Reading Spectacles: Prescriptions (Hansard, 14 June 1985)

§ Lord Rugby
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

The Earl of Caithness
My Lords, we have received no evidence that this is happening. The early signs are that the Government's measures to promote fair competition in the optical market are working effectively.

§ Lord Rugby
My Lords, will the Minister recall that at the setting up of the 1958 Opticians Act one of its most important pillars was that there should be a separation between the two functions of testing eyesight and selling spectacles, entirely in accordance with the same kind of Act to which medical doctors had to conform? Will he tell us now whether there is not a suspicion that the taxpayers are funding a prescription which with a very small addition can be slanted in the direction of the sales department of the opticians? In fact, there is a suspicion that the prescription is nothing more than a chit which will have to be spent at the company's store.

The Earl of Caithness
My Lords, if there is a suspicion, I should very much like it if the noble Lord could produce firm evidence so that we can have a look at it. With regard to the dispensing of the prescription and the selling of the finished article, as he will be aware, in April this year regulations came into effect under the Health and Social Security Act passed last year which enable unregistered opticians to dispense spectacles on condition that there is a prescription.

§ Lord Bruce-Gardyne
My Lords, is my noble friend not aware that the optical press is carrying letters from opticians, advising other opticians how prescriptions can be drafted, in order to ensure that they cannot be taken next door and the glasses supplied from another purveyor? Surely this is an inevitable result of the quite unnecessary stipulation that those who require reading 1484 glasses must first obtain a prescription. Surely it is hardly surprising that opticians should resent being expected to put forward a prescription which is then taken elsewhere. Is not the solution, as we suggested at the time this Bill was carried through, that the obligation for those who require only reading glasses to have a prescription, should now be removed?

The Earl of Caithness
My Lords, we return to the happy territory of July last year. I remember well debating this issue with my noble friend. It was agreed by the House and passed as an Act of Parliament that to dispense spectacles one must have a prescription. Until it has been proved that that policy is not working satisfactorily, I think it is right to stick to it. Even if one gets a prescription, one can go to a non-registered ophthalmic optician to obtain spectacles. I think the success of the Government's policy is proved by the fact that one can now obtain glasses with prescription for as little as £12.45.

§ Lord Harris of High Cross
My Lords, I wonder whether, in view of this latest flurry of interest, the department is prepared to contemplate the possibility that it is confronted by a determined professional conspiracy to use a variety of tricks to preserve its closed shop in the sale of simple reading glasses. In view of the evidence that the noble Lord, Lord Rugby, has recently acquired, I want to ask the Minister whether the department is prepared to take the initiative to try to establish the extent to which the manipulation of the prescriptions for reading glasses is being used to defeat the purpose of the 1984 Act, which was to open up the supply of reading glasses to beneficial competition.

The Earl of Caithness
My Lords, with regard to the manipulation of prescriptions, I think, as we discussed in July last year when the Bill was going through this House, it is very important that a person is protected. That is the reason for the prescription. There will be statistics later in the year to show whether there has been a change in prescribing since the regulations came into effect on 1st April. However, I can tell the noble Lord that about two-thirds of low-powered spherical corrections were added to prescriptions even before the Act came into force. Thus this has already happened in the normal method of prescribing.

§ Lord Ennals
My Lords, does not the noble Earl recall that there were very many Members on both sides of the House who were deeply opposed to the measure that was introduced, to which reference has been made? Is not the Question that has been raised by the noble Lord, Lord Rugby, the response that immediately came from other sides of the House, and the absence of knowledge on the part of the noble Earl, precisely what could have been prophesied as a result of the Government's decision to put onto the open market—or, in other words, to privatise—the making and sale of spectacles? Was it not almost certain that we should get this kind of pathetic argument which is now taking place? Was it not the Government's action itself which so many of us criticised, that, as has been said, has created hardship, to the British manufacturer and also to the patients?

The Earl of Caithness
My Lords, with due respect, I think the noble Lord is entirely wrong. I think the Government's action was absolutely right because it has brought down the price of spectacles. When was the noble Lord last able to go with a prescription and buy a pair of spectacles for as little as £12.45? I think that what we have done has been a very great success. Of course, as the noble Lord will be well aware, there are two extremes: there are a few opticians who still want everything to be done by the registered ophthalmic opticians, and there are those, like the noble Lord, Lord Rugby, with a perfectly valid point of view, who want ready-made spectacles available. I am sure that what the Government have done has been proved to be very successful. I am sure that if the noble Lord goes round the country he will not find much support for his view that we should go back to £60 spectacles.

§ Lord Orr-Ewing
My Lords, in his first reply, my noble friend said that he had not any evidence. When these eye tests are done, forms have to be filled in which now say that they can be taken away by the client and dispensed elsewhere. However, a claim is made on the National Health Service. I think a fee of £9 is paid. Therefore, surely these forms must be returned to the DHSS before the money is paid. Can my noble friend not therefore examine this as a matter of urgency? I have an example of a chemist up north to whom 300 prescriptions for spectacles have been presented, every one of which has a minor correction, not in the main number of dioptres but in cylindrical and/or axis corrections which are irrelevant to the needs of the client but which make it impossible for that client to take this to a prescriber and obtain a good pair of reading glasses at a much cheaper price than he would otherwise pay.

The Earl of Caithness
My Lords, from the noble Lord's question we have the exact point. The noble Lord says that some of these additions to the prescription are not necessary. The Government think that they are necessary in order to protect the patient, the customer. As I said in an earlier reply to the noble Lord, Lord Harris of High Cross, this is not something new. This is something that has been happening for a long time in prescribing. The latest figures, which are up to 1st April this year, show that at least two-thirds of prescriptions have exactly these matters which my noble friend is now raising.

§ Lord Ennals
My Lords, is not the noble Earl aware that the opticians themselves, who after all are professionals in this field, are very far from satisfied with the results that the Act has produced? Are we not now in a situation where the noble Lord, Lord Orr-Ewing, with the best intentions in the world and with all the expertise at his disposal, comments on prescriptions written out by opticians as if they were themselves professionals? Is not this precisely the kind of situation which all of us knew would be created when the Government introduced their iniquitous Bill?

The Earl of Caithness
My Lords, I have had very detailed discussions with many eminent registered ophthalmic opticians and senior people in the eye service. Yes, they are disappointed. They are 1486 disappointed for this reason: that the Act is working so well that they have admitted that the unregistered opticians are doing a very professional job in a large number of cases.

§ Lord Leatherland
My Lords, may I ask the noble Earl the Minister whether he will open his eyes to what is going on?

§ Lord Somers
My Lords, is it not a fact that only a minute percentage of people have both eyes with an exactly equal focus and that therefore spectacles with two equal lenses would be entirely inaccurate for them? Is it not also a fact that using spectacles which are not accurate for one's eyes is extremely bad for one's sight?

The Earl of Caithness
My Lords, with regard to the first point made by the noble Lord, this is exactly the reason why we considered it necessary that spectacles should not be dispensed unless there was a valid prescription within a two-year period.

§ Lord Ferrier
My Lords, must we go on with what amounts to a ritual dance? Can we not take the guidance of the noble Earl and wait to see what the figures are like when they are given in a few months' time?

The Earl of Caithness
My Lords, I am grateful to my noble friend for that, but I am very happy to answer the questions that the House puts to me.