Opticians Act 1989

Lord Prior of Brampton Excerpts

Monday 8th February 2016 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, I thank the noble Lord, Lord Newby, for bringing this subject, which is a new one for me, to our attention. I tried on a pair of adjustable-focus glasses a few days ago, and they are easy to use. The noble Lord is wearing some this evening, and although they may not be as fashionable as some pairs of glasses, I can see that they are perfectly serviceable.

It is odd for us on this side of the House—it is certainly odd for me—to find ourselves painted into the position of being against choice, competition and deregulation, which are now being advocated from the Liberal Democrat Benches. I do not normally associate them with that particular role. Instinctively I am a deregulator, and to be honest, many of the arguments that noble Lords have made resonate strongly with me. Clearly there is a huge vested interest at stake. Whether that is being improperly used in this case I do not know—but one can see that there will always be a strong voice for the status quo.

I should also pay tribute to the company for its work in Rwanda, which is clearly very important. Equally impressive, in many ways, is its breaking into the Japanese and American markets—no easy feat for a small private company. I take on board the words of the noble Lord, Lord Hunt, about how often we hear about companies finding it easier to break into overseas markets than into our own market. It is deeply frustrating, when we produce so many highly innovative products such as this one.

As for an independent review, perhaps we can come back to that question later. I rather like the thought, but although the role of the PSA was brought up in the context of the GDC, I am not sure what powers it has in such areas. That may be worth exploring. Unfortunately, however, I am going to disappoint the noble Lord, Lord Newby—but perhaps not wholly. We shall see when we get to the end. I shall put the other side of the argument, if I can—but in doing that I do not want to imply that the arguments we have heard are not powerful: they are. I know that my right honourable friend in the other House, Oliver Letwin, back when the Deregulation Bill was going through, would have instinctively been very positive towards the arguments that noble Lords are making.

As noble Lords are aware, in order to do what the noble Lord asks it would be necessary to amend the Opticians Act to remove requirements relating to the sale and supply of optical appliances. Clearly this is something we would do only after very careful consideration, and if we were confident that the proposal could stand parliamentary scrutiny. So if we were to take this forward at all, an independent review of some kind would be a requirement.

In the UK the sale of optical appliances is governed by the Opticians Act, which requires spectacles and contact lenses to be dispensed to a prescription issued by a registered optometrist or medical practitioner following a sight test. We are probably all aware of the exception that has been made. In response to the noble Lord, Lord Stoneham, I should say at this point that I will reread—or rather, read for the first time—the 1989 review, where similar arguments were put forward against the exception for reading glasses.

The Opticians Act does allow reading spectacles to be sold over the counter to adults with age-related sight loss. However, this exception has very limited criteria. The reading glasses must have the same power in both lenses, the power of the lenses must be in the range between 0 and 4 dioptres, and the glasses must be for reading purposes only. The General Optical Council is responsible for regulating the sale of glasses in the UK.

I am aware that Adlens has been in discussion with the GOC about its proposal that over the counter sale of its adjustable-focus glasses be allowed. As noble Lords know, in considering this issue the GOC sought the views of its standards committee, asking for its views on any benefits that adjustable-focus spectacles might bring, and any adverse effects that these products might have on the public’s health and safety. I am not aware of the extent to which it took into account the Charman report, which the noble Lord, Lord Hunt, mentioned. That is something that we should look into.

The standards committee raised a number of concerns, including concern about the safety of the product and the possibility that the product might not meet legal standards for driving.

[Lord Hunt of Kings Heath]

The point is that although the note we have says that the standards committee was provided with the independent report, it is not clear what it actually did with the report. It does not look as if the committee went through it in detail and considered the arguments—but that might just reflect the way in which the note was taken.

[Lord Prior of Brampton]

We have often been provided with reports, but that does not necessarily mean that we have read them and given them our full attention. I will ask that question.

I was going through the standards committee’s concerns. Another was that individuals may incorrectly self-adjust, causing a danger to the public when driving. Another was that the sale of these products may distract the public from having regular eye examinations. That is an issue that needs consideration. I appreciate that the noble Lord may not be convinced by the arguments put forward by the GOC’s standards committee, but we would be foolish not to take into consideration its professional view—the precautionary view that the noble Lord, Lord Hunt, mentioned. We have to give that due weight.

I understand that one of the original intentions behind the development of these glasses was to bring accessible vision correction to the developing world, particularly to areas where there was little or no affordable eye care. In the UK we are lucky enough to have no barriers to accessing sight tests and optical appliances which correct refractive errors. The NHS provides free sight tests to children, older people, those with or at risk of eye disease, and people on low incomes. In addition, help with the cost of glasses is available to children and people on low incomes.

It is already the case that self-adjustable glasses can be supplied by a registered medical practitioner or optometrist if they would benefit patients in particular circumstances. I do not think that we should downplay the important role of optometrists in carrying out sight tests. Optometrists are healthcare specialists trained to examine the eyes to detect defects of vision, signs of injury and ocular diseases, as well as problems with general health. Anyone who has had a sight test in recent years will know how much more is done these days than would have been done four or five years ago. Optometrists also offer valuable clinical advice, in addition to prescribing glasses and contact lenses.

One of the concerns raised by the standards committee was that members of the public might be discouraged from attending for regular sight tests. I appreciate that noble Lords do not agree with this argument, given that the availability of ready readers has not had such an impact. However, ready readers have a minimal prescription power and are for reading only.

[Lord Stoneham of Droxford]

I reiterate to the Minister why it is so important to read the report about reading glasses. Exactly the same arguments were used then—that they would undermine eye tests—yet exactly the opposite happened.

[Lord Prior of Brampton]

I have made a promise, and that will be among my other reading material. I do not know how long the review is; we shall see.

However, reading glasses are for a very specific, limited purpose, so might not lead people to think that a sight test is no longer necessary. Self-adjustable glasses, on the other hand, are for wider use, and could potentially lead people to think that their vision needs have been met. They may make do with those glasses for longer, and not consider the need for a sight test. In that way, the case might be slightly different from that of reading glasses.

I accept that there is reasonable concern about the potential impact on the take-up of sight tests if these glasses were to be made available over the counter. It is important to be clear that a sight test is not only about checking whether or not you need glasses. As I said earlier, it goes much further than that. A sight test can identify at an early stage diseases such as macular degeneration, glaucoma, diabetic retinopathy and cataracts. Good vision is also particularly important for safety on our roads, both for drivers and pedestrians. So I appreciate the concern raised by the GOC in respect of the safety of drivers using these self-adjustable glasses.

I draw a distinction between the current proposal—which, as I understand it, is for a range of magnification beyond that of ready readers—and magnification restricted to that of ready readers. I am not sure whether or not that makes sense. It makes sense if you read it slowly.

Even if the concerns I have outlined were overcome, it would be very difficult to justify a greater range for the adjustable, and arguably more risky, product than is allowed for ready readers. There is no appetite that I am aware of to extend the exemption applied to ready readers to stronger prescriptions, and similar objections would apply in that they would cease to be simply aids for the limited activity of reading.

However, I note that while the GOC standards committee did not endorse the idea of sale of adjustable glasses restricted to the ready readers range, it commented, as the noble Lord mentioned, that this might be acceptable. I do not know whether those proposing change have had further discussions with the GOC on this point but, if not, it would be sensible to do so before further consideration by the Government. I am not sure whether the noble Lord has had further discussions with the GOC. He might like to say so at the end. This does not mean that the GOC is convinced that this would be a sensible change or that the Government are minded to consult in the near future. I merely highlight that the GOC’s response was nuanced.

Changes to primary legislation are for government, although noble Lords will obviously appreciate that changes will only be made in the light of professional advice, and one of the sources of that advice will be the GOC. The GOC’s report was nuanced and is probably worth following up. I have an instinctive gut feeling of sympathy for the arguments made by the noble Lord but there are genuine objections from the GOC.