely clear about the relevance of the point concerning one of them coming from Scotland, but the point has been made.
Be that as it may, since the Committee stage I am informed that agreement has been reached on this matter between the doctors and the ophthalmic opticians, for which I am grateful. I therefore move the Amendment.
§ Mr. Russell
I beg to second the Amendment.
I should like to emphasise that the Amendment has been accepted by the ophthalmic opticians only with considerable reluctance. They hope that as a result of its acceptance and there being an extra doctor on the General Optical Council when it is formed, there will be no further opposition to the Bill, at least from the B.M.A., when it reaches another place.
Naturally, one cannot prevent possibly unofficial opposition, but at least, one hopes that there will be no official opposition by the B.M.A. It is on that understanding, or at least in that hope, that we accept the Amendment.
§ Mr. Hastings
I should like in a word or two to say how grateful I am that the Amendment has been accepted. 574 Although I am a member of the British Medical Association, I do not suggest that I agree with it on everything, but I feel that this is a useful Amendment. We as doctors are watching with great interest and enthusiasm the development of the ophthalmic opticians as a learned profession. We feel that in this development members of my profession can be of assistance to them and give them some help.
We have developed from pharmacists and barber-surgeons in the last 200 years and our experience may be of value to others. Because of that and because of the help that ophthalmologists are able to give to, if I may so put it, their younger sisters, I am particularly glad that the Amendment is being accepted by the promoter of the Bill.
§ Mr. Chapman
I recall the discussions we had about this matter in Committee, and I recall how the hon. and gallant Member for Croydon, North-East (Vice-Admiral Hughes Hallett) withdrew——
§ Mr. Chapman
I beg the hon. and gallant Gentleman's pardon. Perhaps it was a private conversation with the hon. and gallant Gentleman that I recall, when he was talking to me about this pressure by the British Medical Association.
I want to ask the hon. Member for Wembley, South (Mr. Russell) why we are now going so far from what the Crook Report recommended and why, having gone so far, we do not go even farther. I think there has to be some justification for what is being done compared with what was recommended.
I recall from paragraph 59 of the Crook Report that the members of that Interdepartmental Committee laid down three specific recommendations about the balance of members inside the General Optical Council, and this Amendment seems to me to be upsetting that balance quite substantially. I have done my best to get my figures right in this matter, and I believe I am right in saying, although I am subject to correction, that the Crook Report recommended that there should be three members of the Privy Council, the Chairman and two members. The Bill has now put this total up from three 575 to four. So we have there first of all the balance against the practical men of the profession increased by that much.
Then we come to the category which we can most conveniently call the optical examining bodies. The Crook Report recommended there should be six representatives of those, and the Bill faithfully follows that recommendation. Then we come to the ophthalmic opticians. The Crook Report recommended that there should be four from England and one from Scotland, making five. The Bill agrees and makes that number five.
Then we come to the dispensing opticians. Here the Bill differs from the Crook Report. The Crook Report recommended only one representative on the Council. The hon. Gentleman the Member for Wembley, South, in his Bill makes it two. Am I wrong?
§ Mr. Russell
I think the hon. Gentleman has overlooked that one was to represent dispensing opticians in England and Wales and one those in Scotland.
§ Mr. Chapman
So up to now we have been following the balance recommended in the Crook Report, except in the case of the Privy Council nominees.
Now we come to the medical men. The balance that was originally recommended in the Crook Report was five, and the hon. Gentleman is accepting an Amendment which raises that number to six. There is now a new complication in Northern Ireland, but I do not think that that matters in considering these comparisons I am trying to make between what is in the Bill and what was recommended by the Crook Report.
If we accept the Amendment, we shall have reached the stage where the General Optical Council, in its small total of about twenty, already has two extra non-medical men, men not engaged in the profession, compared with the recommendations of the Crook Report. This seems to me to be to some extent flouting—I do not want to make too much of it—or gainsaying what the Crook Report 576 recommended. It is a significant difference in view of the total membership of about twenty.
I will point to the more practical results of what I have been saying. I should like to know why the hon. Member has gone as far as he has and also why he did not widen the breach once he had made it. I have stated several times that I would expect the General Optical Council to do largely what opticians wanted it to do. I remember my hon. Friend the Member for Sheffield. Attercliffe (Mr. J. Hynd) asking me how one proved it from the figures, and I replied that it was because they had, roughly, generally a majority on the General Optical Council.
Am I correct? Let us look at the figures. We have now got six members from the optical examining bodies, five ophthalmic opticians and two dispensing opticians, which makes a total of thirteen. We have left the four members of the Privy Council and, under the present proposal, six medical men and one from Northern Ireland, which amounts to eleven. What the hon. Gentleman has done is to swing the balance entirely inside the General Optical Council. I believe he has not gone far enough, however. He has got towards the prevention of a majority of opticians and optical views generally on the Council, but he has not gone far enough. He has made it thirteen-eleven instead of the Crook proposals of thirteen-eight. I should like him to go a little further than is now proposed.
Throughout the stages of the Bill I have contended that it would be very salutary if this profession, which incorporates in it a trading function, were on trial for a little time to enable it to attain the very high standards that we expect of professional men in our community. That is a legitimate thing to say. It is not one of the top-ranker professions. We want to make it so, and that is why the Bill has been introduced. I think I am entitled to say that, for various reasons which I pointed out in some detail in Committee, the profession cannot be said to have been applying the best professional standards so far.
I feel that we ought to have gone further than the Amendment and that for the time being at least the majority of the optical men on the Council should have been taken away. There should 577 have been more than six medical men and more than four members nominated by the Privy Council. If we could have got near a balance or perhaps tipped it the other way to a majority of non-optical men, I should have been much happier.
After ail, what is the contentious point in the profession which the Council will have to decide fairly soon? It will be necessary for the Council to decide fairly soon whether to give effect to the provisions of this contentious Clause 25, when it will be possible, by a simple rule of the Council, not merely to regulate but to prohibit all forms of advertising. I am only guessing, but I presume that price display is included in the word "advertising." The Council will have to decide whether to bring this into operation.
When that problem comes to be decided, what will be the constitution of the Council? There will be five ophthalmic opticians and two dispensing opticians. I admit that there will be a bit of dispute between those groups, but there will be six members of the ophthalmic examining bodies and I would say that by and large they will be hand-in-glove with the ophthalmic opticians. The fair chance is that the people putting forward the professional point of view will be able to carry a majority inside the General Optical Council and to that extent will be able to force their view through.
What would I have liked to see as an alternative? I say quite bluntly that before the profession becomes fully fledged and is acknowledged by all of us to be in the highest bracket of our professions, I would like to have seen more medical men and more nominees of the Privy Council who, so to speak, could have applied this corrective. They could have said to the optical men, "We are not going to take all these things that you have put into practice in the past in the system of charging or anything else. We are wanting to see you put your house in order. We want to begin to apply the sort of standards observed by the higher professions, which have been established longer and have been fully safeguarded by legislation longer than you have." Had the Privy Council nominees and the medical men had a majority on the General Optical Council, 578 if there was a fight within the Council at the outset they would have been able to urge this higher professional point of view upon the Council and prevent the majority of opticians from carrying through their views.
How automatic is it that this arrangement will go through? Given the present constitution, I said that they have virtually a numerical majority. I want to remind the hon. Member for Wembley, South of the provisions in relation to membership of the British Optical Association. As I stated in Committee, that Association takes the most extreme view of advertising and wants to get it stopped. It carries this principle so far as to delete from its membership employees of firms which advertise. I have pointed to this injustice before and have said that the better way to proceed is by example and by blacklisting the firms and not the employees.
This principle is so essential, in its view, that it will move quickly, decisively and strongly in the matter, and I fully expect it to try to put into the rules of the General Optical Council the sort of restrictions which appear in the rules of the British Optical Association. If the members of the Association want to do this, given the constitution of the Council as laid down in the Bill—and which is not satisfactorily corrected by the Amendment—we shall have no power to prevent their doing so, before putting their own house in order.
What shall we end up with? We now have a situation in which merely the Association blacklists refractionists and employees of firms which carry on advertising and price display, but if this constitution is accepted the medical men on the Council will not be able to prevent the Association members using their majority to carry through a provision, virtually with the force of an Act of Parliament, proscribing refractionists and other quite guiltless people who happen to work for employers who advertise.
That is going a long way. I have with me correspondence from persons who have been in this situation. These innocent men, who work daily for their living by testing sight, happen to work for firms blacklisted by the Association and have been thrown out of membership—and now they will be blacklisted by the Council.
579 The sponsor of the Bill has already gone a considerable way to make a break with the Cook Report. He has half accepted my contention by allowing an increase in the number of medical men and the number of members nominated by the Privy Council. He should now go the rest of the way and provide that the Council should have a majority of non-professional and non-trading members. This would put the profession on its mettle, and persuade it to put its house in order and adopt a high professional outlook. If the hon. Member would agree to go a stage further than is proposed by his hon. and gallant Friend I should be very pleased, for all the reasons that I have tried to outline.
§ Amendment agreed to.
§ Further Amendment made: In page 25, line 1, leave out "five" and insert "six".—[Vice-Admiral Hughes Hallett.]
§ Vice-Admiral Hughes Hallett
I beg to move, in page 25, line 3, to leave out "three" and to insert "four".
This Amendment provides that the doctor to be added to the Council shall be an ophthalmologist.
§ Amendment agreed to.
§ Further Amendments made: In line 4, leave out "three" and insert "four".—[Mr. Russell.]
§ In line 26, after first "the" insert "first".
§ In line 28, leave out "three" and insert "four".—[Vice-Admiral Hughes Hallett.]
§ 3.30 p.m.
§ Notice taken that 40 Members were not present;
§ House counted, and, 40 Members being present—
§ Mr. Russell
In moving the Third Reading of the Bill, I wish very briefly to thank my supporters on both sides of the House for the help they have given and also my hon. Friend the Parliamentary Secretary and his advisers for all the work they have put into the preparation of the Bill. I also wish to thank the ophthalmic and dispensing opticians, who are the real promoters of the Bill, and 580 the medical profession for the co-operation they have shown.
My interest as the sponsor of the Bill has been to try to reach the greatest common measure of agreement between the various interests, and I think that, at any rate to a very large extent, we have succeeded in doing that. A number of changes have been made in the Bill since Second Reading, most of which, I think, I undertook to make during Second Reading. I think that they have improved the Bill, although I know that the hon. Member for Kirkdale (Mr. N. Pannell) would not agree with some that have been made.
The hon. Member for Northfield (Mr. Chapman) said earlier that he hoped I did not think him unreasonable. I did not think him unreasonable for having raised the points about which he is particularly keen during the Committee stage or, again, today. We have had a very long discussion on the topic, both in Committee and on the Floor of the House, and in view of the fact that the hon. Member for Northfield is in a small minority and as the profession has already given attention to the points he raised, and will continue to do so, I think I am entitled to say that I think he would be unreasonable if he now took any action to prevent the Bill being given its Third Reading this afternoon, particularly as he has attempted to do that today by twice drawing your attention, Mr. Deputy-Speaker, to the number of Members in the House. Therefore, I hope that he will not press his opposition any longer.
My hon. Friend the Member for Kirkdale, who feels equally strongly about the points he raised, has accepted the position that he is in a minority, and he did not press the Amendment on the Notice Paper in his name. I realise, of course, that the hon. Member for Northfield also withdrew his Amendment. I hope that he will also accept the position that he is in a minority in taking the line which he has taken this afternoon, especially in view of the fact that the points which he has raised are already being considered. I think he can be definitely assured that they will be taken into consideration by the General Optical Council when it is formed. In view of that, I hope he will not press further any objections.
581 In reply to two points, one of which I think the hon. Gentleman raised a short time ago on my hon. Friend's Amendment, to which I did not reply, may I say that he asked me whether magnifying glasses would be allowed under Clause 21. I made it clear in Committee that they were allowed, and I am only too glad to make it still more clear now that, under Clause 21, magnifying glasses—though not, of course, spectacles—are allowed to be sold in chain stores, or by any other unqualified person.
The only other point which the hon. Gentleman made which I should like to take up is the one about the firm now supplying spectacles to the chain stores being put out of business. The hon. Member asked me how long I thought it would be before that happened, and I said it would be about two or three years. The reason for that is that it will be about that time before it will be possible to bring into operation the prohibition Clause, which cannot be done until the first register has come into operation. That is what I am advised. Therefore, I think there is plenty of time for any redundancy caused by this provision to be taken into consideration. In any case, I understand that the firm concerned makes other optical appliances besides spectacles, and I therefore hope that the disturbance caused will be the minimum possible.
With those few observations, I invite the House to give the Bill a Third Reading.
§ 3.38 p.m.
§ Mr. Blenkinsop
I think the majority of hon. Members in the House hope that the Bill will receive its Third Reading and go on the Statute Book fairly soon. This is a matter which has been discussed for a number of years, and I think, quite frankly, that it has been unconscionably delayed in coming before us in this House.
As I said earlier, I am rather sorry that the Bill was not introduced as a Government Measure, but I take the opportunity to congratulate most sincerely the hon. Member for Wembley, South (Mr. Russell) on steering a Bill of this sort this far, and I hope very much that it will reach its final stage. It is a highly complicated and detailed Measure, and there cannot be many comparable examples of a Measure of this kind and 582 complexity going on its way through the House under the auspices of a private Member. It says a great deal for the hon. Member's work and that of others who I know have helped him in it, and certainly it shows the hon. Gentleman's ability.
We have high hopes that once the Bill reaches the Statute Book there will be a great advance in the profession, and that this will inure to the benefit of the general public. There have been many criticisms, some valid and some perhaps not so valid, of the optical profession generally, and there is no doubt that it can make a very great contribution in our National Health Service. We hope that this Measure will enable them to give even better service to the public than has been possible in the past. We shall watch with interest to see in what way they are able to exercise the new responsibilities which they undertake as a result of the Bill.
§ 3.40 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Richard Thompson)
I think it appropriate if I say a few words during the Third Reading debate on this Bill which has occupied a great deal of the time of many hon. Members. It has reached a stage where, although different in some respects from its original form, it provides a good example of a Measure about to leave this House in much better shape than when it was introduced. It was clear during the Second Reading debate that important modifications were necessary particularly regarding the testing of sight and the sale of glasses by unregistered persons. There was unanimity of opinion that in its original form the Bill did not provide what was wanted and that a clear distinction between the professional and technical functions of opticians on the one hand and the medical care and treatment which only a doctor can carry out on the other needed emphasising and underlining.
The promoters have accepted Amendments to meet the views of the House. A major Amendment was made during the Committee stage to Clause 1 and the Bill now provides that the register of ophthalmic opticians be in two parts, those proposing to test sight only and those proposing to test sight and to dispense glasses. This Amendment implements what the Crook Committee 583 had in mind and the promise given by my hon. Friend the Member for Wembley, South (Mr. Russell) during the Second Reading debate.
In Clause 20 Amendments were accepted which prohibit the testing of sight except by a registered medical practitioner or a registered ophthalmic optician. Exceptions were provided for medical students and opticians under instruction, which was only sensible in the circumstances. In Clause 21 there is a prohibition on the sale of optical appliances except by or under the supervision of a registered medical practitioner or a registered optician, again with exceptions for wholesaling and sales to hospitals, clinics and matters of that kind. I am sure that the Amendments which have been made reflect the opinion of the House.
I was very pleased to hear the welcoming remarks which the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) made a few minutes ago about the Bill. If it becomes law the Bill will confer a new, highly responsible and more secure status upon opticians. As the only people other than doctors who are allowed to test sight, they will have a heavy responsibility to maintain the highest professional and training standards.
Judging by the standards which they have maintained on the whole in the past, I have no doubt that they will live up to the new responsibilities which are laid upon them by the Bill. In the past, they have shown as a body a high regard for ethical standards, and I am sure that they will continue to do so in the future.
Today's debate upon Report produced one or two important changes. Of these I would mention the Amendment to Clause 25, which now defines the scope of the optician's work in relation to the work of the medical practitioner. This is a point with which my hon. and gallant Friend the Member for Croydon, North-East (Vice-Admiral Hughes Hallett) was concerned in Committee. I am glad that it has been found possible to introduce wording into the Bill which defines in a satisfactory manner those responsibilities. It is vitally important that the optician should not overstep the 584 boundary between his functions and those of the doctor.
I accept absolutely what was said by the hon. Member for Manchester, Exchange (Mr. W. Griffiths) about opticians always having fully understood this, and that they did not object at all that the Bill should define their respective functions beyond a peradventure. I am glad that, as a profession, opticians are entirely in agreement with this provision. The Amendment has been most carefully considered, and should provide an excellent basis upon which the General Optical Council can work. I am glad that it has been found possible to add the Amendment to the Bill.
The work of sight-testing opticians is closely connected with that of doctors whose medical advice should be of help to the optical profession. The hon. Member for Barking (Mr. Hastings) made an appreciative reference to the scope of this co-operation, which will no doubt be of great assistance in optical training and practice. We can look forward to a constructive partnership between opticians and doctors in the future as the result of the Bill, and of the setting up of the General Optical Council.
There are some 8,000 ophthalmic opticians and 800 dispensing opticians in the United Kingdom at the present time. Opticians give over 5½ million sight tests a year and dispense just under 5 million pairs of glasses under the Health Service alone in England, Wales and Scotland. The opticians' own representative bodies have already established high standards both in training new entrants and in devising and enforcing rules of conduct among their members in regard to the testing of sight and dispensing of glasses. The Government are, however, satisfied that the time has come when the training and disciplinary machinery of opticians should be put upon a formally regulated footing.
The Bill sets out to achieve this object through the establishment of the General Optical Council which, with its carefully devised and balanced constitution, will be in a position to rise above any differing interests which might seem, superficially, to exist among those most closely concerned with the future development of opticians. It is of the greatest importance that the General Optical Council should be master in its own house and should be able to give guidance as appropriate 585 on all aspects of the conduct of opticians work.
That brings me back to one of the discussions we had earlier today. It seems to me that to attempt to define too closely every aspect of its functions might well be to deprive it of the essential authority and independence it ought to bring to its labours. For this reason, certain Amendments, if I might say so, admirable in their general intention—I am thinking particularly of the debates we had this afternoon when the hon. Member for Northfield (Mr. Chapman) took a leading part—Amendments, for example, designed——
§ Mr. Speaker
I am sorry to interrupt the hon. Gentleman, but I think he is now dealing with Amendments we have rejected and are not in the Bill.
§ Mr. Thompson
I was about to say, Mr. Speaker, that I felt the independence of the General Optical Council, which by any standard seems to me a desirable and necessary thing, should not be impaired—as it ran the risk of being impaired—by some of the Amendments we successfully resisted this afternoon. Nevertheless, we should expect the General Optical Council to give a lead to the best professional and trading standards and do it more effectively by being allowed a reasonable latitude in the process.
Finally, I say a word of commendation of my hon. Friend the Member for Wembley, South. I think he has done a great service in introducing this Bill and piloting it through long and complicated Committee and Report stages. It is no easy task to take a Bill as technical and complicated as this and to do justice to all the people who want to see it become an Act. My hon. Friend has done that with tact, firmness and good humour which is always so necessary when trying to bring a number of varying bodies of different opinions into some kind of harmony. In this he has been admirably assisted by the hon. Member for Manchester, Exchange. With these words, I commend the Bill to the House and hope it will receive its Third Reading.
§ 3.55 p.m.
§ Mr. Chapman
I have no intention of talking the Bill out, but after the speech of the Parliamentary Secretary I am 586 tempted to do so, because he seemed to be padding out the last half-hour, when we could have been exchanging final remarks on the Bill, with many remarks which might have been made on another occasion.
I am grateful to the hon. Member for Wembley, South (Mr. Russell) for the tolerant way in which he has treated me on my Amendments. I hope that the way in which I have made him run the gauntlet today will be taken as an indication by the profession that there are many shots in the Parliamentary locker which can be used even now if they do not put their own house in order in the matters which I have raised.
Under Clause 25 the rules about advertising will not come into force until they have been approved by the Privy Council, and they will be exercisable by Statutory Instrument, which will be subject to annulment by the House. I serve notice that when the time comes, if the abuses to which I have referred have not been put right and if the better professional approach has not been adopted, I shall move a Motion in the House to annul the Statutory Instrument which the opticians will want. They now have a period in which they are on trial and in which they can put right some of the things which I have been raising continually in the House and in Committee.
I wish the Bill every success. I have taken as much part in it as anybody and I may therefore be allowed to wish it success after my attempts today. I say again to the profession that the Parliamentary gauntlet is not finally run, even with the passage of the Bill, on the matters which I have been raising, and I hope that the time will not come when I shall have to raise them again. They have a wonderful opportunity of professional status ahead of them. If they will put the whole matter on a professional basis I shall be glad, I shall not have had to sit here in vain from 11 a.m. to 4 p.m. with nothing to eat and I shall at least have one reason for being very satisfied and pleased. With those words I wish the Bill every good fortune.
§ Question put and agreed to.
§ Bill accordingly read the Third time and passed.