Increasingly we are buying things over the internet. It saves time, is convenient, and often results in us paying less. A wide range of items are purchased in this way, including medicines and other healthcare products such as contact lenses.
Of course, while it is more convenient, and may be cheaper, the online supply of items which could adversely affect our health is proving to be a headache for healthcare regulators. This is particularly true in relation to companies which supply within the UK but are based outside the EU.
The General Optical Council (GOC) is one of the regulators concerned about the online supply of healthcare products. In March 2014 it launched a consultation, and at a meeting in July 2014, announced the development of a strategy to combat illegal practices, including the unlawful supply of powered or cosmetic (plano) contact lenses. The new strategy will be launched early next year and a review will be carried out two years later.
Market research on behalf of the GOC showed that 14 per cent of people who wear contact lenses buy them over the internet. This is an increasing trend. In its consultation document, the GOC expressed concerns about the sale of cosmetic, plano contact lenses, particularly as these can often be bought from places such as fancy dress or joke shops. While the GOC concluded that people who wear cosmetic lenses do so less often than those who wear powered lenses, the way in which they may be purchased, and the lack of aftercare, may mean that the potential for harm is greater.
Power to prosecute
The GOC already has the power to prosecute where a criminal offence has been committed. However, this power is used infrequently, mainly because prosecutions must be brought within six months, and the GOC lacks the resources to pursue a large number of people through the courts. Instead of bringing its own prosecutions, the GOC works with other enforcement authorities, such as Trading Standards. It also concentrates on its fitness to practise powers. However, while these can be used against individual registered professionals, as yet, not all businesses are registered.
There are changes in the pipeline which should make the regulation of the online supply of contact lenses easier. Following a review last year, the GOC has decided to regulate all businesses which carry out a restricted function. But before it is able to do this, certain changes must be made to the law, and law reform is likely to take some years. A proposal has also been made by the European Commission to change the classification of cosmetic contact lenses to bring them within the rules which govern medical devices – in which case they would be regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA).
While waiting for changes to come into force, the GOC has decided to take more immediate measures to protect the public. It says it will target its resources on particular areas of risk, and on practices which pose the greatest risk of harm to the general public. It also recognises that, at present, its approach to dealing with illegal practices is reactive, only taking steps when a complaint is made.
The GOC’s strategy will involve introducing a voluntary code of conduct for contact lens suppliers. Non-compliance with this code may assist the GOC when taking fitness to practise action against registrants, but it will not help in policing unlawful internet sales in the UK by sellers based overseas – something which the GOC concedes will remain a difficulty. This is not a problem which is specific to the GOC; it is something which other healthcare regulators are also grappling with. For example, pharmacy regulators, including the MHRA are having to think of ways to counter the problem of counterfeit medicines entering the supply chain, as well as medication being supplied without prescription via online pharmacies.
Public awareness
The GOC has committed itself to increasing public awareness of the risks associated with buying contact lenses online, such as an increased risk of infection, and stressing the importance of aftercare and regular check-ups. It hopes that by educating the public, the dangers will be reduced. It remains to be seen how much impact stronger regulation will have. Probably a successful outcome will depend on the combination of enforcement and education. In the case of online medicines sales, the General Pharmaceutical Council and the MHRA have published warnings in the past about the risks, and for many years the General Pharmaceutical Council has invited online pharmacies to display a special logo on their websites designed to identify genuine internet pharmacies. However, concerns about internet pharmacies remain, and the European Commission has introduced a logo which will become compulsory for online pharmacies to display. It will also become a legal requirement for online pharmacies in Europe to be registered
with a specific regulator.
The GOC seems to be taking sensible first steps. The forthcoming extension of compulsory registration will, in due course, help the GOC exercise control over businesses carrying out regulated activities. However, the greatest risk of harm still appears to emanate from the supply of lenses from outside the UK or EU. The question is whether raising public awareness of the risks will be sufficient, or will the GOC have to consider taking further action. It may be that a Europe-wide approach will be required.
Rachel Warren is a solicitor and senior associate in the Healthcare team at law firm Charles Russell LLP (rachel.warren@charlesrussell.co.uk)