Eye Tests: Charges (Hansard, 2 May 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, we are currently conducting a survey into the number of sight tests carried out during the first quarter of 1990. We expect results to be available towards the early summer. The survey is being conducted by NOP on behalf of the Government. It will provide an independent analysis of the present market situation. The market is, however, still unsettled, as people generally have their sight tested only once every couple of years.

§ Lord Ennals
My Lords, will the Minister accept that there has already been a thorough and professional study of sight tests since the Government introduced charges? That study shows 1037 a 30 per cent. decline in testing. Even if the pattern were to settle down to a 20 per cent. reduction, that would lead to approximately 2-5 million people not having their eyes examined. It could mean as many as 50,000 people would not have conditions such as cataracts or glaucoma diagnosed. Is this not confirmation of the most convinced concerns expressed by noble Lords when this House voted against the Government's decision?

§ Baroness Hooper
My Lords, it is far too early to draw such conclusions from the surveys that have been carried out. The market has obviously not settled since the April 1989 changes. In fact, we estimate that since 1987 and before 1989 about 1-4 million more sight tests were carried out over and above normal expectations. Extensive publicity about charges undoubtedly encouraged many people to bring forward their appointments to avoid the April deadline. As people generally only have their sight tested once every couple of years it will take time for a true picture to emerge. Notwithstanding that, one-third of the population is still entitled to free sight testing.

§ Lord Hampton
My Lords, is the noble Baroness aware that in January and February the Liberal-Democrats carried out a survey of almost 2,000 opticians' practices? The noble Lord, Lord Ennals, has referred to a figure of 30 per cent. Our survey showed a 29 per cent. fall in the number of eye tests since the introduction of charges last year. There was no evidence of a large increase in tests the previous year.

§ Baroness Hooper
My Lords, I am of course aware of the recently published survey by the Liberal Democrats. It covered a relatively small number of people. On the other hand, the government survey to which I referred is an independent market research arrangement which will cover a random sample of about 10,000 adults to ascertain whether they have had a sight test since Christmas and, if so, whether it was done through the National Health Service or privately. We believe that it would be better to await the outcome of that survey before drawing any conclusions.

§ Baroness Ewart-Biggs
My Lords, is the noble Baroness aware that it has been reported that a considerable number of people involved in motor accidents are subsequently found to have poor eyesight? Therefore, does not the noble Baroness agree that the unsettled position she describes, and the results of the surveys that have been made, can only exacerbate that grave danger?

§ Baroness Hooper
My Lords, it seems unlikely that a charge of between £10 and £12 once every two years, or even following an accident as the noble Baroness suggested, should deter too many people. There is certainly no evidence to suggest that serious eye diseases are going undetected.

§ Lord Cullen of Ashbourne
My Lords, while agreeing with my noble friend that it is too early to 1038 be quite sure of the deterrent effect of having to pay for eyesight tests, is she aware that the organisation that made the inquiry to which the noble Lord, Lord Ennals, referred was the Federation of Ophthalmic and Dispensing Opticians, of which I am president. The survey was carried out through an independent firm of chartered accountants. It represented nearly 30 per cent. of all the sight tests which had taken place during the course of the nine-month period. Therefore, I think one can consider it as being entirely accurate. In fact, the result was a fall of 36 per cent.

§ Baroness Hooper
My Lords, I am grateful to my noble friend for giving the House more details of that survey, but I am glad that he agrees it is too early to draw Final conclusions.

§ Baroness Seear
My Lords, before the noble Baroness denigrates the survey carried out by the Liberal-Democrats, does she not agree that it represented a far higher proportion of opticians than is commonly the proportion questioned in opinion polls to which, until recently, the Government have paid a great deal of attention?

§ Baroness Hooper
My Lords, I had no intention of denigrating; I do not think that I said anything which did so. I simply recommended that your Lordships have a little patience and await the outcome of the current government survey.

§ Lord Stoddart of Swindon
My Lords, are the noble Baroness and the Government really satisfied with their policy on eye tests? Is the noble Baroness aware that people are now being encouraged to have eye tests and, indeed, buy glasses at departmental stores and even by mail order? The charge for the glasses and the so-called eye test is cheaper than the standard charge by opticians for an eye test. Surely that cannot be good. Will the Government reconsider their attitude, even at this stage, as people's sight is bound to be injured?

§ Baroness Hooper
My Lords, as I said, there is absolutely no evidence to suggest that serious damage is going undetected. We believe—I have said this on previous occasions to your Lordships—that those who can afford to pay for sight tests should do so. That is the way to free resources for other parts of the health service. After all, children, people on low incomes and those with special needs, continue to enjoy a free service.

§ Lord Ennals
My Lords, is the noble Baroness aware that I simply do not accept that there is no evidence? The Royal National Institute for the Blind—surely no one is going to run down that organisation or its degree of knowledge—has conducted its own survey. It found that around 2,240,000 people have been deterred from having their eyes tested. As regards deterrence, the institute points out that people on low incomes appear twice as likely to be deterred as the better off. The poorest people are three times more likely to be deterred than the very well off. What the noble Baroness says is simply not in conformity with the view of the 1039 experts. We should listen to those representing the Royal National Institute for the Blind.

§ Baroness Hooper
My Lords, I can only repeat that we believe that this continues to be an unsettled period and that any effects are temporary. We realise that there may not be total awareness among those entitled to a free service. A publicity campaign intended to bring attention to entitlement to free NHS sight tests is to be launched later this year.

§ Lord Hatch of Lusby
My Lords, if I heard the noble Baroness aright, in her first reply she stated that there is a survey covering the first quarter of this year. Surely the Government know what the figures are for the nine months between the introduction of the order and the end of 1989. What do those figures show? Do they bear out what the noble Baroness said, namely, that this is an unsettled period and that we need not worry? Or do they show what other surveys have shown—a drastic drop in the number of eye tests since last April?

§ Baroness Hooper
My Lords, the figures that we have for the earlier period relate to those obtaining a free service under the National Health Service. As I have said, that applies to about a third of the population. There is no change in the uptake of eye tests in that proportion of the population.