Health and Social Security Bill

HL Deb 12 June 1984 vol 452 cc1071-107

House again Committee on Clause 1.

Lord Northfield moved Amendment No. 2: Page 2, line 2, at end insert—(";or (g) containing two lenses of equal strength and of a power not exceeding 4 dioptres for reading purposes.";")

The noble Lord said: The effect of this amendment would be to allow reading spectacles, as all call them, to be freely on sale without prescription. This is rather like old times; the situation makes me think of the Agricultural Holdings Bill when we were dragging the Conservative party, which was protesting if not actually kicking and screaming, towards a free market and on that occasion the noble Earl, Lord Caithness, was on our side. It will be very interesting to see whether, on being made a minister, he has been sufficiently nobbled to swap side and be against a free market.

Seconly, I believe that we are on familiar ground because of something I said in the House of Commons on 16th April 1958. As all noble Lords will recognize, I was a mere boy then. On that occasion I seconded an amendment in these exact terms after having tried to count the House out in order to kill a Bill. I did not succeed on either stratagem. So here we come to do battle again.

Today I am talking about spectacles of the type that I am now wearing, which still have their label on, which are available in America for about 12 dollars or which I can buy on the streets of Hong Kong for about £1.50. I am taking about the progress that we have made in this direction in the last 26 years. First, we have obtained an agreement from the Government that the selling of spectacles by an optician is a commercial operation and that it should be separated from the professional one. We have at last won that point. Secondly, we have convinced the Government that to wear the wrong spectacles does not cause any great harm. As the noble Lord, Lord Glenarthur, said in replaying to the last debate, that was at the core of the undue restrictions that were placed on sales in 1958.

In this amendment we ask the Government to go one step further and to admit at last that presbyopia (which is the effect of ageing in the eyes when one begins to need magnification) is not a disease but is a perfectly natural process and should not be classed as disease and thus subject to all the restrictions on appliances that go with disease. Everyone should be able to have magnification in reading glasses as they become older.

Much of the trouble regarding this arises from the paternalistic outlook of many people. They say that they do not want poor people rummaging about in Woolworth's, as they used to do, because they cannot afford a decent pair of spectacles. That is not how spectacles are handled today. If you go into any American store which sells spectacles over the counter, you will find that they are properly arranged in display cabinets, with the degree of correction perfectly clearly stated, and with the degree of correction perfectly clearly stated, and, with the help of the shop assistant, you can choose the pair that provides the degree of magnification that you need. Let us get away from the feeling that there is something terrible about helping oneself to spectacles. As old age approaches, it is quire proper and it is not the degrading process that it used to be rummaging around for cheap good in cheap shops.

Secondly, would people be so foolish as to be tempted to avoid sight tests? This is one of the arguments against the amendment. First, we must recognize that that will not be the case because they know that sight tests in this country are free. It might well be that in some other countries they would be tempted to avoid sight tests if such spectacles were on open sale, but in this country, with free sight tests, they will go for eye tests and profit from them, and thus from time to time check on their eyesight.

In the report of the Office of Fair Trading at paragraph 9.9 it states that they carried out a public survey and that 98 per cent. of the public knew that they should be sight-tested before buying spectacles. Therefore, after years of the health service, there is now a full understanding that proper care for the eyes means having one's eyes tested and checked from time to time.

Therefore, the issue is: should we force people to do this or should we leave it optional, as the amendment proposes? The real issue is: what is freedom in this case? I reject the degree of paternalism which was brought out in the last debate, which says, "We know that you might do yourself some harm by choosing your own spectacles; therefore we shall stop you". We must get away from that approach. After years of the health service, 98 per cent. of people are sensible enough to take advantage of the free sight test.

Apart from this sense of personal responsibility in these matters, there is the question of freedom. In paragraph 9.35 the report of the Office of Fair Trading says that the proponents of this change, like myself or Mr. Trevor-Roper, the distinguished ophthalmologist who supports us on these matters, believe that generally Section 21 of the Act"— that is, the restrictions in it— represents an unwarranted intrusion on the personal freedom to choose a lower level of service in return for a lower price".

That freedom ought to be open to us and we should not have to say that we must always go to a fully qualified man and go through all the hoops, with all the expense. We should be able to have a lower level of service and buy over the counter at a lower price if we make that choice. We should also be able to buy spare pairs of spectacles when we break them or if we are going abroad and need some spares to take with us.

Lastly, there is no reason why we should not allow people to buy these spectacles as fashion dictates. Women are very influenced by fashion when they choose spectacle frames and there is no reason at all why they should not have a few spare pairs of simple correction spectacles of a fashionable type that go with their various outfits. Therefore, there are many reasons why we should have this freedom to choose spectacles over the counter without causing great harm to our eyesight.

What would be the size of the market? The report of the Office of Fair Trading says that in the United States of America it is about 10 per cent. However, they estimate that in this country it would be between 3 per cent. and 5 per cent. of the market for spectacles because most people would continue to take advantage of the National Health Service, whereas in the United States there is no such service. So the report says that between 3 per cent. and 5 per cent. of spectacles would fall in this category if the freedom existed here.

The only real disadvantage that the Government put forward is the danger of non-detection of disease. I want to examine that disadvantage before I sit down. Mr. Trevor-Roper and other distinguished medical men have given clear evidence to the Office of Fair Trading inquiry, which was very fair. One noble Lord said that he did not believe that they had taken evidence from the opticians. My goodness, they did—to the point where the noble Lord, Lord Orr-Ewing, and I were complaining that the whole thing was being inordinately delayed and we thought that the Government were trying to sit on this inquiry for too long and hold it up. I repeat, it was very fair.

Anyway, Mr. Trevor-Roper made clear that in his opinion—and he is backed up by other medical men—most diseases of the eye are sufficiently apparent to cause the patient to seek medical advice. This is crucial to the argument. The only case where this is not so is that of glaucoma. The Government's case for resisting this amendment up to now has been the fear that people with glaucoma will not be detected if we do not force them to have an eye test before they buy spectacles.

Can we examine this as my final point? Mr. Trevor-Roper and others—this comes out in the OFT report, and the OFT people accept the figure—estimate that between 0.2 per cent. and 2 per cent. of the population are susceptible to glaucoma. We are first of all arguing about a very rare condition. But what one has to look at is how many people would be at risk. I have said that only 3 to 5 per cent. of spectacle purchasers would fall in this bracket. Therefore, we are arguing about the danger to 1 or 2 per cent. of 3 to 5 per cent. of spectacle purchasers: an infinitesimally small number, a tiny number, of 1 or 2 per cent. of the 3 to 5 per cent. of the population who might buy over the counter, who might be detected as suffering from glaucoma.

In those circumstances, can we really justify that all of us, without exception, must go through an eye test before we are allowed to buy a pair of spectacles? Is it not getting ridiculous when it is down to figures of that sort? I end on that note about paternalism. I can stand a certain amount of paternalism where large numbers of people arc involved, but are we going to say that everybody in our society must have an eye test because 0.2 per cent. of 3 per cent. of the population might in some way be detected as having glaucoma? I could go on with the argument, but I shall not. It is as ridiculous as that, and I hope that this time the Government are going to accept the principle of this amendment. I beg to move.

8.43 p.m.

Lord Bruce-Gardyne

I bow to the enormous experience which the noble Lord, Lord Northfield, has displayed in this area. I must admit that in my involvement in politics it has not frequently been my experience to find myself as wholeheartedly in agreement with every word that the noble Lord has expressed from the Opposition Benches as has been the case with what the noble Lord has said tonight. I would go further and make it clear that so far as I am concerned I would not for a moment quibble at his amendment, which seems to me to fulfil admirably the purposes that the amendment which I have drafted seeks to achieve. Therefore, I am only too happy to tag on behind the noble Lord's amendment tonight.

I should like briefly to describe my personal involvement in this area, such as it is. About four or five years ago I lost my reading glasses. I needed them urgently, and I was eventually advised that there was an establishment in Wardour Street, or somewhere like that, where you could get a pair of spectacles within the day with a prescription. That I achieved, and it cost me £65. Three years later I suffered a similar inconvenience. By that time I was a Minister in Her Majesty's Treasury. One of the inconveniences of being a Minister in Her Majesty's Treasury, in my experience, is that you cannot afford to go to Wardour Street and pay £60 for a pair of spectacles. Therefore, I had to obtain the appropriate prescription and wait for three days before I could obtain the spectacles I needed. In the meantime, I had to try to do my best with borrowed spectacles, or none.

I do not know whether all the dangers which we were warned about on the earlier amendment as to the hazards to our eyesight have any substance at all. I must say that I doubt it very much; but I find it hard to believe that they are liable to do more harm to one's eyesight than borrowing other people's spectacles or trying to use none in order to read during the period one has to endure before one can obtain spectacles on a prescription.

On the third occasion, four months ago, when I again had the misfortune to lose my reading glasses, I was advised to repair to the establishment of a gentleman called Mr. Risdon, to whom the noble Lord, Lord Northfield, referred earlier. Mr. Risdon had opened an eye shop in Clerkenwell. This evening I have with me a pair of spectacles which I obtained from his eye shop. I went into his eye shop having no prescription. I examined a series of cards, and found a pair of glasses which appeared to enable me to read quite adequately. I have been using them ever since, and they seem to suit my purposes entirely. I can read very well with them, I can assure my noble friend. They cost me £7–50, and I was out of the shop in three minutes.

That is a convenience and also an economy which this amendment, and the others to which I and other noble Lords have put our names, is designed to open up to all our fellow citizens. We would be conferring an enormous benefit on the generality of our citizens: the large number who need glasses for reading, who suffer from what I gather is called presbyopia and who could obtain their glasses with convenience and economy if these amendments were passed.

I want to refer briefly to some of the arguments that we have heard in the Committee tonight against this extension of personal freedom and personal economy, some of which the noble Lord, Lord Northfield, has already dealt with. I do not think that we need delay ourselves over the proposition that there is any danger of people damaging their eyes by acquiring glasses in the way in which I acquired mine, because at the trial of Mr. Risdon for his open defiance of the 1958 Act the President of the Ophthalmological Society (I hope I have the title right) acknowledged in court that there was no possibility of damage to adult eyesight from the acquisition of the sort of spectacles which Mr. Risdon was offering to his public. Frankly, I do not think that anybody this evening has attempted to refute that proposition, though they have made other allegations, to which I shall refer.

The second allegation is that if people who may need (as most of us do, unless we are lucky, with the advancement of age) the assistance of magnifying glasses for the purpose of reading are not subjected to a preliminary test, then there is a danger that serious defects of vision, or diseases of the eye, will go undetected. The noble Lord, Lord Northfield, exposed most effectively, if I may say so, the drawbacks to this proposition. I should like to add one or two further drawbacks.

The optical profession has told us all that it is estimated that in this country something like 236,000 among us—the precision of the figure I find fascinating—are today wandering around with glaucoma. If that is the case it does not suggest that this magnificent testing system is particularly effective in its job. If ever there was an "own goal" it seems to me that that is one. But I submit to your Lordships that the argument goes rather wider than that.

I wrote an article in one of the public prints recently which in effect, I must admit, was advancing the case for the amendments which we are discussing tonight. Subsequently I received a letter from a gentlemen who wrote as follows: I write as one who has worn spectacles for the correction of short-sight and mild astigmatism for over 40 years so that by middle-age I had experienced a fair number of two-yearly eye tests from a succession of well-established opticians. Around my fiftieth birthday, just after I had paid the usual exorbitant sum for a new pair of spectacles made to a prescription only marginally changed from the previous one, the company for which I worked introduced routine eye screening for staff engaged upon certain research projects. The eye specialist retained by the company lo do this screening subjected me to a very comprehensive examination, which went very well until he concluded the proceedings with a determination of my ocular tensions (which I now know to be an important indicator in glaucoma). With some alarm he told me that my tensions were "phenomenally high and potentially so dangerous to my vision that it was imperative for me to undergo further examination and treatment without delay". He then went to see a specialist and was found indeed to be suffering from severe incipient glaucoma. He asked why this had not been identified in the numerous tests over many years that he had been subjected to by opticians. The specialist replied that the usual acuity tests carried out by an optician would be quite irrelevent to his condition.

I can add another example even nearer home. I am led to understand that my noble friend Lady Trumpington found the need to acquire a pair of glasses. She purchased a pair of glasses after the usual optical tests. She found that they did her no good. When she returned to the optician the optician said clearly she was suffering from diabetes, so she went to a specialist who found that she was not suffering from diabetes in any way at all. What she was suffering from was incipient cataract. This was corrected and I am delighted to say that my noble friend is now totally restored in her vision. She has given me her personal agreement that I should mention these facts to the House because I think they are highly relevant to the matters that we are discussing this evening.

Lord Cullen of Ashbourne

May I ask my noble friend whether, after what he said about opticians, he wants less well-trained opticians in the future?

Lord Bruce-Gardyne

What I am trying to say is that the argument that eye testing as at present conducted is a means of controlling, preventing, or checking eye disease is totally unsubstantiated and all the evidence points in the opposite direction. I believe it is arrant nonsense to pretend that the sort of tests that are conducted as a means of obtaining a prescription for glasses are a means of identifying serious eye disease—that is exposed as completely hollow. This is the proposition that I am advancing to your Lordships.

I would personally accept that there is one argument which may be advanced against these amendments. It is not one I think that is often advanced by the optical profession. If the proposition may be advanced that those of us who with the advancement of age—something that indeed happens to all of us—require magnifying glasses to enable us to read were exonerated from the obligation of obtaining a prior prescription, then it is possible that the points at which a prescription could be obtained for the rest of the glasses-wearing population who genuinely need prescriptions, and who are quite rightly not covered by these amendments, might be reduced. That is a serious argument, but I do not believe that the sensible way to deal with that is to impose upon the majority of our fellow citizens who need magnifying glasses for the purposes of reading an obligation to obtain a prior prescription.

As my noble friend from the front Bench said earlier, it is demonstrated without any contravention that there is no hazard at all to eyesight in adults obtaining magnifying glasses which they need for reading without benefit of prescription. I believe that the evidence is overwhelmingly against the proposition that the obligation to obtain a prescription is any sort of a genuine control, a genuine detection, of eye disease.

I must say, with regard to the argument which we heard earlier—that if we are all to be free to go off and buy our glasses off the peg without prescription then we shall all be bumping into each other or falling off the pavement under buses—that it makes one wonder about those in other countries: and there are a great many of them, Australia, most of the Scandinavian countries, contrary to what the right honourable noble Lord said earlier, something like 90 per cent. of the states in the United States, where people have no such obligations imposed. Do we find them all falling off buses, bumping into each other? Is there an enormous incidence of horrifying accidents and disasters because they can go and buy their spectacles off the peg in a shop, as we were able to do until 1958 in this country? Is there any evidence at all that in the period up to 1958 we were all banging into each other, falling off pavements, or driving into each other on the M. 1? The argument really does not stand up.

To my mind the logic of what we are doing tonight is that we should carry the freedom and choice for the individual, and the economy that would result, one stage further. The Government have in this Bill, I believe, made a major strike for improved competition and better choice for the citizen. Let us go on one stage further, and if we carry these amendments that is what we shall do.

Lord Mottistone

I think my noble friend said that he was taking his Amendments 3 and 4 with number 2. Is that right?

Lord Bruce-Gardyne

Yes.

Lord Mottistone

It was a little surprising to have nearly an 18-minute speech in a Committee stage in this House from the number two speaker. I hope my noble friend will note that. The point that the noble Lord, Lord Northfield, made, which was the key to his amendment and the key to my noble friend's amendment, was that the effect of these amendments is to remove the need for the prescription. The noble Lord, Lord Northfield, said that 98 per cent. of people know that they need to have the eye test. Of course, that might be so. We have been at it for nearly 20 years—or is it 30?—and we have become accustomed to it. But, in my experience, when the pressure that the legislation imposes is removed, it does not take long for the 98 per cent. to go rattling down.

Lord Northfield

Even when it is free?

Lord Mottistone

The point about this is that the prescription has a validity. Both the noble Lords said that it did not have a validity for the maximum number of people. That may be true, but it has a validity for some of the people some of the time. I take very much the point that was made briefly in a splendid speech by the noble Baroness, Lady Robson of Kiddington, that we do not want to rush into making a total change overnight. We have a system which has been serving us well. The noble Lord, Lord Ennals, pointed out how other countries are coming in our direction.

Lord Northfield

They are not.

Lord Mottistone

Yes, I think that this is true. I do not know about the United States. I am always suspicious about the United States—

Baroness Jeger

Hear, hear!

Lord Mottistone

—suspicious in the sense that sometimes people will go over there and do things which are not legal under the law of the state in question at the time. So one needs to watch that, but in Europe I think this is true.

The whole point of these things is to abolish the need for the prescription. If it was necessary—and this seems to be the sense both of the debate now and the debate that we had earlier—to go to have our eyes tested perhaps every two months, that might be a terrible imposition, but we do not need to do that if we are of the normal run of people. We need to go, at the most, every two years, and in my case I am now round the three- or four-year mark. This is not a great strain and it is up to me. There is a lot of freedom. With all the remarks about freedom from the noble Lord, Lord Northfield, I thought he was coming to join us on these Benches. I hope he will talk about freedom to his noble colleagues in all sorts of other areas in which they do not really recommend freedom.

The whole point about these amendments is that they abolish the prescription too soon. It has a validity and there is a need, and I trust that your Lordships will resist all these three amendments.

Lord Rugby

The matter of the prescription is only important in certain respects. The main one is to get a properly prescribed lens. It has nothing whatever to do with a medical check. I stress that the whole tenor of the legislation was to state that by no stretch of the imagination were opticians to be accorded a medical status. They have no medical status and the noble Lord seems to be suggesting in his speech that, if one goes to have a test and a prescription is given, that that as well is an automatic screening for various aliments either of the eye or possibly of other parts of the body and for diabetes.

Unfortunately, when the prescription is also tied to the sale of an appliance, the likelihood is that the prescription will be directed towards that sale. All too often, even if something is evident, the optician is not likely, or has no need, to declare it, because it will do his own business down by failing to sell the valuable product at the end of the sale. In other words, he is doing the very thing which doctors were stopped from doing—namely, having a consultancy and at the same time prescribing medicines which they had invented themselves and which were known as cure-alls. For the same reason, we are asking that there should be a separation now between the optician who does the eye test and the department which persuades the person to buy the prescriptive glasses on those premises. They should take that prescription out to see whether they can extract the best advantage from it.

Lord Bowden

I wonder whether I may be allowed briefly to intervene and explain something of the history of the connection between eye testing and the ability to detect eye diseases, because it originated in Manchester.

Years ago we had a two-year course leading to a diploma. We thought that it would be a good idea to upgrade it and to make it into a three-year course leading to a degree. But to make that possible we decided that it was essential that a student should have an opportunity of seeing the treatment given in the Manchester Eye Hospital. Ever since that time, all students of ophthalmic optics in Manchester have worked for quite extended periods under supervision in the Manchester Eye Hospital; it being clearly understood that the purpose of this tuition was not in any circumstances to make it possible for them to treat the diseases concerned but rather that they should be able to identify them and, if need be, refer patients for expert treatment.

That has been an extremely important development which has made our own department celebrated and has since been copied by many others—the Northampton School in London, for example, does much the same. It is very important indeed to realise that students who are learning to dispense spectacles should, at the same time, have experience of diseased and malfunctioning eyes so that they can recognise them and arrange for the people whom they see to have further, better and proper medical treatment. That is my first point.

The second point I would make is that everyone realises that it is quite wrong that ophthalmic opticians should be required in effect, to subsidise their professional skills with the selling of spectacles. Everyone has always disliked it for the very reasons which were mentioned moments ago which make it impossible for medical men to do that in this country. It is very much better that there should be a separation between these two functions which makes the proper function very understandable and makes it possible for the profession to exercise the skills which it has learned both in the correction of visual defects and in the analysis of malfunctioning eyes.

The first and second points that I must make are that, in no circumstances, should there be a dependence on the part of those who are earning their living as practising ophthalmic opticians to supplement their incomes by dispensing spectacles. For this reason, we very much welcome the increase which was recently given by the Department of Health in the price to be paid for an individual eye test.

These are complex issues indeed. The question as to what extent a profession should be encouraged to advertise is very hard for the layman to consider dispassionately. Solicitors of course are now going to be encouraged to advertise, and I very much hope that sooner or later the Bar will do the same. What a thought that lawyers and barristers will be able to say, "I got Three-Fingered Jack off with only six months. Look what I can do for you!" This possibility, I am sure, would transform the nature of the Bar and the legal profession. But the question we have to ask ourselves is this. Would the Bar like it? And we know of course that they would not. Would they tolerate it? We know of course that they would not. In any event, would the practice of the law be improved if it were insisted upon by the Government? The answer obviously is, certainly not.

These traditional practices really are only a survival of the medieval guilds. Someone—I think it was Shaw—once said that all professions are, in essence, a conspiracy against the public. So let us face the fact that ophthalmic opticians are working within the same constraints as are the members of all the other professions, and that they are no better or no worse because they have to try to exploit their opportunities when they can. I know ophthalmic opticians very well. We had a very big department of ophthalmic optics. They are extremely dedicated, responsible and serious men struggling to create a profession where until recently there was not one. After all, it was not very long ago since the barbers first separated themselves off from the surgeons and created the profession of surgery. That was not very long ago. When the Duke of Wellington fell ill, he said, "Send for the apothecary!"—there being no such person in those days as a professional physician. All the professions are growing; they are becoming more and more self-assertive if you like, and they are in the process of giving a better and better service to the community. The ophthalmic opticians are doing the same.

9.12 p.m.

Lord Monson

I, too, should like to endorse every word spoken by the noble Lord. Lord Northfield. I particularly liked his attack upon the wholly un-Thatcherite paternalism we have heard expressed in this Committee tonight. Like my noble friend—or I suppose that I should correctly say, the noble Lord—Lord Bruce-Gardyne, I, too, have bought spectacles from Mr. Peter Risdon, one pair of which I have in my hands at this moment. In fact, I have bought three different pairs from him, costing £4, £7.50 and £8.50 respectively. They are of different magnifications for different lighting conditions—for daylight, for good artificial light and for poor artificial light, respectively. They are also of different magnifications for different times of day because, it may not be generally appreciated that one needs lesser magnification in the morning when one's eye muscles are rested than in the evening when one's eye muscles are tired.

The problem with stipulating that prescriptions must be produced before a pair of reading glasses can be bought is that the strength prescribed if the eye test is carried out in the morning will be different from the strength prescribed when the test is carried out at midday and even more different from the strength prescribed if the test is carried out in the evening. What many of us object to about the present state of affairs is not primarily the high prices of spectacles, although we would welcome the reduction that this Bill certainly would produce, partly because of increased competition and partly because of the scope that opticians would have to reduce their high overheads by moving from over-furnished, prime, High Street, ground-floor sites.

Neither is it a question of courtesy. I have always been treated with great courtesy on the rare occasions that 1 have visited an ordinary optician in the United Kingdom. What really gets under my skin—and, I suspect, under the skin of tens of thousands of my fellow countrymen—is being described inevitably patronisingly (and therefore insultingly) as a "patient" when there is absolutely nothing wrong with us. The use of the word "patient" is part of the mystique put about by the optical profession to pretend to a medical skill which in fact they do not possess. People over 45 who need simple reading glasses are not in any way diseased or disabled; an individual over the age of 45 who finds that he or she needs reading spectacles is no more to be described as a "patient" than a neighbour of the same age, who finds that he needs to take a lift up to the fourth floor instead of climbing up the stairs as hitherto, is correctly to be described as a patient.

Lord Auckland

I think that we are in grave danger in this debate of getting into undue technicalities. I was very surprised to hear my noble friend Lord Bruce-Gardyne say that he had to pay £65 at a shop in Wigmore Street. This morning I obtained a new pair of spectacles at a cost of £37, including of course the eye test from an optician, who I had been visiting for some years. It has been argued that opticians have a monopoly; but many other people have monopolies. I would be quite prepared to see an obligation on opticians to display their prices outside their shops, as indeed many do.

I think the whole query about this amendment is, if it is carried and if no prescription is required, what redress has the person whose eyes may become affected later and whose sight becomes seriously impaired? This point should be very much considered. If an optician makes a mistake, he or she can be proceeded against. That is my understanding, anyway. Therefore I think these amendments are defective. There is too much made of the fact that perhaps only 2 per cent, of the population suffers from glaucoma, a disease which is largely, or was at one time, suffered from in the tropics. There are other eye diseases besides glaucoma. I do not know the figures for these diseases but we have the possibility of the prescription being withdrawn—I know it is there for children under 16 but it must also be there for others because at any age eyesight can be impaired. Therefore I hope that these amendments are rejected.

Lord Cullen of Ashbourne

I just want to make one brief intervention, and I promise I shall not give any views as to where I have just bought a pair of spectacles, whether it was in Wigmore Street, Hong Kong, Singapore or anywhere else. I think that we have heard quite enough about individual pairs of spectacles when what we really want to be doing is taking a responsible view for people who are perhaps not so fortunate as other noble Lords who travel all over the world and who need to get their spectacles on a reasonable basis, which is what I hope they will be able to do in the future.

I have only one other point to make. We hear a good deal about this magnification. I know that we do not want to get technical (and I cannot get technical, anyhow) but magnification is not the appropriate term. What I understand—I have been given this on pretty good authority—is that the point of having reading spectacles is to focus light on to the back of the retina from a near object. As we all know, after 45 years one is not able to do that naturally and therefore the lens is meant to provide a clear image and not an enlarged one. So I think that we ought to stop talking about magnification.

The Earl of Caithness

We have had a long debate on this matter and we have covered a lot of the ground in the first amendment as well. The Government, when studying the Office of Fair Trading report, gave serious consideration to the merits of allowing self-selected reading glasses. I accept the evidence, which is quite clear, that they cannot ruin adult eyes. The noble Lord, Lord Northfield, reminded me of the happy hours we spent on the Agricultural Holdings Bill. We made great strides in liberalisation, which this Government are doing now. We are persuaded of the merits of requiring a sight test before glasses are dispensed. This is in line with the thinking and practice of most Western countries. Such sight tests perform a valuable role in ensuring that glaucoma and certain other serious eye and general diseases, such as diabetic retinopathy, cataracts, vascular abnormality, macular degeneration—I could go on for a long time but I do not wish to bore your Lordships—are detected.

It has been our stance throughout this controversy that we are proposing nothing that will expose the public to a greater level of risk to their health. Similarly, we do not believe that the public interest is served by letting someone drift into preventable blindness out of sheer carelessness or lack of knowledge. This amendment and Amendments Nos. 3 and 4 would break the present link between sight testing and sales of glasses. It is this factor that matters, not whether reading glasses are involved or relatively low-powered lenses. I do not believe that the sight test requirement is a really onerous condition. The public can readily obtain them, and they are free.

It is our firm belief that the eye test performs a valuable screening role. Glaucoma is not a major disease numerically, but having the sight test does allow for early detection of any cause of blindness. The acuity test is not in itself sufficient, but an optician who failed to examine the back of an eye with an ophthalmoscope, which is the most reliable method, would be in breach of his professional terms of service and his professional code of practice. There is already an obligation on an optician providing NHS sight tests to hand the prescription over on request. Some proportion of patients do request their prescriptions now, and many more will doubtless do so when this Bill is enacted.

In preparation for this Bill, we have begun consultations with optical bodies on changes as to the terms and conditions of service of opticians providing GOS sight tests. As my noble friend Lord Glenarthur has already said on Amendment No. 1, one of these changes is to make a positive requirement that a prescription is given to a person after a sight test is completed.

The noble Baroness. Lady Robson, the noble Lord, Lord Ennals, and just now my noble friend Lord Mottistone, said we should proceed in stages; and we believe that this Bill, as at present drafted, is the right stage to have reached at the moment. We will, of course, keep the matter under review. I therefore hope that the noble Lord, Lord Northfield, will be persuaded to the Government's view that considerable liberalisation can be achieved by the Bill as it stands and that the additional competitive benefits in self-selected reading glasses are outweighed by the greater risk to which some people would be exposed.

Lord Monson

Before the noble Earl sits down, would he not agree that the arguments he has just advanced about testing for diabetes, and so on, could be used to justify a requirement that every single adult in the country should undergo a periodical eye test, whether or not he or she needs glasses?

Lord Northfield

The debate has gone exactly as I forecast. The memories of the Agricultural Holdings Bill debates are reinforced because I see that the noble Lord, Lord Belstead, who was resisting the open market in farm rents, has now been brought in to reinforce the Front Bench in resisting the free market on this issue, too. It is amazing how hard it is to drag the Tory Party towards the free market, and I must confess that on matters like this I am beginning to despair of them.

There are just two points I would make quite briefly. First, it is not the case that Western countries are moving towards restrictionism in this matter. The Office of Fair Trading report makes it quite clear that ready-made spectacles are on free sale in the United States, in several of the Australian states, in the whole of Japan and in the whole of Canada, for example—and in Portugal, Greece and Sweden as well. It is not the case that countries which are rather like our own in some way are drifting apart on this matter. They are in fact in favour of freedom, and you can buy freely there.

Secondly, I would say that it just is not the case, despite the noble Earl getting all mixed up with the names of all the diseases, that an eye test is needed in order to detect them. As Mr. Trevor-Roper has made clear a thousand times, most of those diseases are sensed by the patient anyway, and he would go haring off to a doctor or an optician the minute he felt them. They are not things from which he would find relief by buying a pair of spectacles. So it is clearly quite silly to confuse this argument with all these other diseases. They will be detected in the normal process of medical care, as soon as the patient realises the discomfort and that spectacles do not cure it.

We end where we began. I shall go on as I now go abroad. Noble Lords from all parts of the House come up to me and say, "I hear that you are going to America. Will you bring me back a pair of spectacles of this correction?" and I come back loaded with spectacles for my noble friends. 1 just feel sorry for those outside, who do not have friends going to America or Hong Kong to help them. It is quite ridiculous. These spectacles can be bought for £5, £6 or £7 in America, and in Hong Kong I get them for £1.50. I will take orders after this debate, if some of your Lordships are envious of these prices.

I shall, of course, beg leave to withdraw the amendment, but we shall have an attempt at drafting it more accurately in a way that can be forced to a Division at Report stage. So 1 hope that we can get an amendment which in drafting terms is watertight. Finally. I wonder where this paternalism is going to end. As the BMA said at one point in this long argument, "Are we next going to say that dentists must have a monopoly of selling toothbrushes, because somebody who wants to buy a toothbrush should be checked to see whether he has dental decay before he is allowed to buy an appliance?" It is becoming as silly as that and I only hope that that sort of point will one day register with this Government. We have dragged them so far into the open market. I hope that one day we will get them the rest of the way. In the meanwhile, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 3 and 4 not moved.]

Lord Monson moved Amendment No. 5: Page 2, line 20, leave out from ("not") to ("before") in line 21 and insert ("earlier than three years").

The noble Lord said: This is very much the second or even third- best amendment, because I would have much preferred that of the noble Lord, Lord Northfield, or one of those of the noble Lord, Lord Bruce-Gardyne. However, it represents an effort to find some sort of common ground between the libertarians, on the one hand, and the paternalist lobby, on the other. If it is necessary for people who are not in any way ill or disabled—I do not accept that it is necessary, but if it is considered so—to have to undergo the inconvenience and. to some extent, the indignity of obtaining a prescription for perfectly straightforward reading glasses, which in many other civilised countries, as the noble Lord, Lord Northfield, pointed out, they could buy across the counter, then, for Heaven's sake!, let them not have to submit to this charade more than once every three years. I beg to move.

The Earl of Caithness

The noble Lord, Lord Monson, raises an interesting point. We still have an open mind on the time for which a prescription should be valid. Some have suggested that this should be as short as one year. However, our view is that two years would be an appropriate period. This view is backed by the views of the Faculty of Ophthalmologists and the Ophthalmic Group Committee of the BMA. We are still open to listen to other views and to receive other evidence. Because views differ, and indeed could well change in the light of scientific discoveries, I believe that the time should be specified in subordinate legislation. This will provide flexibility without losing parliamentary control since orders are subject to the scrutiny of both Houses. With that, I hope that the noble Lord will withdraw this amendment.

Lord Monson

I started off being very encouraged by the noble Earl's reply, but became rather despondent towards the end. I will read carefully what he has said and perhaps come back to this matter at Report stage. With that, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

9.30 p.m.

Baroness Robson of Kiddington moved Amendment No. 6: Page 2, line 28, at end insert— (": or (c) any other appliances with the exception of reading spectacles prescribed to correct presbyopia and with lenses not exceeding a maximum power of +4 dioptres.")

The noble Baroness said: The purpose of this amendment is to propose a compromise which I hope may seem reasonable to the Committee. I am particularly encouraged in that thought by the fact that the noble Lord, Lord Rugby, has put his name to our amendment. We have heard impassioned speeches ever since this debate started, either for or against free dispensing of spectacles. The passion has been equal, I feel, on both sides.

The effect of the amendment is to provide that an order under subsection (3A) of the Bill would not only prohibit unqualified and unregistered sellers from fitting contact lenses to anybody, or supplying spectacles to children under the age of 16; it would also confine non-opticians to the supply of reading spectacles, which is, after all, what many noble Lords have been talking about.

I believe, on the other hand, that the Government are correct to insist upon the continued requirement of sight testing. It is frequently discovered at the time of a sight test that there is a medical reason for the fact that the eyesight is deteriorating. As a result, the person concerned is referred to his general practitioner to find out what is the problem.

It is quite unforgivable for the noble Lord, Lord Bruce-Gardyne, to draw a conclusion from the fact that one member of a profession makes a mistake. That does not condemn the profession as such. There is no profession in this country that has not occasionally made a mistake. You do not condemn all solicitors because one person has made a mistake. You do not condemn all chartered accountants because one of them has failed to discover a fraud in a set of accounts. It is a human weakness that occasionally somebody makes a mistake, but this does not condemn the profession as a whole. I beg to move.

Lord Bruce-Gardyne

I did not condemn the profession. I did not utter a word of condemnation. All I said was that there did not seem to be very clear evidence that sight testing was a very effective way of discovering serious eye disease. Would the noble Baroness comment on the proposition from the opticians themselves that nearly 250,000 people in this country are suffering from undetected glaucoma? Does not that suggest that the eye testing regime which we have at present is less than wholly effective—if, indeed, there is any truth in the figures?

Baroness Robson of Kiddington

I have no means of checking whether those figures are true. I am aware that to detect glaucoma in the early stages is one of the most difficult things to do because, to begin with, it is virtually symptomless. It could be that the figures which have just been quoted imply that that is the number of people who have the beginnings of glaucoma. My experience is that, when people have their eyesight tested, the prescribing optician is able to discover whether a more serious problem than purely bad eyesight is present. I believe, therefore, that there are strong arguments against the sale of ready-made spectacles without prescription, and I am delighted that the Government have recognised those arguments.

The opticians are not, perhaps, very keen on the amendment standing in my name and those of my noble friends. They would think it very undesirable that unqualified people should dispense even reading glasses. However, I am certain that opticians and many others, both in this House and in another place, feel that to permit unqualified people to sell reading glasses is the lesser of two evils. I hope that the Committee will support the amendment. I believe that this compromise amendment could make the two sides meet and that improvements could be made to the Bill which is before us.

We in this country have, I believe, a very high standard in ophthalmic dispensing. It is important that that high standard should be retained. It must be restricted to those who attain a minimum standard of competence through training and qualification. That is important. It is that which the Bill has now jeopardised. Therefore, I believe it is right to limit the harmful effects of the change by restricting unqualified people to the dispensing of reading spectacles only.

Lord Rugby

I am afraid that I must dissociate myself from this amendment because I misread it, and I thought that this amendment was concerned purely and simply with the other amendment relating to reading spectacles. I have already stated, and have gone on the record as stating, that the dispenser of optical appliances is nothing more or less than a seller of optical appliances.

The actual make-up of the lenses is not conducted by the dispenser; the lenses are made up by members of the Optical Manufacturers' Association: by the prescription manufacturing houses. The prescription is sent to be made up by a recognised manufacturer. The lenses are returned in the post and fitted into the frames. Those lenses conform to very highly qualified procedures from which there can be no deviation. Therefore, there is no reason at all why an optical dispenser should not dispense any lenses he likes.

Lord Kilmarnock

So far, I have not intervened in this debate between what the noble Lord, Lord Monson, rather felicitously called the libertarians on one side and the paternalists on the other. I support the amendment moved by my noble friend. I am sorry that the noble Lord. Lord Rugby, is not with us, because I was encouraged by seeing his name to this amendment. I thought that he was moving towards a compromise position, but it seems that he is moving back. I should like to tell the noble Lord that I was initally attracted to the movement led by him and supported by the noble Lord, Lord Northfield, together with other noble Lords on the Benches opposite, towards relaxing the law on these matters. But the more I looked into the effects that it would have on disadvantaged groups and upon those with really bad sight, the more reservations I found I had.

I was not happy with the first amendment moved in Committee this evening, and nor am I happy with the Bill as it stands. Later, we shall come to amendments dealing with costs—which are also very important. But here we are concerned simply with dispensing; in what circumstances dispensing must be done by registered qualified dispensers, and in what circumstances it may be opened up to those who are not qualified—provided they sell spectacles against a prescription.

I remain sympathetic to what one might call the "reading glasses movement" headed by the noble Lords, Lord Orr-Ewing and Lord Bruce-Gardyne. But I do not believe that unqualified dispensing should go any further than that very substantial sector of the market. Unqualified dispensers should certainly not be permitted to dispense the more complicated prescriptions for bifocals, trifocals or varifocal lenses of progressive power, nor other lenses incorporating worked prisms or corrections for astigmatism. Certainly it cannot be right or sensible to allow post-cataract patients to have their spectacles dispensed by someone who may have no training or qualifications.

On those grounds, I support this amendment. In fact, I should be prepared to support either of the amendments, because I believe that there is another in the name of the noble Lord, Lord Ennals. However, I understand from my noble friend Lady Robson that our amendment is slightly better drafted in professional terms, and so on balance I will support that amendment—but I am certainly behind both of them. It seems to me that we have here a reasonable compromise between the libertarian position and the paternalistic position which has been attacked by the noble Lord, Lord Northfield. I suggest to your Lordships that we should rally behind one or other of these amendments.

Lord Mottistone

With your Lordships' permission, I should like to speak to my own amendment, Amendment No. 7, which is in effect an alternative to Amendment No. 6.

Amendment No. 7: Page 2, line 28, at end insert— (": or (d) any optical appliance defined by order as being either a low vision aid or an optical appliance, which includes in its composition a high power, complex or multifocal lens.")

I am very sad to hear that the noble Lord, Lord Rugby, does not support Amendment No. 6. I thought he had realised that there was a need for some kind of a compromise position regarding dispensing—but he clearly does not. But as this debate goes on, we might convert even him. I would have thought that he was the leader of his side, and not my noble friend Lord Orr-Ewing, in this particular battle.

The purpose of my amendment, as, I think, is the purpose of the amendment tabled by the noble Baroness, is to control the dispensing of high power complex or multi-focal lenses and low vision aids by limiting it to registered opticians. I think that your Lordships will readily understand that in these specialised cases specialised skills are needed. It is quite simple. I hope very much that my noble friends on the Front Bench will agree that in this area the Bill has not gone quite far enough. We understand that they are wholly overboard in the sense that reading glasses of the type I am wearing at the moment do not require any aids at all; and the fact that I might fall down the steps is quite irrelevant to them. We know all about that. But when one needs very special spectacles—as does my noble friend Lord Suffield, for example, as he told us on Second Reading—it is perhaps right that they should be dispensed by an expert rather than by just any person. I suppose that it is reasonable that we should have an amendment either on the lines of the amendment tabled by the noble Baroness or mine. I have no great preference, but I think that my amendment is better because it uses less technical words. I commend it to my noble friends.

Lord Ennals

I only rise to make one comment which is that I supported the noble Lord, Lord Mottistone, quite intentionally. I have no intention of withdrawing. I made no mistake. I might have supported the amendment of the noble Lord, Lord Kilmarnock, but did not do so when I saw that the noble Lord. Lord Rugby, had added his name to it. I hope that Amendment No. 7 will be seen favourably by the Government.

Lord Northfield

The noble Baroness looked at me when she was talking about a compromise. I want to make clear that this is not a compromise between me, or the people who I stand with, and anybody. This is a compromise between the people who do not want to do anything at all and the Government. It is going one step back compared with the Bill. It is certainly not a compromise with us. Therefore. I hope that the noble Baroness will not look at me when speaking on this issue. She has the wrong compromise in mind. She wants to go further back than the Government. Goodness knows, they have not gone far enough! The noble Baroness has it wrong.

As for the noble Lord, Lord Kilmarnock, he has it wrong, too, if I may say so. There is a failure to understand how the industry works. A dispenser does not sit in a back room making spectacles and lenses; nor does an optician. The prescription arrives and the person who receives it whether an optician or one of the new non-qualified people, simply sends it to a prescription house which makes it up. All that then happens when it comes back to the person doing the dispensing is that he puts it in a frame and makes sure that the frame fits on the face of the person concerned and that it is centred. Frankly, the complication of the lens which the noble Lord talked about at great length has nothing to do with the dispenser. That is a specialised function carried out by the optical houses. The noble Lord has the story completely wrong.

The Earl of Caithness

With the leave of the Committee I, too, should like to speak to Amendments Nos. 6 and 7. I start by saying yet again—and I should like to stress it as would my noble friend Lord Glenarthur—that the medical evidence is quite clear that glasses, however complicated or powerful, cannot damage adult eyes. It is also widely acknowledged that the more powerful the prescription, the more noticeable symptons of dispensing errors will be. There is therefore no reason why alternative suppliers should be limited to the more simple glasses.

It is certainly true that the more complicated prescriptions require a higher level of attention to such matters as centration of the lenses and the back vertex distance of the glasses. However, those who choose to supply such glasses are under a clear legal requirement to supply glasses which conform to the prescription. We are considering carefully what additional steps might be taken to strengthen the hand of the consumer; for example, that the taking of certain measurements is a necessary contractual condition between supplier and customer. The public make many sophisticated judgments on a wide range of consumer choices. There really is no reason to believe that they will be incapable of detecting error, complaining and obtaining redress.

We acknowledge that there is a very small number of people whose eye condition requires more knowledgeable dispensing—conditions where the background knowledge of a fully trained person will be required to help ensure a successful outcome, and occasions where mere technical competence in interpreting and making up the prescription may not suffice. In such cases it is open to the doctor or other prescriber strongly to advise his patient that special care is needed in the selection of his supplier. He may even feel that the prescription should be endorsed with his advice to use one of the many registered opticians. This will be entirely acceptable. Indeed, we are considering reinforcing this approach by requiring alternative suppliers to display a warning notice advising would-be customers to heed their preserver's advice. The needs of this minority can therefore be met in the context of doctor-patient relationships. For these reasons, we believe Amendment No. 6 is inappropriate and unnecessary, as the public can be protected without having to be nannied.

I turn now to part of Amendment No. 7 in the name of my noble friend Lord Mottistone, where he raises the point of low vision aids. I should like to assure my noble friend that there is no intention that unregistered opticians should sell low vision aids required by those with the worst sight. Low vision aids, for the information of noble Lords, cover a variety of devices of varying complexity prescribed to aid those with little vision. At the simplest level, a hand-held magnifier could be a low vision aid. At the other extreme, a closed circuit television system could be used as an aid. Each device or combination of devices is devised for the individual patient. Many obtain low vision aids on loan from the hospital eye service. Not many qualified opticians undertake this work. We believe that it is unlikely that unregistered suppliers will want to enter this market. However, to avoid any risk, I undertake to ensure that orders for exemptions exclude such optical appliances. The definition will require some considerable thought to avoid catching quite legitimate sales involving simple hand-held magnifiers. We will of course consult on these orders. I hope that my noble friend will accept this assurance. For the reasons already stated, I cannot however share his desire to exclude the more complicated forms of glasses. I therefore ask the Committee to reject these amendments.

Lord Mottistone

May I ask my noble friend to explain this? Do I understand that he agrees at any rate with the first part of my amendment and will put down an amendment of his own at the next stage, or is he suggesting that the relevant parts of it will be incorporated in the relevant orders?

The Earl of Caithness

No, we will not bring forward an amendment. We will have it in orders.

Baroness Robson of Kiddington

While thanking the noble Earl for his reply, regretting that he has not been able to go any further towards meeting us in our amendments and not being certain what the noble Lord, Lord Mottistone, will do with his amendment, 1 am afraid that I must press my amendment.

9.48 p.m.

On Question, Whether the said amendment (No. 6) shall be agreed to?

Their Lordships divided: Contents, 24; Not-Contents, 52.

DIVISION NO. 2
CONTENTS
Attlee, E.	Mottistone. L.
Auckland. L.	Nicol, B.
Banks. L. [Teller.]	Pitt of Hampstead, L.
Cork and Orrery, E.	Ponsonby of Shulbrede, L.
Cullen of Ashbourne, L.	Renton. L.
Ennals. L.	Robson of Kiddington. B.
Ferrier, L.	Stewart of Alvechurch. B.
Jeger. B.	Stewart of Fulham, L.
Kagan, L.	Stoddart of Swindon. L. [Teller.]
Kilmarnock. L.
Lockwood, B.	Underhill, L.
Masham of Ilton, B.	Winstanley. L
Molloy, L.	L

NOT CONTENTS
Allerton, L.	Hailsham of Saint Marylebone, L.
Ampthill. L.
Avon. E.	Hives, L.
Bauer. L.	Ingrow, L.
Belhaven and Stenton. L.	Killearn, L.
Beloff. L.	Lawrence. L.
Belstead. L.	Lindsey and Abingdon, E.
Brougham and Vaux. L.	Long, V.
Caithness. E.	Lucas of Chilworth. L.
Carnegy of Lour. B.	McAlpine of West Green, L.
Coleraine. L.
Colville of Culross, V.	Marshall of Leeds, L.
Colwyn, L.	Monson. L.
Craigavon, V.	Montgomery of Alamein, V.
Craigmyle. L.
Croft. L.	Northfield. L.
Davidson, V.	Rankeillour, L.
Denham, L. [Teller.]	Rochdale, V.
Drumalbyn, L.	Saltoun, Ly.
Effingham. E.	Skelmerdale, L.
Elliot of Harwood. B.	Suffield, L.
Elton, L.	Swinton. E. [Teller.]
Fortescue. E.	Taylor of Blackburn, L.
Fraser of Kilmorack, L.	Trumpington. B.
Gisborough. L.	Vaux of Harrowden, L.
Glanusk. L.	Westbury. L.
Glenarthur, L.	Whitelaw. V.
Grimston of Westbury. L.

Resolved in the negative, and amendment disagreed to accordingly.

[Amendment No. 7 not moved.]

9.57 p.m.

Lord Banks moved Amendment No. 8: Page 2, line 28, at end insert—

1. (e) any optical appliance for a registered partially sighted person:or
2. (f) any optical appliance for an old age pensioner.")

The noble Lord said: I move this amendment at the invitation of my noble friend. As the Committee is aware, the Bill as it stands requires qualified dispensing only in the case of children and in the case of the provision of contact lenses. This amendment would require, in addition, qualified dispensing for the registered partially sighted and old age pensioners. In fact, 75 per cent. of registered blind and partially sighted people are over 65, so there is a considerable overlap between these two categories. Twenty-seven per cent. of all elderly people have some visual impairment.

Old people often need complex lenses. References has already been made on a number of occasions today to those required by, for example, people recovering from cataract operations. Often, old people may have serious eye conditions. We do not believe that these two categories should be exposed to any risk, however small some people may think it is. We feel it is essential that their glasses should be dispensed by fully qualified persons. I beg to move.

Lord Glenarthur

I should like first to deal with the question of old age pensioners. There are no medical grounds for excluding the over-65s from unregistered suppliers. Their eyes are no more capable of permanent damage from inappropriate glasses than are those of younger adults. It is probably true, as the noble Lord. Lord Banks, suggests, that a higher proportion of this age group require more powerful lenses, but this does not of itself make unregistered sellers undesirable. Indeed, patients with high-powered lenses are more likely to notice visual distortions. There is no argument for excluding pensioners from the benefit of greater competition and the lower prices that this will bring.

So far as the other part of the amendment is concerned, those who are registered partially sighted will usually be advised by their medical advisers to obtain glasses from a qualified optician. But we are not at the moment convinced that the law should deprive all registered partially sighted of the right to choose where they should obtain their spectacles and thus expose them to possible extra financial costs that might be avoided by the rest of the population.

We are still considering representations on this matter. If we are persuaded that legal constraints are needed, these can be put into orders under the powers which are contained in the Bill. So an amendment to this Bill is not required and it would, of course, be open to your Lordships to pray against any orders that came forward. I hope that with those remarks the noble Lord will not press his amendment to a Division.

Lord Ennals

I was very glad to hear the noble Lord, Lord Glenarthur, say that consideration was being given, particularly in the field of disability, because it is rarely the case that disability can be neatly categorised and that a person's disability is confined to one particular aspect of his or her way of life or health. It is certainly true that disabilities affecting the nervous system are often evidenced in the eye and that other disabilities increase a person's dependence on his own good sight.

For many people with a disability the economic provision of National Health Service spectacles has an important effect on their quality of life in just the same way as access to the whole range of national health services is important to them. The withdrawal of NHS optical dispensing from these groups should be seen in the context of the total health provision.

Some may say that it seems curious that the blind require spectacles. But for many of these people the preservation and enhancement of the tiny part of their eyesight that remains is vital to their lives. The blind and the partially sighted together, as a group of disabled people whose disability may not be confined to sight, deserve continuing access to NHS optical dispensing. So I was very encouraged by what the noble Lord said, and I hope that when consideration is being given to orders—even though I understand that the noble Lord, Lord Banks, will not be pressing the amendment—consideration will be given to an order which will give effect to the principle in relation to disabled people.

Lord Banks

I, too, am glad to hear that consideration is being given to the position of the partially sighted. I cannot pretend that I was altogether satisfied with the reply which the noble Lord gave. I would like to consider what he said and perhaps to return to this particular subject at a later stage. But in the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Cullen of Ashbourne moved Amendment No. 9: Page 2, line 32, at end insert— ("(3E) No order under subsection (3a) above shall be made unless a draft of the order has been laid before and approved by resolution of each House of Parliament.".")

The noble Lord said: The purpose of this amendment is to require that any order which is introduced to permit the sale of optical appliances by unqualified persons should be subject to affirmative resolution of each House of Parliament. Whether or not the amendment is technically correct I am not quite sure, but I would like to hear the views of my noble friend on the Front Bench.

This seems a reasonable amendment to propose, because during the Committee stage of the passage of the Bill in another place, the Government accepted that any Order in Council making changes in the General Optical Council Publicity Rules dealing with advertising should be subject to the affirmative resolution procedure. It can be argued that the conditions and safeguards to be applied to unqualified sellers of spectacles, upon which the Govenment have placed such great reliance, are a matter of much greater public importance than the advertising rules affecting opticians. It is, therefore, important that Parliament should positively approve the adequacy of any such safeguards.

At the moment, apart from the safeguards built into the Bill to prevent unqualified people from dispensing contact lenses or selling spectacles to children under the age of 16, the only other safeguard envisaged by the Government appears to be the requirement that spectacles should comply with British Standards. However, this will not correct any errors in dispensing and there still remains a very big question mark about how the Government propose to ensure that the conditions and safeguards to be laid down in the Order in Council are in fact to be enforced.

At the moment the Goverment appear to be relying on the fact that a breach of the Order in Council would render an unqualified seller of spectacles liable to prosecution under Section 21. However, the police have never shown any willingness to undertake such prosecutions in the past and there seems no likelihood of their adopting a different attitude in the future. Such prosecutions as have been brought in the past have been initiated by the General Optical Council. But that body has no statutory duty to prosecute, and since its primary duty is to regulate the registered profession, it is open to doubt whether the GOC will still be prepared to assume a prosecuting role, especially when neither the General Medical Council nor the General Dental Council do so in relation to doctors and dentists.

Futhermore, this enabling power, taken in subsection (1) of Clause 1 of the Bill, to end the so-called opticians' monopoly, is another example of an objectionable tendency in legislation to deal with matters of major importance in subordinate legislation. In this particular case Section 21 of the Opticians Act 1958 is an offence-creating section, and it can be argued therefore that if the ingredients of that statutory offence are to be changed, then it should be done by direct amendment to Section 21 rather than by subordinate legislation subject merely to the negative resolution. I beg to move.

Lord Ennals

Very briefly, I wish to support the noble Lord, Lord Cullen, and indeed my name is down to the amendment. Clearly a number of Orders in Council will flow from this legislation. We had one example in the previous short debate. That being the case, it is important that both Houses should have the opportunity of scrutiny without the need to pray against it. Therefore, I strongly support this particular amendment.

Lord Mottistone

I, too support my noble friend. It seems to me that at the moment, apart from the point made on my Amendment No. 7, the Bill contains so much of the detail which will be set out in the orders that this is a case where we should have an affirmative procedure and not a negative one. I should have thought that the case for it is overwhelming, and I hope that my noble friend will agree.

Lord Rugby

I was not here when this debate started, but 1 understand that in fact the noble Lord, Lord Cullen, acts as president for the optical corporate bodies, which are highly commercial concerns. I am sure he will admit that he is involved in a commercial exercise in putting forward their points of view. if anyone doubts that, I would refer him to the public relations department which those bodies possess and which apparently has an abundant supply of money in order to publicise the case for the retention of a monopoly, in which they are very predominant. That publicity material has been sent around both Houses of Parliament on a very large scale. I regard that as a form of advertising, if no one else does. If they can advertise in that form, I see no reason at all why other people who wish to enter the market should not equally enjoy the same privilege.

Lord Cullen of Ashbourne

With great respect, that is a very interesting observation, but it has absolutely nothing whatever to do with the amendment.

Lord Ennals

If I may say so to the noble Lord, Lord Rugby. I think that that was a most unpleasant intervention. I am able to stand up and say that because I am not involved in any financial implications at all. Of course, professional bodies are entitled to lobby this House as they are entitled to lobby the other place. It would be absolutely wrong if we in this Committee were to criticise their ability and freedom to do so. In fact, much of our work would be made harder if we did not have the benefit of the expertise which they place at our disposal. So I deeply resent that the reference was made and I assure the noble Lord that I have not gained one penny from it.

Lord Renton

On reflection, I hope that the noble Lord, Lord Rugby, will not persist in the line which he has just taken. All my working life until recent years I have belonged to a very highly competitive profession indeed. But it is also a highly qualified profession. We hope that these regulations will have something to say about the requirement that people in the competitive world which the Government quite rightly envisaged have adequate qualifications or are subject to adequate safeguards. That should be so, whatever the interests of opticians, as they now are, may be. I hope that the noble Lord, Lord Rugby, will not expect the Government to accept his argument as part of this case.

Lord Rugby

I was not putting forward an argument. I was trying to make a statement of fact. We have the optical corporate bodies who now occupy prime sites in the selling end of optical appliances in all the major city centres. They occupy a privileged position because they now dominate a monopoly position. That is what I am trying to bring home. In order to get competition into the market I believe that other people should be allowed to advertise in the same way that is their privilege at the moment.

Lord Mottistone

What relevance has the speech which the noble Lord, Lord Rugby, has just made and the one he made earlier to Amendment No. 9? It may have been suitable for other occasions, but of all the amendments it has no relevance to Amendment No. 9, apart from the fact that it was most distateful and uncalled for, but that is neither here nor there. It is quite irrelevant, and I should think that it is out of order in the Committee.

10.12 p.m.

Lord Glenarthur

Not for the first time have I or many of my noble friends stood at this Dispatch Box and discussed the question of affirmative versus negative resolution. I think that the noble Lord, Lord Northfield, knows what I am talking about. I cannot share my noble friend's enthusiasm for the affirmative resolution procedure in this case either. The Bill as drafted provides an adequate means of parliamentary scrutiny. The orders which can be made under it can be the subject of a Prayer by either House. The Government have been open minded on this subject.

Orders which override the wishes of the General Optical Council in the matter of advertising are to be subject to the affirmative procedure. It is clearly unusual for the Privy Council to be given power to override the decisions of a statutory body exercising jurisdiction over an independent profession. It is clearly a power which must be exercised sparingly if the independent status of the GOC is not to be undermined. A power of this nature justifies special scrutiny.

My noble friend Lord Cullen queried whether or not the amendment was properly drafted. I am advised that it is excellently drafted. I understand that parliamentary counsel could not have improved on it. Its only technical failing is that it should have been in substitution for subsection (3D) and not (3E), but that no doubt is a point which he has already noted.

However, the orders we are dealing with here are not an unusual exercise of power, as my noble friend suggested they were. They are mainstream examples of subordinate legislation, and nothing particularly unusual. The subject matter is indeed important but the orders will merely be putting flesh on the bones of the clear principles set out in the Bill before the committee. They will specify what appliances can be sold by non-opticians and lay down the conditions governing their sale.

The Bill itself puts clear constraints around the powers. It sets out the important exceptions to the appliances which can be exempted. The Bill imposes the most important condition: the prerequisite of a sight test. I really do not see what real additional checks on the Privy Council are required here. They are tightly constrained by the Bill as to how far they can go. Their proposals are subject to a Prayer of annulment by either House if your Lordships or Members of another place believe that the orders are not satisfactory.

To adopt the affirmative procedure in this case will subject the public to unnecessary delay in the furtherance to their advantage of the Bill's proposals. The public want to see a liberalisation of the market in glasses and they want lower prices, too. They will see no advantage in a delay. The negative resolution procedure will give the public what it clearly wants, while retaining adequate parliamentary scrutiny over the orders. I believe that no good purpose is served by this amendment, and I hope that my noble friend will see fit not to press it.

Lord Banks

The noble Lord says that there are clear principles in the Bill and because of that it is not necessary to have the affirmative procedure. Is the noble Lord saying that the affirmative procedure can only, or should only, be used when the orders are based on principles not contained in the Bill?

Lord Glenarthur

I think the noble Lord is twisting my argument. What I said was that these are mainstream examples of subordinate legislation—not unusual orders—and I think the noble Lord, in the way that he put it, is in fact misrepresenting the argument.

Lord Cullen of Ashbourne

In reply to my noble friend, of course I shall not press this amendment. I would say that the way in which these regulations are done is extremely important. They will be very carefully examined. Many of us are highly doubtful as to how they will be enforced in so far as unqualified and unregistered opticians are concerned. Who will make sure that they are not selling spectacles to children, not selling contact lenses or whatever, when there is no way of actually knowing who they are, what their address is, or anything else? However, having said that, I am happy to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Rugby moved Amendment No. 10: Page 2, line 32, at end insert— (" (c) in subsection (4), before the word "appliance" in the second and third places where it occurs there shall be inserted the word "optical", the words "of being used" shall be deleted and for the words "a defect of sight" there shall be substituted the words "an optical abnormality or disease";").

The noble Lord said: I have seen fit to add the word "optical" to the word "appliance". I think it is important that it should be qualified all the time. There are many appliances on the market which might be described as having a relationship to the eye. For instance, if you take an extreme case, a white walking stick could be described as an appliance in that particular sense. I believe "optical appliance" perhaps clears up any misapprehension. I would in fact only wonder whether it should be "ophthalmic optical appliance" where a prescription is supplied by someone who is a qualified ophthalmologist, because I think in that way we would probably get nearer to what we are really looking for. However, I think it makes it quite clear that an "optical appliance", when referred to, should not be just an appliance.

I wish also to go into the realm of the word "defect" which is apparently capable of great misunderstanding. In a court case to which I recently listened the word "defect" was clearly totally inappropriate and nobody could give a proper description as to what was meant by the word "defect". I think if we had had "an optical abnormality or disease" then that would have cleared this point up because in certain cases—it applied especially in this court case-we are dealing with what is described as "a normal defect". I think it would have been better if "a normal defect" could have been described as an abnormality. It would have made it clearer for everyone concerned.

Could we therefore have an "optical abnormality" instead of "defect", especially where age is concerned because one cannot describe age as a defect. In court age was described as a defect, but it seems to me that where one is dealing with a certain age group of people—say, people all of 45—one has to consider a normal condition for people of 45 years of age. If somebody has an abnormality, and I should like to bring this into the Bill instead of the word "defect".

Lord Mottistone

As I am advised, the effect of this Amendment No. 10 would be to change the defence available to someone prosecuted for selling an optical appliance to make it easier for ready-made reading glasses to be sold without prescription. That is the practical effect as opposed to all the remarks that the noble Lord, Lord Rugby, made.

Lord Glenarthur

I have listened with care to what the noble Lord, Lord Rugby, said in moving his amendment and to what my noble friend Lord Mottistone said also. I have to tell Lord Rugby that I do not believe that this amendment actually achieves his intentions. As I see it, having carefully looked at the Opticians Act 1958 and the Bill, his amendment would merely alter the nature of the proof required when someone sought to use the defence that they sold glasses as an antique rather than to correct—or whatever—a defect of sight; or, as the amendment would make it, to correct an optical abnormality or disease. I believe that the noble Lord wanted this amendment to allow a general defence against prosecution on the grounds that the glasses concerned were only intended to correct the results of the natural ageing process of the eye or presbyopia.

Once again I must stress the point that we are not maintaining that self-selected glasses to correct presbyopia would, in themselves, be harmful. The person concerned might get less than his full potential correction to his vision but his eyes would not, at the end of the day, be harmed by it. Our objection to self-selection is that it breaks the link between sight testing and the sale of glasses: a point made earlier by my noble friend Lord Caithness. It thus would allow some cases of glaucoma and other diseases to go undetected. We believe that this is a risk we need not and we should not take. The requirement to have a recent sight test is not particularly onerous and will not detract much from the Bill's aim to improve competition. We believe that the extra competitive advantages of self-selection are not commensurate with the risks involved. Thus I hope the noble Lord will be able to withdraw his amendment.

Lord Northfield

I shall not enter the general argument, but I wonder whether the noble Lord would care to look into the point that if an amendment on these lines were to be moved at Report stage the best place to make this amendment would be in the definitions of the words "optical appliance" at the end of the 1958 Act? In case we wish to return to this matter at the Report stage, perhaps he would write to me and confirm that that is the best drafting advice that the Government can give.

Lord Glenarthur

I certainly shall come back to the noble Lord. I think that probably he is correct; but I need to seek advice on that. Section 30 is probably the appropriate place; but I shall need to confirm it in writing.

Lord Rugby

With that assurance, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Rugby moved Amendment No. 11: Page 2, line 32, at end insert— ("(d) at the end of subsection (4) there shall be added— or that he supplied or repaired an optical appliance for purposes of restoring partial or total visual accommodation where otherwise the safety of the individual might have been adversely affected.".")

The noble Lord said: This amendment is in relation to repairing or giving first aid to somebody who has had an accident, possibly a car accident or something of that sort, and thus is incapacitated because his spectacles are damaged, but needing quite simple repairs such as those which can be effected by a jeweller or an engineer enabling him to make a temporary repair and thereby restore partial, if not total, sight to that person.

I believe that this is a very important amendment because at present it is stated that an optical appliance is an empty spectacle frame and anybody who dares to mend either a hinge, an arm or any part of it can be prosecuted. In view of the immensely incapacitating effect on people without their glasses, I believe that somebody in a professional capacity should be fully entitled to assist, if at all possible and, if necessary, to charge a professional fee for that repair to safeguard that person from another form of worse accident.

Lord Mottistone

I am advised that this also would provide a similar extension to the last amendment to defences available to an individual prosecuted for selling readymade glasses. I think perhaps it is not all that it seems.

Lord Glenarthur

I have some sympathy with the intention which lies behind the amendment of the noble Lord, Lord Rugby. In future many people will probably keep prescriptions for glasses upon their persons; but if not, it will not be too onerous to have to go to a registered optician. One of the benefits of increased competition will be that the prices charged by opticians will become more reasonable. Also, increased competition will make all suppliers more customer-conscious and give a faster service.

I fear that the amendment would open the door to abuse and would put suppliers in a difficult position if faced with a plausible tale of woe from a customer. I am not convinced that the benefit of the extra flexibility proposed would be commensurate with the extra risk which could arise from its abuse. Repairs to frames have not been illegal in the past. In future, even replacement frames will be able to be supplied without prescription. I do not think, anyway, that lenses can be repaired. Replacement lenses will only be available on production of a prescription, and this point was covered earlier this afternoon. I accept that to some extent this could be irksome on occasion; but, as I have said, this minor inconvenience must be balanced against the possible abuse to which the amendment could lead. I hope that the noble Lord will not press the amendment.

Lord Rugby

I have been told by a doctor that perhaps one of the worst things that can happen to persons in an accident is the loss of spectacles. They are so totally incapacitated. I cannot believe that anyone in this Committee would be so heartless as to say that they should be left in a semi-blind state while an optician, who is probably not available over the weekend, is only prepared to say that people must carry a spare pair of glasses around with them; when they cannot possibly anticipate this type of occurrence. Many people must realise that spectacles are highly fragile and that we might have to carry half a dozen pairs around with us in those circumstances. It is ludicrous to say that somebody cannot make a repair for fear of hurting this closed-shop opticians' profession.

Lord Glenarthur

If I can return to the noble Lord, the point is that if he is referring to frames there is nothing to suggest that the repair of frames is illegal. I accept the fact that hinges come undone and that damage can be done to the plastic. We have all seen examples of repairs which have been made to glasses. The noble Lord, in praying in aid the point about damage, suggested that it would not be possible for someone to get a repair to his glasses over the weekend. I understand the intention behind the amendment, but I think we should be going a little too far in this case, particularly in view of the fact that frames can be repaired at the present time while broken lenses cannot be repaired anyway.

Lord Winstanley

I apologise for detaining noble Lords and the Committee on this matter but I assure the noble Lord that there is a point here and one that I hope at some stage he will look into. Perhaps noble Lords will forgive me if I recount a personal experience which tended to make me take the view that Lord Rugby has taken on this.

Not very long ago I had to travel from your Lordships' House to do something which required reading. I had to read a script. The screw came out of the corner of my glasses. They were a metal pair and when that happened they expanded and out dropped the lens. I could have seen the screw and I could have seen the hole that the screw goes into if I had had my glasses on. But I could not put my glasses on and could not screw the screw in. I was at Euston Station and I asked the chemist there if he could do it. "Oh, no," he said, "that is optical work. I could go to prison for doing optical work." I said, "Where shall I go? Is there an optician here?". He said, "No, but there is an instrument maker outside. Try him." I went to the instrument maker and said, "I wonder if you could put this little screw into my spectacles." "That's optical work. It is more than my living's worth to do that. It is optical work." So I said, in that case, would you be kind enough to sell me that little screwdriver and that lens so that I can put the screw in?" "No," he said "that would be helping you to do optical work."

The story did have an happy ending. I travelled on the train. I was going up to do a broadcast in Manchester. I happened to be sitting next to a pop-singer from a group known as The Paper Dolls. She was not an optician. She had not got a screwdriver. But she had very long finger nails. This tale is absolutely true. I said, "Look, dear, do you think you could put this screw in my spectacles?" She was able to do it, I was able to do my work later on, and I got out of a rather difficult situation. It was not a dangerous situation but it really did seem to me an absolute absurdity if, under the Opticians Act, it was an offence for somebody to put a screw in a pair of spectacles. I wonder if the noble Lord would look into that point at some stage and let me know so that we can decide whether or not the monopoly in the Opticians Act as far as that kind of work is concerned does require some kind of relaxation.

10.30 p.m.

Lord Mottistone

Perhaps the noble Lord might take a leaf out of my book. I always keep a spare pair of spectacles and a screwdriver in my briefcase because I have had just the same experience as he has. I do it myself and no one has taken me to court yet.

Lord Glenarthur

I must confess that I do have some sympathy with the point of the noble Lord, Lord Winstanley, and my noble friend Lord Mottistone. When I have been asked to do anything in this line, I have found a very thin piece of fuse wire to be an answer and it has worked quite well. I cannot give an undertaking that it will be possible to do anything, but I shall take away what the noble Lord has said and study it in the Official Report. If it is possible to do something, I will of course be in touch with him and let him know. I would not like to give any undertaking now except to say that I will certainly look at what has been said.

Lord Rugby

I thank the noble Lord for that. He must remember that many people do not carry briefcases. They live very far away in the country and sometimes, especially in agriculture in which I am engaged, it is very important that they should be able to see properly. We can easily have accidents with these very fragile things and we are not within miles of opticians' shops. Often we cannot get to a person who can do repairs. I think this is something which the noble Lord should look at carefully because life can sometimes be difficult and dangerous situations can be involved. For instance, electricians are perhaps engaged in circuitry in very uncomfortable positions and wearing perhaps only a pair of slacks and a sweat shirt. Where do they keep a spare pair of spectacles? The standard spectacles supplied by opticians are very fragile and break very easily. They are for self-employed people, and I do think that first aid for spectacles is vital and important, and I hope that the Minister will look into it. In the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Baroness Robson of Kiddington moved Amendment No. 12: Page 2, line 41, after ("Council") insert ("and such bodies representative of the interests of the general public as seem to the Privy Council to be appropriate").

The noble Baroness said: May I speak also to Amendments Nos. 13 and 14:

Amendment No. 13: Page 3, line 5, leave out from ("Council") to end of line 7 and insert ("and to such bodies representative of the interests of the general public as seem to the Privy Council to be appropriate to the modifications they propose to make and consider any observations of those bodies thereon.")

Amendment No. 14: Page 3, line 23, after ("Council") insert ("and those bodies representative of the interests of the general public which the Privy Council has consulted").

These amendments seek to extend consultation beyond the professional interests and to involve the consumer. Similar amendments were tabled at the Report stage in the Commons but were resisted by the Government. I felt that the resistance was not very logical for the Government argued that they intended to consult the consumer interests anyway and that there was therefore no need to write it down. In my view, all too often when it comes to discussing consumer interests the argument is that it is not necessary to write a provision into a Bill and that it will automatically happen. It is my experience that it does not. I believe that it should be written down in the Bill. I should also like the Government to clarify what consumer interest they would consult. Would they consult the voluntary organisations? Would they involve the CHCs? These are questions that I would very much like to have answered. I beg to move.

Lord Glenarthur

I note what the noble Baroness said in proposing her amendment, but I have to tell her that I feel that her amendments are unnecessary. The clause already requires that where changes are made without the GOC's consent the orders shall have to be approved by both Houses of Parliament. In other cases either House can pray against the orders. Members of your Lordships' House and of another place represent the public. To require affirmative resolution procedure unless both the GOC and bodies representing the public have indicated consent might well require all orders to be so treated. The GOC and the other bodies might well take up opposed views. It is more satisfactory for the Government to perform their usual role in such matters and reach their own judgment after carefully considering all viewpoints.

The GOC itself is not there simply to represent the views of the optical profession. It does have a small number of lay members who are intended to represent the general public. Sadly, however, this body, on this issue, has, I fear, become somewhat out of touch with public feeling generally and is only reflecting the wishes of the profession.

There is ample evidence in the OFT report that only minimal restrictions on advertising are needed. We believe the report also reflects public feeling on this particular issue. We have, for example, the full support of the Consumers' Association and also of the National Consumer Council for our proposals on this matter.

Ministers can take soundings from such bodies without the need for formal arrangements. If it would in any way help the noble Baroness. I certainly can give an assurance that both these bodies will be given an opportunity to comment on any orders on which we are bound by the Bill to consult the GOC. I hope that, with that, she will be satisfied and will not press her amendment.

Baroness Robson of Kiddington

I thank the noble Lord for his reply, and, in view of his assurances that the consumer interest will be truly consulted, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 13 and 14 not moved.]

Lord Ennals moved Amendment No. 15: Page 4, line 6, at end insert ("( ) The Secretary of State shall by order make provision for the control of the advertising, publicising or promotion of optical appliances as defined by the Opticians Act 1958 in any manner to the public, by persons not being registered medical practitioners or registered opticians.").

The noble Lord said: I beg to move the amendment standing in my name. The Government's contention has been that advertising will increase competition; but there clearly will not be fair and equal competition, and clearly there will be a risk to the public, if the unregistered sellers of spectacles are allowed to advertise appliances in a profligate and unrestrained manner. While precisely similar advertising restraints will be placed upon the registered seller and the registered practitioner, there remains a similar duty upon the Government, I would submit, to protect the public interest—and this is the point that the noble Lord, Lord Glenarthur, was making just a moment ago.

If the unregistered sellers are free to make spurious claims, to advertise worthless qualifications and to engage in misleading price comparisons, as against registered practitioners—which presumably registered practitioners will quite properly be prohibited from doing—then the registered practitioner goes into the new situation with one hand tied behind his back. The public will be faced, on the one hand, with restrained, properly controlled and regulated advertising of professional services, and, on the other hand, with unregistered sellers able to use every advertising trick to gull the unwary patient and persuade him away from qualified and registered dispensers.

The purpose of this clause is to make provision for the Secretary of State to formulate by order simple restrictions on the mode and content of advertising by the unqualified to satisfy the requirement that the public should not be misled as to whom they are consulting or what services are being offered. Further, the order should prevent comparative price advertising as against registered practitioners, and the advertising of bogus or spurious qualifications. I beg to move.

Lord Northfield

I do not want to intervene at any length on this, but I think my noble friend may find it is already covered by the Bill. That is for the Government to say. While I am on my feet—and it is the only opportunity we have—I think we should give a welcome to this relaxation on advertising. My noble friends on this side of the Chamber often wonder why we distrust opticians to some extent. If my noble friend would only reflect on the job we had to get opticians to display prices—my goodness, the pressure and the years it took to get that! And even then they only carried the display of prices by, I think one vote on the General Optical Council. It was absolutely disgraceful.

The Minister has said what he wants advertising to do. He said in column 388 (I have to paraphrase; I cannot quote) that he wants opticians-and the dispensers, too—to be able to advertise their whereabouts, their hours of opening, the range of prices of frames available and all the basic information to allow the market to flourish and the consumers to exercise some choice as to where to go for what they need. It surely is right that we should have this degree of advertising by both opticians and the new non-registered dispensers.

Finally, it is worth reading out what the Office of Fair Trading said about the present restrictions on advertising. This is in paragraph 11.103 of its report, and it said: The rules on publicity of 1981 effectively deny consumers information on available opticians in their locality; the range and prices of available products; and the services which are offered by opticians in terms of opening hours, speed of dispensing, product guarantees and specialised services such as contact lens work and, to a lesser extent, quality. Consumers are therefore denied the knowledge on which to make an informed choice of optician". How right that is, and how many years have we been battling to get opticians to admit it! I unreservedly welcome the relaxation on advertising that is in the Bill.

Lord Suffield

For the reasons he gave, I support the noble Lord, Lord Ennals, about advertising. I feel that like should be compared with like, because the same constraints should be on both commercial firms and professional firms. It is not like car manufacturers, who are all the same and can run down each other's product. While there are contraints on the professional firm there must be constraints on the commercial firm for the reasons that the noble Lord gave.

The Earl of Caithness

The effect of the amendment proposed by the noble Lord, Lord Ennals, would be to require the Secretary of State to make orders controlling the advertising of optical appliances other than by registered opticians or doctors. We see no need for this sort of bureaucratic arrangement for regulating advertisements or publicity involving glasses by either manufacturers or retailers. Advertisements for glasses, like other things, will be subject to the Trade Descriptions Act, the law on misrepresentation and the codes of the Advertising Standards Authority and the Independent Broadcasting Authority.

The noble Lord, Lord Ennals, will be pleased to hear that both of the latter bodies already have provisions in their codes relating to advertisements containing health claims or involving health-related products. Indeed, they are aware of this Bill and are both prepared to revise their codes to cover any particular problems which liberalising the sales of glasses might throw up. Our present view is that these codes are adequate to avoid the excesses which some noble Lords fear.

Furthermore, it must be remembered that there is the buffer of a sight test which stands between advertising-generated demand for glasses and their supply. I think that this point must be borne in mind when considering some of the points which the noble Lord. Lord Ennals, made. The fact that one has to have this sight test—and this is one of the good reasons for maintaining it in the Bill—means that any excesses of advertising will be subject to it. Therefore, I cannot accept that the advertising of glasses requires special legal controls, and I hope that the noble Lord will now see fit to withdraw the amendment.

Lord Ennals

I do not feel at this moment that I want to withdraw it, and I will explain the reason why. My noble friend, who has not always been my friend in the course of the proceedings, Lord Northcliffe—I beg his pardon; I mean Lord Northfield. I deliberately try to insult him by calling him by the wrong name! It is quite effective sometimes; but it is hard on the Chief Whip, who criticises one for that sort of tactic in another place. But my noble friend Lord Northfield said in his intervention that this is to be found in another part of the Bill, and it is not necessary to have this amendment. Perhaps he will intervene and explain to me where in the Bill this is covered. So far as I can see, the responsibility that I am trying to place upon the Secretary of State is not covered in any other part of the Bill.

Certainly I welcome the points that were made by the noble Earl in his answer, and his reference to the Trade Descriptions Act and the Advertising Standards Authority's willingness to guarantee that there will be fair competition. But the point that I wanted to make was made by the noble Lords who supported my amendment; namely, that there ought to be equal with equal, like with like: that if there is going to be an effective system, as there is, of advertising for the professionals, there must be an effective system of advertising for the non-professionals. I have argued the case against the clause; I do not wish to have it at all. But we have got it. If some element of restraint is going to be placed upon those who are not qualified, the best way in which to impose it is, as I have already suggested, by the Secretary of State standing as the moderator. He should have the responsibility of ensuring that like is compared with like, and that there are proper restrictions in relation to the non-trained, non-qualified dispenser. I am hoping to have an answer from the noble Earl.

The Earl of Caithness

I do not think I can add much to what I have already said. However, I omitted to thank the noble Lord, Lord Northfield, for his welcome of our proposed relaxation of advertising. The point that the noble Lord raised with regard to this amendment is not covered elsewhere in the Bill. However, any constraints on the optical profession are, in effect, self-imposed. We are having to take legislative powers in order to force the GOC to liberalise. No doubt they will bear in mind the disadvantage under which this will place them. They can revise the rules themselves. No doubt they should have done so by now. We see no reason why the GOC needs so many rules.

Lord Northfield

I thought that the matter was covered at the bottom of page 2, by the orders which the Privy Council can make. If I have misled the noble Lord I apologise. I said that it was not for me to dictate to him the answer that the Government would make. The Government have given the right answer, though it was not the one I thought.

Lord Ennals

I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 1 agreed to.

Lord Denham

This is probably the right time to resume the House. I beg to move that the House do now resume.

Moved accordingly, and, on Question, Motion agreed to.

House resumed.