Spectacles (Hansard, 15 March 1977)

§ Mr. Hattersley

In its report on the supply of private spectacles the Price Commission suggested that what was wanted was more competition, less reticence about prices and a more rational and more open system of pricing. To this end it made a number of recommendations, on which there have been intensive consultations with the organisations which represent optical practitioners.

In these consultations the spokesmen for opticians have stressed that theirs is a Para-medical profession characterised by high standards of training and demanding profesional examinations, and one regulated by ethical standards upheld by the General Optical Council, which was established under the Opticians Act of 1958 and is empowered to make and enforce rules which opticians must respect as the condition of continuing ability to practise. These rules include restrictions on advertising. Opticians consider that continuity of eye-care is clinically important and, while they wish patients to have a free choice of practitioner, they do not consider it to be consistent with the standards of the profession or the interest of its patients for opticians to compete with each other for custom.

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While fully accepting the optician's responsibilities as a clinician I pointed out that alongside the purely ophthalmic professional aspect of eye-care there exists another element—the marketing of spectacle frames, involving fashion and consumer choice. As a result of our discussions we have reached agreement on several points relating to the supply of spectacles.

The first concerns the display of prices. At present some opticians display within their premises the prices of the frames which they have on offer, while others provide information orally about frame prices but prefer not to display the prices physically. The General Optical Council has confirmed that its rules do not prevent the display of the prices of spectacle frames which are on offer inside an optician's premises. The organisations with which I have had discussions have agreed to inform their members of this and to recommend to them that prices of frames should be displayed.

Under the rules and guidance established by the General Optical Council opticians may not display the price of optical appliances in their shop windows, under pain of disciplinary proceedings and possible removal from the register. The Government have in the past asked the General Optical Council to re-consider this restriction, which appears to deprive the prospective purchaser of information to which he is entitled. The Council has, however, consistently declined to do so and in my consultations opticians have also shown themselves firmly opposed to any change. They consider that such display of prices would be misleading since the cost of frames is only part of the total cost of eye-care and is no guide to the quality of professional service. I have told the representatives of the opticians and the General Optical Council that I regret their unwillingness to modify the rules.

The Price Commission recommended that patients should be more aware of the right to take their prescriptions, after their sight has been tested under the NHS, to any registered optician of their choice. Patients have in the past been informed of this right, though few of them exercise it. The Commission's recommendation raises no difficulty of principle. The notes on the form on which opticians claim payment for NHS work already make it 110W clear that the patient has this right and the point will also be covered by advice currently in preparation.

The Commission recommended that opticians should stock and display the full range of NHS frames. The professional organisations have encouraged their members to do so—and have been prepared to take action in any case of complaint. It seems clear, however, that further steps are needed, and the Health Departments will be pursuing with the profession the desirability of making this part of their terms of service with the NHS.

No decisions have yet been reached by my right hon. Friends the Health Ministers about the extension of the NHS range of spectacle frames. It is clear from discussions so far that this is likely to have substantial expenditure implications.

The Price Commission recommended further that pricing arrangements should be more rational and more readily understood by patients. In particular, patients' bills should be clearly itemised so that they can see what they are paying for. The opticians' organisations have agreed to recommend to their members that patients should be given bills on which the following items appear, where they are applicable: Total amount to be paid, sub-divided into the statutory National Health Service charge for lenses and the charge for the appliance. They have also assured me that where patients require additional information about the composition of the total amount payable, their members are always ready to comply. In this connection, the Health Departments are discussing with opticians better ways of informing patients about NHS charges.

I welcome these new arrangements, which I believe do much to strike the balance between the proper maintenance of professional standards and concern for the interests of the patient as a consumer.