HL Deb 17 December 1984 vol 458 cc496-523

7.36 p.m.

Lord Ennals rose to move, That an Humble Address be presented to Her Majesty praying that the Order of Council [1984 S.I. 1778], laid before the House on 19th November, be annulled.

The noble Lord said: My Lords, I should not be moving this Humble Address if I did not think that this was a thoroughly undesirable order. But none of your Lordships will be surprised that I seek the annulment of this order in view of the position that I took on behalf of my colleagues on these Benches when the Bill itself was brought before your Lordships' House a few months ago.

The main effect of the order is to allow anyone—butcher, baker, candlestick-maker—without any training or qualification whatever to dispense ophthalmic prescriptions and sell spectacles to anyone over the age of 16 who is not registered blind or partially sighted. The order will permit the sale of spectacles by anyone—barrow boys, market traders, door-to-door salesmen, or mail order. In fact, it will open the door to many of the abuses which the Opticians Act 1958 was originally designed to prevent. In future no minimum standard of training, knowledge or competence in ophthalimic dispensing will be required in this country. Any suggestion that a period of one week's training or any other period of training might be sufficient is nonsense. The question is whether a fall in the standard of ophthalmic dispensing will be in the public interest. My submission is that it will not. The educational and examining bodies for optics are totally opposed to the order, which seems to be based on the philosophy that proper training in ophthalmic dispensing is a luxury which the public can do without. I think that their opposition is totally justified.

I and the professions are firmly convinced that accurate and correct dispensing is essential for safe and comfortable vision, whether on the roads, at work, or for leisure activities. The so-called "safeguards" in the order are no substitute for the safeguard of professional training and qualification. As I shall seek to prove a little later, they are likely to be very difficult, if not impossible, to enforce.

On 23rd August 1984, the Association of Optical Practitioners wrote to the Department of Health and Social Security commenting on the initial draft proposal for an order on which they were being consulted. That letter was acknowledged on 19th November. The submission was made on 23rd August; it was acknowledged on 19th November by the department, who enclosed with it the final order that was laid before Parliament on the same date.

The profession was not afforded the opportunity to comment on the Government's precise proposals while they were in final draft form and before they were laid. This simply is not good enough. If there is going to be change, whether one likes the change or not, the professions are entitled to be consulted. They are entitled to have their views considered, whether the Government agree with those views or not. We are having too many cases brought before this House in which consultation has been a myth and not a reality.

I welcome the inclusion of the partially sighted in the categories of patient to be protected against unregistered dispensing. It is one step forward. But I particularly regret that the order does not take into account the following points. First, the prescriber should be given the right legally to vary the normal validity period of a prescription, if there are genuine clinical reasons for doing so. This is the only effective way of ensuring that patients whose sight needs to be monitored carefully and at intervals shorter than two years have the care and attention that they require.

Secondly, unregistered sellers of spectacles should be required to keep a simple register of their sales for a period of, let us say, three years in order to introduce for the protection of the public the minimum detail and record keeping required to enable a complaint raised by a member of the public to be dealt with satisfactorily. Thirdly, unregistered sellers of spectacles should be limited to—and I am quoting—"bricks and mortar" premises, and no sales should be allowed from stalls, pitches, caravans or the like, or by door-to-door selling, or by post or mail order.

It is extraordinary that these issues were not included in the order which your Lordships are expected to swallow, unless you accept my wish that the order be annulled. This requirement is essential to ensure that the patient can return to a known address for "after-sales service" on spectacles supplied, or otherwise trace a vendor should he or she wish to do so in connection with the service provided.

Fourthly, it is a matter of concern that unregistered sellers will be permitted to supply industrial safety spectacles. The efficiency of these appliances depends not only upon their accurate prescription and dispensing but also on the fact that they need to be fitted properly or they become unsuitable as protective devices. The supply of safety spectacles is a clear example of a field where the services of a registered optician protect both employer and employee in a situation where professional knowledge and judgment are required.

Fifthly, the order contains no provision for monitoring and control of these sellers of spectacles apart from reliance on the trading standards departments of local authorities. The inevitable inaccuracies that will arise from the activities of these traders will place an intolerable burden upon trading standards officers and will mean that there will be little effective redress for people using their services. I say this at a time when the Government are, by other means, imposing financial burdens on local authorities and yet expecting them to be able to carry out statutory responsibilities which in my view they will be unable to fulfil.

The Minister of Health, Mr. Kenneth Clarke, claimed in another place that, these overdue reforms carry no risk to the wearer of glasses but will lead to greater competition, provide greater choice, and, above all, have the effect of bringing down the price of spectacles to the benefit of the public. This implies that the present price of spectacles is unduly high, which in my view is untrue. The 1984 edition of Optics at a Glance shows that the average price for all types of spectacles is £35.

The Government have accepted that registered opticians should not sell to either registered partially-sighted or blind people. That has been welcomed by the Royal National Institute for the Blind. But it does not mean that they are by any means satisfied with the order now before your Lordships' House. In a letter to me dated 10th December, they say: Our concern remains about the Order as a precursor to ending general NHS subsidies for glasses from April 1. We fear that people who need complicated glasses will face big price increases. The Health Minister, Kenneth Clarke, has said (letter to Director-General RNIB, 29th June 1984) that the maximum present subsidy is £40. People now getting subsidies of £15 or more will still be able to get general ophthalmic service glasses, but at the full economic cost. Thus, they will lose the NHS subsidy. Opticians readily give examples of items for which they say the cost of materials plus VAT is at least £20 or £30 higher than the present subsidised price. Mr. Clarke has said the Government will see that 'Hospital Eye Service patients with a similar optical need to former GOS patients are treated financially in a similar manner'. This must mean that subsidies are to be lost for HES patients, to the same extent as in the GOS, so that patients do not get an advantage by going to the HES".

There is a continuing concern about the power of the Secretary of State, by denying the requirement that exists up to now, to treat unqualified persons as dispensing opticians for the purpose of allowing them to dispense NHS spectacles under the National Health Service. It is an extraordinary provision which, in effect, allows the Government to pretend that people are qualified dispensing opticians when they are not.

When we took the Bill at Committee and Report stages we had considerable discussion about the situation in other countries. My view is that the order is an unnecessary and retrograde step, and this view has been supported by the International Guild of Dispensing Opticians, which at their biennial convention in Toronto on 28th June 1984 passed a resolution deploring the British Government's proposal to permit untrained and unqualified persons to dispense.

The other area of concern is how the order is to be enforced. I hope that the Minister will give some answers to some questions that I want in a moment or two to put to him. In the past, the police have always shown extreme reluctance to prosecute offences under Section 21 of the Opticians Act 1958. The General Optical Council has brought some prosecutions in the past, but it has no statutory duty to do so and its primary duty is to regulate the registered profession. It is difficult to see why the registration fees paid by opticians should be used to pay the prosecution costs of enforcing an order to which the entire optical profession is opposed.

I want to ask some questions about enforcement. Is the responsibility for enforcement to rest with county trading standards officers or with the police? Or will there be any other method of monitoring what is contained in the order? How in practice will they ensure that unqualified persons do not sell cheap spectacle frames made of cellulose nitrate? How will unqualified persons be prevented from selling ready-made spectacles without a prescription from an ophthalmic medical practitioner or ophthalmic optician if they are doing so without a prescription at all? How will they be able to check that this is not being done? How will the requirement that lenses comply with the British Standard tolerances be enforced? How will the Government ensure that unqualified sellers have "verified that the appliance is in accordance with the prescription by means of a focimeter"?

I want the Minister to say how the Government intend this order to be properly and effectively monitored in the interests not only of the profession—which is very proud of its record—but also of the patients whom it serves.

I want to raise two other points before sitting down. I believe that the timing of this order is quite wrong. It permits unqualified persons to start selling spectacles on 10th December 1984. If I may say so, they started to do so long before 10th December 1984. Many of your Lordships will have seen advertisements several weeks before the date on which the order came into effect. I should like to ask whether the Government took any legal action against those who were at that time quite clearly breaking the law. These people are free to advertise themselves subject only to the limited controls applied by the Advertising Standards Authority. I was a little surprised to see a picture of one of our most handsome Ministers—I have to say that he is not a Member of your Lordships' House—Mr. John Patten, who is a health Minister, who is pictured in the Guardian looking very handsome and trying out spectacles which he was buying from Woolworth's. Qualified and registered opticians are, however, still now strictly bound by the General Optical Council Rules on Publicity 1981, which at present restrict opticians from advertising except to the very limited extent permitted by the rules.

I ask your Lordships and the Minister himself—and I think he must give an answer to this—why it is that a special privilege is given to those unqualified people who will be taking on responsibilities now undertaken by qualified people whereas qualified people will not be allowed to advertise their wares. They will be put, for a period of months, at a very severe disadvantage. What is the justification for this? I am sure the Minister must have some reason for this and that he will explain it to us.

Last June the General Optical Council submitted revised publicity rules substantially relaxing the restrictions on advertising. The GOC received no response from the Privy Council until 9th November, when the Privy Council declined to approve the amended rules without some further modifications. As a result, we shall have a position in which qualified ophthalmic and dispensing opticians are still not allowed to advertise and will be faced with unfair competition from unqualified retailers who will be free to advertise without restraint. I submit to your Lordships and to the Minister that this really is a very unfair and a very unsatisfactory situation.

My view is that the order should be completely withdrawn. But, if that is not possible—if the Minister is not prepared to go along with me and if I have not convinced him—then at least the commencement of the order should be postponed until such time as the GOC rules on publicity have been amended, if necessary by a further Order in Council under Section 1(2) of the Health and Social Security Act 1984. Since the Government's aim is to achieve greater competition, the relaxation of the GOC rules on publicity should be the first priority and not the introduction of unqualified sellers, for which there has never been any real public demand.

I hope therefore that, with this series of arguments which I know are sustained by the profession—we know perfectly well also that there has been no demand whatsoever from the public—the actions which will be authorised by this order will not be carried through, and it is for this reason that I seek to secure the annulment of the order.

Moved, That an Humble Address be presented to Her Majesty praying that the Order of Council [1984 S.I. No. 1778], laid before the House on 19th November, be annulled.—(Lord Ennals.)

7.55 p.m.

Lord Cullen of Ashbourne

My Lords, that speech really leaves me with very little to say. I think at last we seem to have some unity in the optical profession and I can only think that the noble Lord, Lord Ennals, has had very similar briefs to the one I had. He practically made my speech. I have just one or two things to say.

For instance, I have tried for the last two years—and I am now very glad to have one or two supporters such as my noble friend Lord Mottistone and the noble Lord. Lord Ennals—to persuade your Lordships that there are dangers in allowing unqualified people to dispense spectacles. It was for that very reason that we had the Opticians Act 1958. It must be a great joy to the noble Lord, Lord Northfield, to see the end of this period, but I have a feeling that the time may come when we see occurring the same abuses that were responsible for the Opticians Act 1958 occurring; that the Government may once again change their mind; and that we may find that it is necessary to have the sort of control and discipline that we have had for the last 25 or 26 years.

As the noble Lord, Lord Ennals, said, what happened was certainly a great disappointment to the international optical profession. It might amuse your Lordships to know that I have made inquiries and I do not believe that there is any other country in the world which has actually introduced a system of training, education, and licensing or regulation, and has afterwards gone backwards and allowed unqualified persons to dispense spectacles. I believe that in the past we have led the world in optics. We now appear to be leading them backwards. I hope that they will not follow our example.

I was very interested in the various points that the noble Lord, Lord Ennals, made about ensuring that the so-called safeguards actually stick. Like him, I really do not see what a person can do if, after somebody carrying a suitcase of spectacles, comes along and raps on his door, and "flogs" him a pair, he finds a day or two afterwards that he gets headaches, that he cannot see properly, and that the spectacles are not properly centred. What does he do? Does he go to the police, or perhaps to the county trading standards officers? Who is going to trace this fellow? What redress is there for the person who has bought the spectacles? This is a new problem which we have not had for 26 years and I just hope that my noble friend Lord Glenarthur will be able to answer these detailed questions that we ask. I shall certainly listen with very great care.

I completely agree that the situation under which unqualified dispensers can advertise while registered opticians still have to be controlled by the General Optical Council seems extraordinary.

What also seems to me to be quite unfair is the fact that the unregistered opticians can now compete in the private sector. They cannot compete in the NHS; that would be quite a different matter. The private sector is quite lucrative. The NHS is a loss-maker. It is a very high volume loss-making business. It would be more reasonable if the unregistered were able to take part in all the business concerned. I see why they are not able to do so. Admittedly under Section 28 there are transitional arrangements so that these unregistered people should be able to do this, but that might not be implemented. I believe it was inserted because there might be a long gap between April 1985 and the time when the new system is introduced where one has a voucher scheme or a grant-in-aid scheme.

It seems that perhaps the reason this is not envisaged by the Government is that they realise that if they allowed the unregistered people into the NHS there would be a great number of complaints. They would not get the same service that they have had in the past, nor would unregistered people have the slightest idea how to fill up forms for getting their reimbursement. There would be all sorts of problems, all of which would come back on the Government; so this will probably never take place.

I do not have much to add, but I should like to finish by saying that if this order goes through people will be tempted to take their prescriptions and have them dispensed by an unqualified person, in pursuit of cheap spectacles. But I fear that many will end up sadder and, I hope, wiser. The effect the order will have on spectacle prices remains to be seen. It is possible that differences of view about that may be expressed in the future.

I should like to have it placed on the record once again that the report of the Director General of Fair Trading found as a fact that opticians' profits had not been excessive in the period 1978 to 1981. Why were they not excessive? Everybody says that the prices of spectacles are unnecessarily high. What happens to the money? Why were not the profits excessive? It seems very surprising. I can tell your Lordships exactly: it is because the NHS work had to be subsidised by private work. That has been going on year after year. The good news is that in April 1985 three-quarters of that work will stop. Opticians will not be subsidising three-quarters of NHS work, and in due course, when the grant in-aid scheme begins, the whole distortion will go. That is when the price of spectacles will fall—not as a result of what we are doing today. When we get rid of the distortion which has wrecked the market for opticians for years and years, then we shall get into a normal trading pattern.

I am pleased to support the noble Lord, Lord Ennals, in his wish to annul this order. I do not suppose for a moment that the Government will agree. But it would be excellent if it were at least held up until the advertising rules for both sections could come together.

The last thing I want to say is that at the end of the day it is the public who will judge the matter. I doubt whether new entrants to the opticial scene who provide an inferior service will survive very long in the highly competitive optical market in the future. It will not be a case only of caveat emptor (which is how I think the Government regard the matter) for the purchasers of spectacles, but a case of caveat vendor for the suppliers of optical services.

8.5 p.m.

Lord Rugby

My Lords, I must confess that the wording of the order is somewhat obscure to me because I am not very good at being able to interpret these documents. I feel that if it had been in clearer English I might have been better able to do so. I understand that, as the noble Lord, Lord Ennals, has said, no particular training is needed to sell complicated lenses provided that a prescription is available. I presume that the prescription has been made out by a qualified optician and that it will be made up by one of the optical manufacturers' houses or association. Consequently, the only check that is needed to ensure that a prescription is correct is a focimeter. In that respect the person selling the glasses needs merely to check that they conform with the prescription. On the other hand, I am not sure about reading glasses. I hope that the noble Lord will advise me about what is happening there, and how differently they are being treated, because I am not entirely clear about that in my own mind.

As everybody knows, my campaign has always been for a freedom of choice in reading glasses. The battle was joined in 1958 when the noble Lord, Lord Northfield, and Mr. Norman Pannell nearly succeeded in having that Bill overturned in another place because they were prepared to accept and to understand that this was a trade war. It was a war about who should market these simple magnifying spectacles, and whether the job should stay in the hands of Woolworth's, which had done a quite superb job, as everybody who remembers the Woolworth counter will acknowledge. But at the end of the day the opticians managed to have that overturned because they brought into both Houses the idea that if people were allowed to buy their glasses there they were in danger of going blind. These statements, which were extremely exaggerated, were accepted. The Bill was pushed through rather quickly, and I believe we have been suffering ever since.

The victims of this war have been the elderly, because the correlation between magnification and age can be drawn with precision on a chart. Virtually all normal, healthy eyes will conform with that chart. It is two parallel lines going together, magnification going up with age. Indeed. I have frequently been asked my age so that reading glasses could be sent to me, and according to my age these reading glasses have arrived and have suited me to perfection. In other words, in presbyopia age is one's prescription; and, vice versa, the prescription gives a good idea of age.

I remind noble Lords that our gracious Sovereign the Queen used magnifying glasses to read her speech from the Throne. I am sure that she was offered a choice of which magnification would be the most comfortable for her in relation to the distance from her eyes at which she wished to hold her speech. If such a choice of glasses is made available to the Queen, then what is right for her is correct for her subjects.

But we do not use magnification only for reading: we use it for a whole variety of purposes. I do not see how we must always have a prescription for the various purposes for which we use magnification. Reading is just one, but I need magnification for various purposes. I asked my noble friend Lord Halsbury how he used it, and apparently he does some very intricate petit point work. For that he needs a higher magnification. I cannot see why that should have to be obtained on a prescription. Indeed, magnification is an abstract concept. How is it possible to make a law which will put magnification on ration and allow it to be obtained only by means of a chit signed by an optician?

Through the years that we have had this Act, it has been necessary for opticians to state that presbyopia is an illness and to refer to presbyopes as patients. I am a presbyope and one thing that I definitely am not is a patient. I decide what magnification I need and for what purpose. That is my right and I stick with it. Furthermore, presbyopia is part of the total body undergoing its natural changes through age throughout our life. That is now accepted by the courts. In a recent judgment, the prosecuting witness, who was an ophthalmologist, refused to be drawn into saying that it was a defect of eyesight. It is also necessary for the General Optical Council to state that presbyopic lenses are not magnifying glasses.

In this way, they can win court cases by getting expert witnesses to make statements to the court upholding this edict. Nevertheless, they registered with the Office of Fair Trading under the Registered Trade Practices Act. I quote from a letter of 9th January, 1981, from the Association of Optical Practitioners, referring to the Restrictive Trade Practices Act. It states: A registered optician should not accept for re-glazing with prescription lenses any appliance which was not originally supplied as an optical appliance within the meaning of Section 30 of the Opticians Act. Thus, in the case of 'magnifying spectacles' in the form of twin lenses of identical power, these should only be accepted for re-glazing to a new prescription if the original lenses [i.e. magnifying lenses] were supplied to a prescription.". I believe that if the present restriction on magnifiers is to succeed, it must be something which must be registered with the Office of Fair Trading and therefore he open to challenge under that Act.

In looking at these various restrictions at present registered at the Offices of Fair Trading, I feel that some are really quite disturbing. I should like to mention just one. It refers to coal miners. Apparently nobody had set about providing coal miners with proper protective glasses when working at the coal face, and such protective glasses as they had were "bashed into their eyes" frequently by falling coal or when hit by jagged rock and so forth. Apparently opticians had these experiences described to them. The upshot was that it was decided that no miner would be allowed to have an optical appliance which was suitable for working in the coal mines unless he had first bought ordinary glasses from the optician and had a prescription from him for those glasses. He had first to get normal glasses in order to prove that he was entitled to wear protective ones underground. Then, on top of that, if the protective pair was one year old, he would then have to go through the whole rigmarole a second time and pay again.

Industrial safety wear in spectacles and its usage is totally overlooked today in the pursuit of these fat profits which can be claimed in the High Street with this monopoly. I should like to ask why it is that in an industrial nation where there is such enormous wear and tear and where so much depends on having proper safety wear, the General Opticial Council, who is responsible and has been charged with these things, has never offered anything in the way of a prize for good designs. We have plently of good designers in this country. They do not have to be opticians. In my opinion, it is absolutely imperative that if we are now to have a proper optical service in this country our best designers should be put to the task of seeing that people who work in industry get the very best protective wear to enable them to perform most efficiently.

Tomorrow I am joining a party to meet the members who have just arrived from the Soviet Republic. When I see them, I shall be asking them what they are now doing in Russia for eyesight. What I am particularly interested in is that they now have an absolutely superb 100 per cent. reliable operation by which astigmats (people with a slight aberration of the eye) can undergo a quick, cheap operation, which, as I say, is 100 per cent. certain, after which they can throw their spectacles away. While we have this Opticians Act which restricts everything, I do not believe that we are going to be in the happy position of the members of the Soviet Republic who can have the operation and can throw these wretched things away and be much more efficient as a result. I sincerely hope that if this law is to he put into effect the Privy Council will see to it that it is no longer used in any kind of partisan way in a trade war, and that people who are over 50, or elderly people, will not have to suffer inconvenience and distress as the result of the restrictions which arc placed upon presbyopic glasses.

8.17 p.m.

Lord Mottistone

My Lords, it is a privilege to follow the noble Lord, Lord Rugby, who has been a pioneer in this campaign. I was not quite sure whether he was pleased with the order that we are debating or whether he thought that it was not good enough. But I do not think that he gave himself enough credit for having been the consistent pusher-forward of this viewpoint. As your Lordships know, I do not agree with it at all, but I still admire greatly somebody who over the years through your Lordships' splendid Chamber can get things changed—whether they will be changed for the better is another matter altogether. I am grateful, as I think we should all he grateful, to the noble Lord, Lord Ennals, for praying against this order. It certainly needed an airing.

I do not think that the order is right in any sense at all, in that the sort of safeguards which I think the public require and would like to have have not been adequately dealt with. The noble Lord, Lord Ennals, in a powerful speech made all the points regarding where the order is inadequate in regard to safeguarding the public; and I shall not repeat what he had to say. I think the most important thing he said was that there was no real public demand for this change. There was a demand from the noble Lord, Lord Rugby, a demand from the noble Lord, Lord Northfield, a demand from my noble friend Lord Orr-Ewing, a demand from one or two highly intellectual people who I know personally in the country; but there was no great demand from everybody in general.

I think that in their various ways everybody, though they might have had to pay a little more for their specs than they might if they bought them when they went on holiday abroad, accepted this as being a reasonable sort of thing in the modern world. I am always slightly suspicious of changes which are brought about by earnest do-gooders such as the noble Lords I have just mentioned, rather than changes which come from the grass roots of the public. I think that this is an example of where we have been rather pressed into it by the earnest do-gooders, rather than encouraged by the broad mass of the people.

The noble Lord, Lord Rugby, talked about the elderly people suffering. I have not noticed that the elderly people suffer. I am only a year away from being an old age pensioner myself, but I have not really suffered from the present arrangements. I have been able to get my specs at different times and at the right sorts of intervals. I shall not bore your Lordships with my comparisons with the cost of whisky, but the sorts of prices I have been paying for my specs seem to me to he reasonable in the modern world; and so I think perhaps the Government were pressured into making changes that were not necessary.

I think that the order has the kind of defects that the noble Lord, Lord Ennals, told us about, and it is very important for the whole position to be reviewed as early as practicable. I suppose that that is of the order of two years' time—and it will probably be longer than that, which is a great pity because there are gaps in it.

The real problem is that it is all very well for what you may call the average person. The noble Lord, Lord Rugby, told us—and I agree with him—that with an awful lot of people the prescription relates to their age. I am sure that that is true. My technical advisers have never said they agree with that, but in my own experience I think it is right. However, I am one of the lucky possibly 80 per cent. of the population who are like that. Unfortunately, I am not at all sure whether the other 20 per cent. are going to be as well safeguarded under this new order as they were before. The great question is: is it fair on them to make these changes if they are not going to have the kind of safeguards that they have not only become accustomed to, but which in the modern world they ought, naturally, to expect? As was said by, I think, the noble Lord, Lord Ennals—or was it my noble friend Lord Cullen?—other countries have moved towards the sort of system that we have had, and have not gone backwards. We seem to have gone backwards, and I am not sure that this is a sound move at all.

In principle, let us see how it works out. What the Government must do—and I hope that my noble friend Lord Glenarthur will reassure us on this point—is keep a very sharp eye open to see whether people who are not strictly following the normal pattern which the noble Lord, Lord Rugby, talks about are in fact going to be disadvantaged in the sort of ways that the noble Lord, Lord Ennals, put before us. I think the Government might be in very grave dereliction of their duties if they do not make quite certain that they have not overdone it with this order that we have before us.

Finally, I am terribly sad that I am speaking before the noble Lord, Lord Northfield, because while listening to other noble Lords during the debate I was fascinated to see him changing his specs as he looked at things. One pair has a price tag on them and the others have not, and I am longing to hear what this signifies. I am sure he will tell us. But I am sad that I am not able to speak after him, so that I can pull his leg about the absurdity of his spectacle changes, which are clearly designed to impress your Lordships with his particular viewpoint, which is unique to him and to the other do-gooders of whom I am highly suspicious.

8.25 p.m.

Lord Northfield

My Lords, I shall resist the temptation to fight old battles and go over old ground. We are not here debating the principle of this matter, which was decided in the Act of Parliament. We are talking about the machinery for implementing it, and I do not really want to go over the whole of that old debate again. I would, however, just comment on three points which have been made by my noble friend Lord Ennals and echoed by other speakers.

First, with respect, I think he is quite wrong to say that there has been no public pressure for this change. Goodness me! I have seen press letters, and people have come up to me all over the place, saying, "I am extremely suspicious of the high price of spectacles". Indeed, in your Lordships' House people come up to you in the corridor and say such things as, "I was delighted to see your speech. How much do you think I paid for these wretched things?" My noble friend must be going about blind and deaf if he has not had any of this public pressure put on him. I am also surprised, on that same point, that he thinks an average of £35 is reasonable. My goodness me!,Spectacles ought to be a good deal cheaper than £35 average, and I shall give some prices a little later on—

Lord Ennals

My Lords, I am grateful to my noble friend for giving way. Does he not realise that Members of your Lordships' House are so kind and so generous that of course they say nice things to him about his speeches? They actually say nice things to me about my speeches, and no doubt that applies to others as well.

Lord Northfield

My Lords, perhaps it is the case slightly less often on this issue, but the fact is that everybody is complaining about the high prices of spectacles and is saying that it is about time there was some competition in order to bring down the prices.

Secondly, I want to comment on what my noble friend said about people being plagued by door-to-door sellers. This is the sort of exaggeration that does not do his case any good. Even under the Act and under this order it will be necessary for prescriptions to be produced and for spectacles to be made up to conform with quite minute differences between the lenses. That is not something that somebody will be able to do on the doorstep. It does not really do any good to the case to exaggerate it in that respect.

My third comment is that I would agree with him, however, about lack of consultation. This is becoming rather a habit with the Government and we are just seeing it again on pharmaceutical prices, about which I shall be saying something on a future date. I really do deplore it. It is not right that large parts of industry and the professions should be treated in a cavalier fashion, particularly when there are details to be settled. If it is true, for example, that a letter which was sent on 23 rd August was not acknowledged until 9th November, with the order in the same post, that really is quite monstrous. I do not think it is the right way to convince us all that this is being done in the most diplomatic fashion possible.

One last point, before I move on to what I want to say about reading spectacles, is that I think we really must accept the division between the two sides on this matter. A lot of us have believed for a long time that the selling of spectacles is a matter that is stranded somewhere between a professional activity and a commercial selling activity. Of course we do not believe that everything in the garden is going to be wonderful now that we have got a change, because there are advantages and disadvantages both ways; but we feel that the advantages competition will bring will outweigh the disadvantages that can be laid at the door of the Act and of this order. It will need more consumer vigilance. People will be in some difficulties, I have no doubt, from time to time and perhaps they will not have the state behind them, as they have had so far, in protecting standards. But I do not regard it as a terribly bad thing. Consumer vigilance has risen to the occasion before and, in doing this, it forces the pace of competition, which should, on balance, result in benefit for the consumer in a situation where, as I say, I have never believed that right is all on one side. But I believe that the balance of right is on the side of more competition in this case.

I now move on to the point about reading spectacles, and I shall be brief. I wanted to make sure that this order will give some chance for cheap spectacles to be put on sale and freely bought. Therefore, in answer to Lord Mottistone's leg-pull, I must say that today I bought a pair of reading spectacles, which I have got on now and which cost me £9.75. They are perfectly good spectacles, with a 3-dioptre correction, which happens to be quite right for me. The point I want to make about the spectacles concerns how I got them, and then I shall move on to the issue that arises under this order.

I got them from a shop in Victoria which is newly opened and which is called The Glass House, where a very enterprising young doctor has set himself up in business with assistants. Under the Act he is able to say that as he is a qualified medical practitioner, he can sell anything to people who call. That is quite clear in the legislation. He is selling, among other things, at £9.75, these reading spectacles which I am wearing. The way I bought them was quite simple. I went into the shop and said, "I have broken my other glasses"—and I had. I had had to wait for a week for them to be repaired, and I had suffered for a week with an old pair; and so, to provide for the future, I said I wanted a spare pair.

The man said, "My assistant will attend to you"—though he supervised him. "We can either make up a pair for you here, which we will do in 24 hours and the price of which will be from £19.75"—not £35, I would say to my noble friend—"or, if your eyes are very similar, in need of correction, you could probably do well with these cheap spectacles at £9.75". He then checked my spectacles, my reading glasses, and said that my correction was about three dioptres and my eyes were very similar, and he asked me to try this pair to see how I got on. I tried them, they were perfectly adequate, and I walked out of the shop 10 minutes later perfectly satisfied with the spectacles at £9.75.

This young man is very enterprising, and he is "getting away with it" (I use those words in inverted commas) because he can under the law. He is a registered medical practitioner. What will happen under this order about the sale of spectacles of this type? I wish to say a few words about that. First, let me say how enterprising I found this shop and let me answer some of the points which my noble friend raised. Look at what competition is already doing in relation to what this shop is providing. It is offering in all its work—not just with these glasses but with the ones for prescription as well—a full guarantee for 12 months; it is offering free tests for glaucoma—it is not going to pretend that that risk does not exist—it is offering free minor repairs and adjustments; it is offering a 15 per cent. discount on extra pairs bought to the same prescription and bought within 12 months. That is only a beginning. Competition will get going. There will be other benefits from competition as it progresses. These are just the first in the field.

In addition, the shop provided me with two very good papers which in simple layman's terms take all the mysticism and pseudo-professionalism—and I mean "pseudo-professionalism", my Lords—away from part of what opticians tell us. The papers tell me in simple language what eyes are, what goes wrong with them, what corrections are normally needed, and how to set about it. That is a sensible way to behave towards adult citizens. This gives me the chance to understand the subject without all the mysticism.

The papers then explain the treatment. In addition, having provided all these commercial benefits, they set out a clear price list. They say, "This is the price for a frame and here are the extras". So much is charged for tinting, so much for extra large lenses, and so on, all in the £5 and £10 range. There is a £21 range for something really fancy at extra cost. But when you go in the shop, when you stand there, you can choose your price, add it all up and you know where you are. I should have thought that that is an immense step forward for the consumer in spectacle buying.

Lord Winstanley

My Lords, I am most interested to hear about this person's admirable commercial enterprise. The noble Lord tells us that this person is a registered medical practitioner. I wonder whether he would care to hazard a guess at how long he will remain a registered medical practitioner if he continues to engage in commercial activities of that kind and in that particular way. I ask that question without making any comment on the advisability of his doing it or otherwise.

Lord Northfield

My Lords, I have no idea, and it is not my business. If he wants to take the risk of doing this in providing a commercial service, blooming good luck to him is all I can say. A very good precedent is being set by this first step into a competitive situation by the young people who are doing this job very well in Victoria. I congratulate them wholeheartedly.

What happens under the order in regard to spectacles of" this type at £9.70, which I want to see more widely sold to people who do not need to pay such high prices for spare pairs and who need them for small corrections, requiring only 1, 2 or 3 dioptre corrections in their reading spectacles? What the order seems to say is that for those who just require corrections for short sight—I believe it is called "near sight"—all that is necessary is that the appliance as sold should be in accordance with a written prescription, with the lenses and frames following the British Standard specification. First, is that correct? Can these type of spectacles be sold so that if somebody goes in for an eye test the person selling can say, "Look, we have done an eye test. You have got your prescription. Your eyes are nearly identical. You should try, if you want to save money, these cheap ones first and if they are not suitable, we will make some up for you at a much higher price"? All that has to be proved, I understand, in those circumstances is that the spectacles conform to British standards in the lens and in the frame.

One more point arises. Paragraph (4) at the foot of page 3 of the order says that the appliance shall have certain tolerances. In other words, the spectacles sold by the seller need not be absolutely accurate to what is in the prescription. There are certain tolerances. This is very important for the spectacles. My eyes are not totally identical. There is some fraction of a dioptre difference in need of correction. But the man assured me when he sold the spectacles to me that I was within the tolerance that is provided by law. I wish to be clear that those tolerances are set, and will be set in the future, in a way that enables people who sell spectacles to say, "you need not be frightened of this standard article because it does not quite fit your prescription. This is a matter for you to decide and there are tolerances in the British standard which will allow you quite freely to buy this and know that it is accepted under the British standards system". What we do not want—I made this point in an earlier debate on the Bill—is to find that the spectacles are suddenly made available but are then frozen off the market because everybody has to have a pair of spectacles delivered to them exactly to their prescription. There must be certain tolerances which will then enable this market to grow and to influence the remainder of the market.

I do not wish to go on any longer. I hope we will accept that this is the beginning of a system. I look forward to seeing the unregistered practitioner setting up. The way the trail is being blazed by these young people at Victoria—I know of another place as well—will lead to the sort of price that I paid for these spectacles today being a standard to which others will be brought down. This same shop is providing spectacles from £19.75 upwards, fully glazed, complete and guaranteed for 12 months. That is the kind of price at which we should be aiming—not £35, with due respect to my noble friend, nor the £70 or £80 which many noble Lords say they have paid for the spectacles that they wave at me in the corridors of your Lordships' House. That is what the Act is about. That is what this order is about. I want to be assured that it helps these cheap spectacles to be as readily saleable as possible.

Lord Mottistone

My Lords, before the noble Lord sits down, will he tell us the price of the other spectacles which he was trying on before, including the ones with something on them which looked like a price tag? Could he explain those too?

Lord Northfield

My Lords, I would be wasting your Lordships' time. These are ones I had on prescription. I do not know the price because they came in a package but I remember the cheque I wrote was for £69.

Lord Mottistone

My Lords, what about the other spectacles?

8.38 p.m.

Lord Orr-Ewing

My Lords, the noble Lord has already told us in his speech. He said that they were £9.75.

I regret that Statutory Instrument No. 1778 does not go rather further. I think that it might have been a little bolder. After 28 years of a restrictive monopoly which, so far as I know, has kept spectacle prices in this country higher than in any other country in the world, I think a little more freedom would have been desirable. A freer market such as that existing in the United States, in Canada and in the Far East should have been permitted. The opticians' interests—they have been quoted to us, particularly the retail interests—have been fighting like tigers. They are entitled to. They have had 25 years of this monopoly. They have done a good job by and large but they have, as a result of the lack of competition, kept prices high and their profits have not been too bad either.

I am encouraged by the Government publication which I came across today. It is entitled Sale of Optical Appliances. For those outside this House, it costs 60p and was issued in November 1984. It states in paragraph 4: Retailers can now sell the normal range of complete spectacles, frames and lenses. They can also glaze an empty frame or reglaze a customer's existing frame, or fit the customer's existing lenses into a new frame, or sell empty frames". That is a measure of extra freedom—but, of course, the customer needs a prescription. I hope the public understand that when they do have their eyes tested, they are entitled to take away—free—a copy of their prescription. There are black sheep in every industry and there are now those people who are demanding, so I am informed, £5 before providing a copy of a prescription. This is a mischarge and I hope the public will not be deceived.

I am a little worried that the amount of freedom depends on balanced eyes. There must, therefore, be an incentive to the less scrupulous to find a minor difference between the two eyes of, say, one quarter of a dioptre or even a little more. I hope the public understand that the eyes are extremely flexible and that that sort of correction can be taken up. If there is a minor difference of that order between the two eyes, it is not essential to ask for special spectacles, which will take a long time to prepare and cost vastly more. But that incentive does exist and some opticians may take advantage of it and try to sell spectacles that cost between £50 and £100 by exaggerating the difference between the patient's eyes.

I am alarmed by press reports that NHS glasses will go off the market. They are of course going to be free for children and for those in the low income groups, and there is no reason why registered opticians should not continue to sell NHS glasses and lenses—although the subsidy which, according to the type of lens, averages £5—will go.

An article in The Times on 10th December set out the facts about current prices. This is probably where the noble Lord, Lord Ennals, got his figures. The article stated that in 1983 the average price of NHS spectacles—the subsidised price—was £16.38, and the average price of private spectacles was £56.39. The noble Lord's average of £35 is between those two figures. I am sure that if we could achieve even that measure of freedom—which does not actually match my needs or desires—it will mean that that cost of £56 will fall nearer to the average price of NHS glasses. There may therefore be no demand for NHS glasses, because the private sector will provide better designs and more choice at a comparable price.

I hope that we shall not see any inhibitions about the importing of spectacles or lenses—particularly from the EEC. If such a measure of restriction was imposed, we should find ourselves in direct disobedience to EEC standards, and the Commissioners would look into any such restriction. I hope that the Federation of Optical Corporate Bodies will not discourage EEC imports, because they will add to the choice that their customers and clients can have. I myself have confidence that, when this competition is allowed, the United Kingdom industry will be able to match both the designs and the quality of spectacles from overseas. I am sure this will be for the betterment of all those who have to wear spectacles.

I am sad in a way that more freedom was not given. I believe that this measure should have gone further. I recognise that there will need to be some supervision—and perhaps my noble friend Lord Glenarthur will deal with this point when he comes to wind up—and a decision as to whether such supervision will be undertaken by trading standards officers or by the Office of Fair Trading. I believe also that there is a readiness to revise. We shall learn as we go along. I do not believe that all the bogeys set up by my noble friends and by the noble Lord, Lord Ennals, will actually come to exist. There is a measure of freedom, and, if the bogeys are shown to exist, then we can think again and undertake some revision. But I am sure that the benefits will be very considerable, and it is only right that we in this country should have the advantages which so many overseas purchasers already enjoy in their own countries.

8.45 p.m.

Lord Kilmarnock

My Lords, we on these Benches are not opposed to the general principles behind this order, although I must say that I agree with the points made by the noble Lords, Lord Ennals and Lord Northfield, about the lack of consultation being all too typical of the Government's way of proceeding—not only in this field but in many others. This said, we do not object to the breaking of the opticians' monopoly. Our objection to monopolies is fundamental to our political philosophy. The noble Lord, Lord Northfield, has put our minds at rest on the question of the so-called unqualified dispensing which worried a number of people (myself included) when we had the Health and Social Security Bill in this House. The noble Lord then made a very interesting speech when he described how most prescriptions are actually made up by large commercial houses. I personally was grateful to him for that explanation.

As regards advertising, we are not opposed to it, but I would put to the noble Lord, Lord Glenarthur, the same question asked by the noble Lords, Lord Northfield and Lord Cullen: is it fair to permit advertising from 10th December while the members of the General Optical Council are still bound by their existing rules on publicity? Would it not have been fairer to suspend commencement until such time as the GOC rules have been amended to bring them in line with everyone else? If we are to have competition then, in the interests of consumers, should it not be full and free competition?

I was glad to learn that under the terms of the order non-registered opticians will not be allowed to sell an appliance either to registered partially sighted or blind people. However, I am slightly puzzled by the wording of paragraph 2(b)(i) where it states that this requirement does not apply where, the seller of the appliance does not know, and has no reason to suspect, that it is for a person so registered". I find that statement rather puzzling and wonder whether the noble Lord can explain what weight can be attached to those words.

I turn to my two serious reservations. They are the same as those that I advanced during the passage of the Bill. They do not affect the liberalisation of the supply of spectacles but they do affect the cover provided by the NHS. This is to be severely curtailed and is to be limited to children and those receiving supplementary benefit. We believe there are many elderly people (perhaps only just above the supplementary benefit level) who will be adversely affected—particularly if they require costly prescriptions. That is to say, we are not so concerned about the method of dispensing as about the financial effect on the poor. We hope that the Government are correct in forecasting a general lowering of prices; but we believe it would have been preferable to keep the GOS cover in position for the elderly—at least until we know how liberalisation is working. I wonder whether the noble Lord would care to comment on that point?

I know that these provisions are not to be put into effect until 1st April and are not the subject of this order—but this is perhaps the last opportunity we shall have to raise this matter in advance of the next regulations. So I want to ask the noble Lord: will the Government think again about this aspect? I repeat, we are not attacking the principle of this order but asking that the umbrella covering a certain section of the population should not suddenly be rolled up.

There is the related point concerning complex prescriptions. We understand that the position of the General Ophthalmic Service will be that people now subsidised by £15 or more—that is to say, those who do need complex glasses—will still be able to obtain them through the General Ophthalmic Service but at full economic cost. This means that some people who are not at all well off will lose subsidies which, on the Government's own figures, range up to £40. We feel that this type of prescription should have been protected from the bracing winds of the market. After all, some people of very limited means may need two or three changes of spectacles within a year or 18 months—for example, after a cataract operation. Will the Government think again about that aspect?

Finally, there is the question of the hospital eye service, which is very important to those with the poorest sight. Mr. Kenneth Clarke, the Minister of Health, has said that the same financial arrangements will apply in the hospital eye service as in the General Ophthalmic Service. He wrote to the Director-General of the Royal National Institute for the Blind on 29th June 1984: in the interests of consistency and equity we shall be ensuring that HES patients with a similar optical need to former GOS patients are treated financially in a similar manner.". I think the noble Lord, Lord Ennals, referred to this aspect. Therefore, it would appear that the Government's intention is to stop hospital eye service patients getting subsidies which are not available to general ophthalmic service customers.

I wonder whether the noble Lord can clear up the position here. Will the NHS-based provision be as limited as in the GOS, or will there be different provisions? Is there to be a maximum charge for the most specialised items not supplied by the GOS? Will he clarify the Government's plans and say how far they have progressed in working them out? I make no apology for raising these matters because I do not see how we can raise them again before the subsequent set of orders comes before your Lordships' House.

To sum up, we are not supporting the annulment of the order but we are seriously concerned about the effect of the regulations that will follow. I want to put this on record now because if we wait until those regulations are laid it will be too late to have any effect on them.

8.51 p.m.

Lord Glenarthur

My Lords, we have had another stimulating debate on this issue, albeit, perhaps, rather shorter than the standard we set ourselves during the long hot summer. Those days, when we last debated the issue of whether or not to allow unregistered retailers into the optical market to sell spectacles, seem only yesterday, but your Lordships will recall the lengthy debates on the Health and Social Security Bill. At that time I informed the House that under the enacted legislation we would prepare an order after having consulted with consumer, optical, medical, commercial and other interests. The Sale of Optical Appliances Order of Council 1984, which is before your Lordships today, is the result of the balance we struck following all the views we received during that consultation process.

A number of your Lordships have raised this question of consultation. As promised in those debates on the Bill, we consulted widely on the content of the order. A large number of views were expressed. We considered those views carefully and reached our judgment on the necessary balance to be struck between the various arguments that were put to us. Because of the very clear expression of views already received in both the consultation exercise and the normal course of business since announcing our proposals last year, it was not felt necessary to consult further with the various groups which had expressed an interest.

I can perhaps develop this a little further this evening without pursuing in detail the discussions over the GOG's publicity rules. I suggest that the criticism levelled at the Government over the time taken to convey their views to the GOC on its latest revised rules serves to deflect attention away from what is the real issue. The OFT report was published in December 1982. The Director-General made perfectly clear his views that the publicity restrictions imposed by the GOC on opticians resulted in prices being significantly higher and efficiency significantly lower than they would otherwise be. I suggest that that report was warning number one to the profession. Warning number two came with our announcement almost a year later of our policy initiative on this issue. Warning number three was the presentation to Parliament of the Health and Social Security Bill last November. Despite these warnings the COG has not felt able to meet the Government's desire to allow the use of an acceptable degree of advertising by the profession.

All along the way the Government have been seeking to persuade rather than to compel. For that reason there was need to study the GOC's revised publicity rules, carefully seeking also the opinions of other Government departments, and to take legal advice before replying to the GOC. This all took time, I know, but we had to get it right in the end. May I assure your Lordships that there was no Machiavellian or other plot conspired in by Ministers or anyone else to synchronise the arrival of the Privy Council's letter at the GOC with the laying of the order which we are debating tonight—absolutely not.

On the question of delays in acknowledgement, which was raised by a number of noble Lords, I think the noble Lord, Lord Ennals, will be aware that the volume of correspondence in the department is huge. If there was delay in acknowledging a letter, I can only apologise and explain that during and after the passage of the Bill we were assailed by a vast amount of additional correspondence which put some strain on our resources. I am sure that the noble Lord will accept that in a department where Ministers alone are signing about 30,000 letters a year, with a further 80,000 signed by officials, there is a considerable burden. It was certainly the intention to acknowledge each reply to the consultation letter, but I accept that at least one acknowledgement was overlooked. If the criticism is that the particular organisation did not receive a detailed commentary on its response, I must say that there has to be an end to the consultation process, finally. Our response in this case was to prepare the necessary order that we are now debating.

Perhaps I should now give an outline of what the order aims to achieve, although much of the ground has been covered earlier. It is based on the firm and expert opinion of both the British Medical Association and the Faculty of Ophthalmologists—and it cannot be stressed often enough—that incorrectly dispensed glasses cannot damage adult eyes. It is also a fact that most people will know when their glasses are not right in some way, and they can take them back. Furthermore, the Faculty of Ophthalmologists has advised us that it has been unable to find any evidence of inaccurate dispensing of spectacles causing actual damage to health or sight of the adult. This assurance allows us to open up the present monopoly with total confidence.

Notwithstanding this, our objective, as we have always made clear, is to provide for the sale of safe and serviceable glasses. The order achieves this by regulating what may be sold rather than by controlling who may sell spectacles. We have not permitted the unregistered to sell contact lenses, low vision aids or spectacles to children under 16 years old. We have also excluded the registered visually handicapped. The order does not permit dangerous materials to be used in the manufacture of frames or lenses. All spectacles must conform to a written prescription completed by a registered ophthalmic optician or doctor, and it must not be more than two years old when it is presented by a customer. British standards will govern conformity to the prescription and also the glazing of lenses. For spectacles other than prescribed simple reading glasses, we have chosen to add conditions governing lens centration, their checking by focimeter and, where prescribed, the checking and adjusting of the back vertex distances. All these conditions will form part of the contract between the buyer and the seller.

I come now to some of the points raised in the debate. The noble Lord, Lord Ennals, spoke about the lack of training that would exist under the terms of what is now proposed. We said from the outset that our objective is to control what is sold rather than who may sell it, as I said a moment ago. We have not de-registered opticians. They may still pursue professional excellence and, indeed, professional registration. We have given individuals the freedom to choose between the registered and the unregistered supplier. We do not believe that this will lower overall standards, as the noble Lord fears. Indeed, open competition is much more likely to stimulate and enhance quality and standards—a view expressed by the noble Lord, Lord Northfield. I doubt whether, as the noble Lord, Lord Ennals, suggested, many butchers, bakers, candlestick makers or what have you will enter the market. If they do, it will be with the objective of attracting and obtaining business. To do that, they will have to offer the services that satisfy the customer. It is that which is the final test of whether or not a patient is happy with the end product.

Other points raised by the noble Lord, Lord Ennals, were the keeping of records and operating from permanent places of business. Both those points are concerned with consumer protection rather than with any special optical considerations. Indeed, those specific issues were not put to us by the national consumer representatives, with whom we also consulted. We do not feel that consumers need such undue protection, as they are quite capable of reaching their own decisions on where they believe they will get value for money, as they do for all sorts of other things.

On the question of mail order spectacles, again all spectacles must accord with a written prescription. All spectacles will have to meet the British standards laid down in the order in respect of glazing and conformity with prescription. It is quite feasible for mail order agencies to develop customer services to provide for the simple reading glasses defined in the order. However, for the more complicated prescriptions, the order lays down the requirements for the taking of measurements in respect of optical centration and back vertex distances, and I should have thought that mail order agents would have difficulty in meeting these particular obligations.

On the question of industrial safety spectacles, which the noble Lord raised, and which I think was raised also by another of your Lordships, the supply of industrial safety spectacles is already governed by the Protection of Eyes Regulations 1974; and under the Health and Safety at Work Act 1974 employers have a general responsibility towards their employees, and rightly so. We consulted the Health and Safety Executive on this point. Their view was that they saw no need to make industrial safety spectacles a special case. The responsibility is with the employer and this is where it should be.

The noble Lord, Lord Rugby, raised a question of design. I am sure that that is a valid point. Perhaps it is something that those who make these things will note. I certainly take the point he made.

On the more general point about the provision of ready made glasses, I perhaps should emphasise one or two things. The order does not seek to prevent the sale of ready made spectacles. They can be supplied provided—and it is an important point—they are in accordance with a written prescription produced by the customer which—and here I quote from Article 3(2)(a) of the order—

  1. "(i) has been given by a registered medical practitioner or registered ophthalmic optician following a testing of sight by him, and
  2. (ii) bears a date not more than two years before the day on which it is presented to the seller for the purposes of the sale".
This will allow a retailer to keep stocks of ready made spectacles but he can only supply them to a customer if they meet the requirements of a recent prescription given to him by that particular customer. If the retailer does not happen to have ready made frames containing lenses of the required strength, he will obviously not be able to supply them immediately. The customer can then either order them or go elsewhere. If a customer does not have a prescription he cannot be supplied. That is a fact.

The order does not permit unrestricted self-selection. A customer cannot walk in off the street, as some might think he will be able to, without a prescription, and rummage through a box of glasses and buy any that happen to take his particular fancy.

Lord Winstanley

My Lords, may I interrupt the noble Lord for a moment? The noble Lord explained to the House that these glasses can be supplied provided they are in accordance with the prescription. Could the noble Lord define a bit more clearly "in accordance with" there? To what extent is there a tolerance? Do they have to be precisely in accordance with or is there an element of tolerance? Can the noble Lord come to that point?

Lord Glenarthur

My Lords, I shall certainly come to it. If the noble Lord will bear with me for a moment, I am in fact going to deal with tolerances and how that affects what he is concerned about in due course. To sum up the point that I was really making to do with this particular matter of ready made spectacles, ready made spectacles are not illegal if they are supplied to meet a recent prescription. I shall develop the theme of tolerances in a moment.

The noble Lord, Lord Northfield, powerfully made the point about relaxation of requirements for reading glasses. As he and others will be aware, we consulted widely on the order. Consumer interests persuaded us that our requirements for a focimeter and that kind of thing might well discourage retailers from entering the market when all they were proposing to stock were simple reading glasses. The requirements regarding centration and back vertex distance are far from critical for such simple appliances, as the noble Lord so elegently put it. Indeed professional opinion is agreed that the latter is hardly relevant for glasses up to 5 dioptres in strength. Checking the glasses with a focimeter is not very relevant, either, to glasses of this nature, where the lenses have mostly been cut to shape and even glazed to the frame in the factory. In any case, patient satisfaction with them is the main criterion. It goes back to the point that I made earlier. Having said that, it will still be a legal requirement for them to accord with a prescription.

The noble Lord, Lord Kilmarnock, raised the question of the blind and the partially sighted. It is a difficult area in which to legislate. It needs a consultant ophthalmologist to make decisions on whether or not someone is blind or partially sighted enough to be registered. I think it would have been a nonsense to put on to shopkeepers the responsibility of deciding whether or not someone was in this particular category. We have therefore made the test one which is reasonable for a shopkeeper to apply. However, if, for whatever reason, a registered person gives a misleading reply, it cannot be reasonable for the shopkeeper to be prosecuted for supplying glasses in such circumstances. I am sure that the noble Lord, Lord Kilmarnock, will accept that. Hence, the order provides that sales in these circumstances are not illegal.

Of course I appreciate that many visually handicapped people decide not to apply for registration, even though this brings them advantages. But they are responsible people and it is their right to choose as they will. If, despite advice to the contrary, visually handicapped people decide to patronise unregistered traders, they must be free to make that choice.

On the issue of the opticians' publicity rules, to which both the noble Lord, Lord Ennals, and my noble friend Lord Cullen referred, I think I covered this in sufficient detail earlier. However, if the noble Lord, Lord Cullen, particularly feels that I have not done so, then I shall be very happy to take the matter a little further. But I should like to say that we see no need to prevent unregistered retailers advertising their services. They will of course have to observe existing codes of practice governing advertising, but competition from these suppliers should have a significant impact on the price which the public pay for their glasses. I think it would be absurd to deny the public information about the availability of glasses from new suppliers. However, I shall read carefully what the noble Lord said and I shall if necessary follow it up in writing.

My noble friend also asked about the powers that exist to permit unregistered suppliers to enter into contract with family practitioner committees to deal with the supply of NHS spectacles. This was of course provided for in the 1984 Health and Social Security Act. The Government do not intend to operate the powers at the moment but of course circumstances may change in the future. All I can say is that we shall not forget that the power exists.

The noble Lord, Lord Ennals, was concerned about enforcement—lack of enforcement in his eyes—because this order does not have specific enforcement provisions in it. There are two aspects to the order. First, there are the provisions concerning the quality of an individual's finished glasses, that is, whether they accord with the prescription, etc. These are self-policing. They form part of the contract with the customer. If they are broken, the customer can demand replacement or his money back. Secondly, there are the public interest provisions concerned with the exclusion of glasses for children and those who are registered as blind and the exclusion of contact lenses. Since 1958, the Opticians Act has regulated who can test sight and who can supply optical appliances. No specific enforcement agency was provided by that Act. Yet no one has ever suggested that there is any general problem arising from unqualified people attempting the testing of sight or the fitting of contact lenses. Similarly, we see no need for such an enforcement agency in the future.

So far as sales of glasses for children are concerned, this would require the active collusion of parent and retailer. Are parents likely to take that sort of risk with their children's sight? I think certainly not. There is no financial incentive to do so because free glasses will still be available under the GOS arrangements. Furthermore, children's glasses which are supplied privately are a tiny segment of the market. I cannot believe that a retailer will risk a £1,000 fine for an insignificant improvement in turnover.

Most of the problems that have occurred with the Opticians Act concern illicit sales of glasses. These breaches of law, which I certainly do not condone, are the direct result of a law that is too restrictive and that has lost all credibility with the public at large. The noble Lord asked me a number of questions on this area, and I shall do my best to deal with them. We talk about prosecution of those who go outside the permitted exemptions. Contravention of Section 21 of the Opticians Act will still remain an offence. If a supplier steps outside the terms of orders made under the new provision he will remain liable to prosecution. On enforcement, again, anyone breaking conditions contained in orders made under Section 21 of the Opticians Act will be in breach of that section and subject to a fine of £1,000. It is up to anyone to lay information before magistrates where they believe that an offence has been committed.

My noble friend Lord Mottistone was concerned about consumer safeguards. Much has been made of the loss of consumer protection as a result of permitting unregistered traders to sell glasses. The unregistered trader will operate under conditions specified in orders made by the Privy Council and our objective has been to ensure that safe and serviceable glasses are sold. Breach of conditions by an unregistered trader will be a criminal offence. It is open to magistrates' courts to compensate those who have suffered loss as a result of such offences. The normal protection of the Sale of Goods and Supply of Goods and Services Acts will also apply. The cost of most glasses will be within the limit for informal arbitration hearing by county courts.

I turn now to the question of tolerances raised by the noble Lord, Lord Northfield, and by the noble Lord, Lord Winstanley. The tolerances applied in ophthalmic lenses vary depending upon the power of the lens. It is important to remember that the tolerances apply to a pair of glazed spectacles and thus the tolerances that appear in British Standards are for each separate lens. So a tolerance of 0.06 of a dioptre for each lens provides for a possible tolerance of 0.12 for the completed pair of spectacles. These tolerances were decided by a British Standards committee which included representatives of the optical and medical professions and industry. The industry has been operating these tolerances without undue problems, I am told, since 1962. This is perhaps the base from which we should start. Maybe, one of the advantages of subordinate legislation is that it provides for speedy changes should these prove necessary. That, I hope, will satisfy my noble friend Lord Orr-Ewing, who I do not see in his place behind me. Clearly, any discussion of British Standards tolerances can become rather technical. But we can pursue that point more fully if necessary by correspondence if both noble Lords would like me to do so.

Lord Northfield

My Lords, would it not be a good idea to have consultations on the figure of a maximum tolerance of 0.12? My guess is that it should be something like 0.25, in other words, that it should probably be double what it is. Could there not be some discussions on whether that would be acceptable?

Lord Glenarthur

My Lords, as I have said, these figures were reached by consultation that took place in the past. If the noble Lord wants us to go wider still, I am sure that those involved will note his views. Beyond that, I do not think that I can give him any undertaking this evening.

Before concluding, I should like to refer to a couple of points raised. First, the suggestion by the noble Lord, Lord Kilmarnock, that the old and poor would be forced to use unqualified suppliers and so risk harming their sight. It is wrong, I think, to assume that qualified opticians will not become much more competitive and reduce their prices. It is also wrong, I think, to assume that new unregistered suppliers will be unskilful in the way that the noble Lord thinks that they might be. Of course, as I said earlier, they will need to try harder to attract and retain custom, mistakes will not cause permanent damage, as I said right at the beginning, and the customer will usually become aware of them straight away.

In regard to expensive lenses, I accept that there are many fears about the future cost of complex lenses in the post-GOS private market. But I think we have already given an assurance of allowing access to GOS to those needing certain complex lenses, and the arrangements which will be made for them in due course will of course come forward.

Lastly, on the question of the Hospital Eye Service, I can tell the noble Lord, Lord Kilmarnock, that there will be no change in the present arrangements for the supply of contact lenses or low-vision aids. However, many hospital eye prescriptions are for quite routine lenses and it would be quite wrong to prevent such patients seeking the best bargain for their glasses. There are some special cases where the patient might be unable to reach a judgment on what his vision should be. In these cases the clinician can be expected to advise the patient of the need for the prescription to be made up by a qualified optician.

We believe that the order strikes a sensible balance between protecting and enhancing the position of the consumer and the opening up of the optical market to competition. This will achieve our objective of reducing the price of private spectacles to the public at large. During the passage of the Bill through your Lordships' House, the noble Lord, Lord Ennals, as he said, opposed our wish to see competition injected into this segment of the market. He described how the purpose of his Prayer today was to repeat that opposition. He and other opponents—my noble friend Lord Mottistone and my noble friend Lord Cullen—claimed that what we are doing is helping to erode the quality of the existing service. Others criticise us for not having gone far enough. I can only deduce from this that what we have really discovered is the right path down which to proceed in complete confidence. Our order involves no health risk; indeed, it protects all necessary health aspects. It strengthens the hand of the consumer but, above all, it allows the consumer the right to make a choice between registered and unregistered dispensing. I believe that consumers richly deserve this freedom of choice and that Parliament has denied it to them for quite long enough. That is why I commend the order to your Lordships.

9.17 p.m.

Lord Ennals

My Lords, I am most grateful to the noble Lord, Lord Glenarthur, for answering so completely the questions that were put. When I say "completely" I do not mean satisfactorily; I mean completely. He would not expect me to be satisfied with a number of the answers that he gave. I am going to take only a couple of minutes in dealing with a few of the points.

First, I was not at all satisfied with what he had to say about consultation. I think it was generous of him to accept that because of pressures within the department—so many protests must have been coming into the department about so many other things—it must have been very difficult for him to get through his work. That would have led me to believe that it would have been better to delay the date of the order in order that it could then have come into line with the date in April when the qualified opticians are able to begin their own advertising. So I see no reason at all why the pressure of work upon the department—which I well understand, having myself been Secretary of State—should have led them to go into a rushed consultation which quite clearly did not take into consideration some of the representations that were made by those within the profession. The attitude, "We warned the profession once, we warned the profession twice, and we warned the profession three times", is not an attitude that I believe the DHSS should take toward any of the professions that work within the National Health Service.

I am not satisfied with what the noble Lord had to say about enforcement and supervision, which really was that it is self-enforceable. Some people like my noble friend Lord Northfield are certainly able to seek enforcement, and so, too, are others in your Lordships' House. But there are some people who have not got the qualification, the guts, or the stamina, in a sense. They are not do-gooders in the way that my noble friend has been accused of; whether he recognises himself by that title I really do not quite know. Certainly when we bring in Lord Orr-Ewing, I do not think he would accept himself as being a do-gooder.

I think the Minister ought to have postponed the date so that advertising could have come in at the same time. If he argues that it is absurd to deny to the public the opportunities of knowing what facilities are open to them, then it must equally be absurd that registered opticians should be denied the right by law to make available to the public the facilities that they can offer. He has put the new private sector into a position which I think is advantageous to them and disadvantageous—if the Minster wishes me to give way, I will do so.

Lord Glenarthur

My Lords, I do not want to prolong this matter but the fact is that the position in which the General Optical Council finds itself is perhaps due to the way in which it has chosen to handle this particular situation. I gather that it is to meet on 20th December to discuss the Privy Council's response, and I hope that it finds itself able to reach a speedy decision. But I do not think that I can go back on what I said.

Lord Ennals

But it is still the case, my Lords, that it will not be until April, as I understand it, that it will be free to advertise in a way which up to now has been denied it under the 1958 Act.

The final point I want to make (except for one concluding sentence) concerns records. I did not think that the Minister dealt adequately with the reason why there should not be proper records kept by those who are taking on a new responsibility. Admittedly, they are taking it on for profit. But the fact that they are doing it for profit is no reason why they should not keep proper records in order that patients should be able to refer back to them one year, two years or even six months afterwards in order to check on the work that was done. It is all part of the supervision and enforcement to which I referred.

I agree with the noble Lord, Lord Mottistone, that the subject needed an airing. It was helpful that we were able, across the Chamber, to air the problem once again. But I conclude by saying that I am sure the noble Lord realises that my worry is not just about this particular order. My worry—and I know that it is shared by many opticians working within the National Health Service—is that we are not very far off the time when the optical service (and, I would add, the dental service, too, but we are not debating that now) will be phased out of the National Health Service. I see this as yet one further attempt—snip, snip, snip—to take services which have been provided by the National Health Service and hand them over to the private sector. That is the basic and fundamental reason why I feel so disturbed by the Government's attitude towards this matter. My Lords, I beg leave to withdraw my Motion.

Motion, by leave, withdrawn.

House adjourned at twenty-two minutes past nine o'clock.