Opticians Act 1989

Baroness Walmsley Excerpts

Monday 8th February 2016 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, first, I apologise to my noble friend Lord Newby for missing the first half-minute of his speech. I am afraid that I was not informed that this debate was to start 15 minutes early; I thought that I was 10 minutes early.

I thank my noble friend for explaining what this debate is all about and for putting the case for looking at this issue again so comprehensively that there is no need for me to repeat it. To me, there are three principles that should apply when considering this matter.

First, the best interests of the patient must come first, so we must ask ourselves whether changing the law would or could do any harm to patients. Secondly, we need to consider whether availability of this new eyewear would deter people from getting a full eye test from a qualified ophthalmologist. Thirdly, would the state of the current law prevent patients receiving any additional benefits that might be available to them through the over-the-counter availability of this new product? We should bear in mind that, when the law went through Parliament, there was no such thing as self-adjustable eyewear, so perhaps it is time to review it.

In considering this matter, we must be impartial to both those already in the optical services business and to those who want to get into it. Could the briefings we have received amount to vested interests? Some noble Lords think so. I am afraid that I think that those who have provided the briefings might have vested interests, although it is perfectly reasonable for them all to make their case and I am sure that they are all providing legitimate information. That is why I ask the Minister whether the Government will set up a completely independent impartial investigation to receive evidence from both sides of the argument and make a truly impartial recommendation, and then will they act on it at the earliest opportunity?

The evidence we have received from the manufacturer Adlens suggests several benefits and no harms. Like the noble Lord, Lord Faulkner of Worcester, I really must congratulate it on its charitable work in Rwanda and other places. It is doing some very important and worthwhile work, which will benefit the economy of that poor country enormously, as well as individual patients. However, it stands to make money in the UK if the law is changed, so we should be aware of that. Mind you, it would probably be a very small amount compared to what companies make in the USA and Japan where these glasses are already allowed to be sold off prescription.

On the other side of the argument is the General Optical Council, the Optical Confederation, the professionals and the retailers who have a financial interest in selling the fixed-prescription spectacles which they prescribe. Of course, they also have a professional duty to put the patient’s eye health first, and I am sure that is their priority.

There would be a very strong argument for refusing to change the law if clear evidence existed that the availability of these adjustable spectacles over the counter deterred people from having a proper eye test—but I have seen no such evidence. We must bear in mind that eye tests are not just done to diagnose and correct vision but also, as the noble Lord, Lord Faulkner of Worcester, pointed out, to screen for eye health and indicators of other types of ill-health. They are very important, which is why we give them free to children and older people.

The fact is that we have been choosing our own vision correction for years. When I go to the optician, I select “red” or “green” and lens 1 or lens 2 all the time. I am selecting my own correction. What, therefore, is the difference between doing that and twiddling a little screw on your own spectacles to get the correction that you need? I accept that these may not be suitable for people with serious astigmatism, but those people probably would not choose them anyway because the quality of vision would not be as good as that from their correct fixed-lens prescription.

Concerns have been expressed about the safety of driving in self-corrected glasses. I was impressed by the study done by the University of Michigan Transportation Research Institute, which showed that there is no statistically significant difference between US drivers wearing prescription glasses and those wearing self-adjusted glasses in their ability to see a hazard ahead. I have seen no evidence to the contrary but, of course, it would be the task of the independent committee that I am calling for to see whether there is any.

As I said earlier, I would be concerned if ownership of these glasses were to deter regular eye examinations, but, again, the evidence I have seen is to the contrary. When over-the-counter reading glasses became available, there was no evidence that this deterred people from getting their eyes tested. Indeed, they need to do so in order to determine what strength to buy from the local chemist. Rather, government agencies and professionals alike believe that the best way to persuade people to look after their eyes and get them tested regularly is by public information and education. A number of these programmes have been mentioned, and they have been around in the UK for years; I am sure Governments would not spend money on them if they did not work.

These new products would have considerable value as a temporary solution for three groups of people: older people may need three different pairs of glasses for different tasks—I know I do—and many find it difficult to afford three pairs; people who have had cataract operations have a period during which their eyesight is settling down and might find these useful then; and new diabetics, whose eyesight may vary while they are working out the right dose of medication to control their blood sugar, may also find these a useful temporary solution. In the last two cases, it is very unlikely that an optometrist would prescribe several pairs of glasses just for a few months. Of course, it is vital that people get their eyes checked regularly, particularly diabetics as there are a number of risks to vision associated with diabetes. However, a pair of these new glasses could be part of their solution.

The fact is that we are already in charge of our own eye health. I recently had to apply for a new driving licence and, as part of the process, had to confirm that I have an appropriate level of vision to drive a car safely. Nobody asked me to get an optician to verify that, although I am in the habit of having regular eye tests and would recommend that everybody do so. In addition, correction prescriptions do not have a finishing date on them, so you can buy contact lenses on the internet using a prescription that is years old if you want to, even though that may no longer be the correct prescription for you. This solution would be a great deal better than that.

I am inclined to allow people to take responsibility for their own eye health, and I thought that a Conservative Government, being in favour of the free market, would be inclined to allow these glasses to be sold without prescription and to give people a choice. However, the cautious thing to do is to set up a truly independent inquiry. I hope the Government will do that, and then the evidence can speak for itself, as can the patients.