NHS Eye Tests for the Elderly (Hansard, 3 March 1986)

Lord Wallace of Coslany
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)
My Lords, information is not available about the demand for National Health Service sight-tests by particular age groups. However, I can say that the overall demand has not been reduced by the recent changes. I have no information about the general supply of spectacles since most people obtain them privately and not through the National Health Service.

Lord Wallace of Coslany
My Lords, is the noble Baroness aware that I agree that, so far as the average person is concerned, there has been no drop whatever? On the other hand—I have this from professional sources—the number of elderly people seeking tests and treatment has dropped considerably. 4 Unfortunately, also, the number of people on supplementary benefit who are entitled to tests has also dropped. This is a very worrying matter, because elderly people need eye treatment more than any others in order to detect diseases arising from defective eyesight.

§ Baroness Trumpington
My Lords, many of the elderly simply need reading glasses and they will be among the main beneficiaries of the more competitive private market. For people requiring the most powerful lenses, NHS spectacles are available at controlled charges as a hedge against fears that were expressed that private prices for these lenses would shoot up. NHS glasses are still available free of charge or at reduced charges to people on low incomes, and of course sight tests remain available to all free of charge.

§ Lord Rugby
My Lords, I thank the noble Baroness the Minister very much for that reply, especially with regard to reading glasses. Is she aware of the fact that a European company is now marketing reading glasses and has been doing so for about a year? It has sold in the region of 30,000 pairs, and this figure is now escalating. That is very economic and this must surely be of very great benefit to those who can select their reading glasses and also to the Exchequer in being able to do away with sight tests for those categories of glasses.

§ Baroness Trumpington
My Lords, while agreeing with the noble Lord, Lord Rugby, that the EC regulations permit the sale of ready-made glasses (and, indeed, these glasses might be helpful to my noble friend the very, very elderly Lord Long!) perhaps I may say that the Government attach importance to the continued link between the sale of glasses and the sight test at which eye diseases can be detected. Therefore while there is nothing to prevent the sale of ready-made glasses as such, their sale by unregistered retailers must be in accordance with a recent prescription for the customer. These arrangements have not prevented many budget ranges of glasses coming onto the market—indeed, I am wearing a pair myself.

§ Lord Kilmarnock
My Lords, can the noble Baroness tell the House whether any help is being given to people after cataract operations when they may need replacements for their glasses two or three times within a year?

§ Baroness Trumpington
My Lords, after cataract operations patients may require frequent changes of glasses until their sight stabilises. Such patients can benefit from what is known as the "technical non-tolerance" arrangements operated by the hospital eye service. Under this arrangement the patient pays only for the glasses which he finally keeps and the cost of the others is borne by the hospital authority. The usual low income remission arrangements would apply to a patient who was unable to meet that charge.

§ Lord Leatherland
My Lords, is the noble Baroness aware of the fact that at my fairly advanced age one of my eyes is weaker than the other? Can I get a monocle supplied on the National Health Service?

§ Baroness Trumpington
My Lords, nobody can get spectacles on the National Health Service now except for the very elderly and children.

§ Lord Ennals
My Lords, may I support my noble friend Lord Wallace? Is the noble Baroness aware that the Association of Optical Practitioners, which has information on these subjects, says that many poor people are not attending for eye tests because they fear that they will not be able to afford the spectacles which will then be prescribed, and that poor people who may not actually be exempt from payment have been deterred from obtaining spectacles, especially complex ones, because of their price? As with heating allowances, does it not seem that the elderly and the poor are the people who suffer particularly under this Government?

§ Baroness Trumpington
No, my Lords. As the noble Lord will know if he is suggesting that free glasses should be provided for the elderly, it has not been the policy of any government since 1951 to give free glasses or help with glasses on grounds of age except, of course, for children. Help has always depended on the ability to pay. The long-standing arrangements for helping those on low incomes are still available. If the noble Lord does not have a copy of the appropriate leaflet, I have a spare one with me in my folder and I shall happily give it to him.

§ Lord Boyd-Carpenter
My Lords, does my noble friend recall that charging for glasses was introduced by the Labour Government in 1950?

§ Baroness Trumpington
My Lords, I am grateful to my noble friend for reminding us all of that fact.

Lord Wallace of Coslany
My Lords, is the noble Baroness aware that I am not grateful to the noble Lord, Lord Boyd-Carpenter? Is she further aware that I would accept that there is a cheaper range of glasses—I know that the noble Baroness has acquired a new pair recently—but that these are known as budget spectacles which have been introduced by the profession in order to assist people to get a cheaper type of spectacles? Is the noble Baroness aware that I am very concerned about the elderly person who is not on supplementary benefit and whose income is insufficient to meet the cost even of the budget spectacles? Being honest as elderly people are and wanting to avoid unnecessary expense, they are not having the treatment that they should have simply because of the present procedure.

§ Baroness Trumpington
My Lords, as I have said, no Government have ever provided pensioners with help for spectacles on the basis of age alone. Naturally we sympathise with those who have difficulty in paying and that is why there are long-standing arrangements giving help. Pensioners who are on supplementary benefit and certain other benefits are automatically entitled to free NHS spectacles. Others whose income is somewhat above the supplementary benefit level can also get NHS spectacles free or at reduced cost through the remission arrangements. For instance, a single pensioner whose weekly income is about £39 after essential outgoings or a couple whose income is about £60 after outgoings might well qualify for help.