Pie in the sky?

The London launch of the career pathways was delivered to a capacity audience consisting of a majority of primary care trust administrators together with a fair sprinkling of ophthalmologists, optometrists and dispensing opticians plus, of course, the great and the good of the professional bodies.
There is no doubt that a tremendous amount of work has been devoted to developing this project and its four pathways and equally one cannot deny the common sense and enthusiasm that has gone into the proposals. However, I think that we all learned a long time ago that when it comes to common sense, particularly common sense that has a price tag attached, then it does not necessarily apply to the NHS.
I am sure that my views will be seen as cynical and unhelpful but realism has to be brought to the situation and get people's feet back on the ground. I am not alone in this, Arthur Swain, the outgoing chairman of the Federation of Ophthalmic and Dispensing Opticians, made similar comments at the FODO annual general meeting.
I have very little criticism of the proposals that are made in the pathways, they are well thought through and would, if implemented, make an immense difference to the effective delivery of primary and secondary eye care services. The problem lies in finding the funding, convincing ophthalmologists, the time it will take to implement them and the refusal to impose implementation. It seems that once again the NHS is paying lip service to optometry and dispensing optics.
While it is true that they have invested in the discussion process and made some money available for pilots there is no sign that the DoH will role out any schemes on a national basis. To quote, 'the report is being issued as commissioning guidance to PCTs and, with the pathways, provides a resource to draw upon in planning the modernisation of eye care services locally'.
From this it is clear that whatever the pilot studies show, it will be up to individual PCTs whether or not they implement the pathways. This from a government pledged to abolish postcode health lotteries. Although the DoH has made £4m available for pilot schemes, this hardly seems generous and rumour has it that some of the proposals are not limited to the eye care pathways.
There is also the question of the need for pilot schemes. Successful pilots have already been completed in and have shown the value of optometry becoming the recognised primary eye health care profession. Many have withered on the vine through lack of ongoing funding. What guarantee is there that this will not happen again?
The benefits of involving optometrists in cataract schemes have been demonstrated by projects such as Peterborough and £53m made available to reduce waiting lists. How much of this had been directed towards primary care funding? Islington PCT has just cancelled a proposal to develop a cataract pathway due to lack of infrastructure and resources, this serves to reinforce my concerns about the future.
Finally, I gained the distinct impression that ophthalmologists are not wholeheartedly behind the proposals. Comment was made that consultants had not been informed by their Royal College about the pathways and that there is considerable concern that there will be attempts to divert funding from the secondary to the primary sector. There was even one who tried to prove that care could be provided as cheaply in hospitals as in the high street!
There is no doubt that many ophthalmologists are trying to retain control within the secondary sector, which is contrary to general health policy. One also gets the impression that there are worries about their private income. As the cataract waiting list reduces so will some of their opportunities for lucrative private surgery.
Unclear code
The long awaited consultation paper on the reform of the GOC and the consequent amendment of the Opticians Act 1989 has now been published and there are few surprises. Unfortunately the document is full of drafting errors, which reflects badly on the DoH.
The emphasis is on changes demanded by the Government following the Kennedy report and these largely concern fitness to practise regulations. The professional protective bodies will be scrutinising these to ensure that they are as fair to the practitioner as they are to the patient.
Considerable interest will centre on the proposals for regulating the supply of contact lenses. While the responsibility of the practitioner is emphasised with a duty to provide a prescription, aftercare and proper information on use and care, the controls on the supply of lenses are loosened and direct supply legalised subject to certain controls. The proposals on plano cosmetic tinted lenses are very confused. Despite assurances that these lenses would be subject to the same control as powered lenses the amendment states explicitly that the definition of a contact lens does not include a zero powered contact lens. A later section then talks vaguely about the sale of plano contact lenses where prescribed conditions are satisfied, but fails to specify the prescribed conditions. This is clearly a response to deregulatory pressures from other government departments.
Suffice it to say that a contact lens is a contact lens, is a contact lens and that the same examination for suitability, instructions on insertion and removal and advice on care are needed as for a powered lens.Pie in the sky?
This month has seen the publication of two major documents affecting optometry and dispensing optics by the Department of Health. The first was the consultation document on the proposed changes to The Opticians Act 1989 and the second dealt with the proposed eye care pathways.
The London launch of the career pathways was delivered to a capacity audience consisting of a majority of primary care trust administrators together with a fair sprinkling of ophthalmologists, optometrists and dispensing opticians plus, of course, the great and the good of the professional bodies.
There is no doubt that a tremendous amount of work has been devoted to developing this project and its four pathways and equally one cannot deny the common sense and enthusiasm that has gone into the proposals. However, I think that we all learned a long time ago that when it comes to common sense, particularly common sense that has a price tag attached, then it does not necessarily apply to the NHS.
I am sure that my views will be seen as cynical and unhelpful but realism has to be brought to the situation and get people's feet back on the ground. I am not alone in this, Arthur Swain, the outgoing chairman of the Federation of Ophthalmic and Dispensing Opticians, made similar comments at the FODO annual general meeting.
I have very little criticism of the proposals that are made in the pathways, they are well thought through and would, if implemented, make an immense difference to the effective delivery of primary and secondary eye care services. The problem lies in finding the funding, convincing ophthalmologists, the time it will take to implement them and the refusal to impose implementation. It seems that once again the NHS is paying lip service to optometry and dispensing optics.
While it is true that they have invested in the discussion process and made some money available for pilots there is no sign that the DoH will role out any schemes on a national basis. To quote, 'the report is being issued as commissioning guidance to PCTs and, with the pathways, provides a resource to draw upon in planning the modernisation of eye care services locally'.
From this it is clear that whatever the pilot studies show, it will be up to individual PCTs whether or not they implement the pathways. This from a government pledged to abolish postcode health lotteries. Although the DoH has made £4m available for pilot schemes, this hardly seems generous and rumour has it that some of the proposals are not limited to the eye care pathways.
There is also the question of the need for pilot schemes. Successful pilots have already been completed in and have shown the value of optometry becoming the recognised primary eye health care profession. Many have withered on the vine through lack of ongoing funding. What guarantee is there that this will not happen again?
The benefits of involving optometrists in cataract schemes have been demonstrated by projects such as Peterborough and £53m made available to reduce waiting lists. How much of this had been directed towards primary care funding? Islington PCT has just cancelled a proposal to develop a cataract pathway due to lack of infrastructure and resources, this serves to reinforce my concerns about the future.
Finally, I gained the distinct impression that ophthalmologists are not wholeheartedly behind the proposals. Comment was made that consultants had not been informed by their Royal College about the pathways and that there is considerable concern that there will be attempts to divert funding from the secondary to the primary sector. There was even one who tried to prove that care could be provided as cheaply in hospitals as in the high street!
There is no doubt that many ophthalmologists are trying to retain control within the secondary sector, which is contrary to general health policy. One also gets the impression that there are worries about their private income. As the cataract waiting list reduces so will some of their opportunities for lucrative private surgery.
Unclear code
The long awaited consultation paper on the reform of the GOC and the consequent amendment of the Opticians Act 1989 has now been published and there are few surprises. Unfortunately the document is full of drafting errors, which reflects badly on the DoH.
The emphasis is on changes demanded by the Government following the Kennedy report and these largely concern fitness to practise regulations. The professional protective bodies will be scrutinising these to ensure that they are as fair to the practitioner as they are to the patient.
Considerable interest will centre on the proposals for regulating the supply of contact lenses. While the responsibility of the practitioner is emphasised with a duty to provide a prescription, aftercare and proper information on use and care, the controls on the supply of lenses are loosened and direct supply legalised subject to certain controls. The proposals on plano cosmetic tinted lenses are very confused. Despite assurances that these lenses would be subject to the same control as powered lenses the amendment states explicitly that the definition of a contact lens does not include a zero powered contact lens. A later section then talks vaguely about the sale of plano contact lenses where prescribed conditions are satisfied, but fails to specify the prescribed conditions. This is clearly a response to deregulatory pressures from other government departments.
Suffice it to say that a contact lens is a contact lens, is a contact lens and that the same examination for suitability, instructions on insertion and removal and advice on care are needed as for a powered lens.Pie in the sky?
This month has seen the publication of two major documents affecting optometry and dispensing optics by the Department of Health. The first was the consultation document on the proposed changes to The Opticians Act 1989 and the second dealt with the proposed eye care pathways.
The London launch of the career pathways was delivered to a capacity audience consisting of a majority of primary care trust administrators together with a fair sprinkling of ophthalmologists, optometrists and dispensing opticians plus, of course, the great and the good of the professional bodies.
There is no doubt that a tremendous amount of work has been devoted to developing this project and its four pathways and equally one cannot deny the common sense and enthusiasm that has gone into the proposals. However, I think that we all learned a long time ago that when it comes to common sense, particularly common sense that has a price tag attached, then it does not necessarily apply to the NHS.
I am sure that my views will be seen as cynical and unhelpful but realism has to be brought to the situation and get people's feet back on the ground. I am not alone in this, Arthur Swain, the outgoing chairman of the Federation of Ophthalmic and Dispensing Opticians, made similar comments at the FODO annual general meeting.
I have very little criticism of the proposals that are made in the pathways, they are well thought through and would, if implemented, make an immense difference to the effective delivery of primary and secondary eye care services. The problem lies in finding the funding, convincing ophthalmologists, the time it will take to implement them and the refusal to impose implementation. It seems that once again the NHS is paying lip service to optometry and dispensing optics.
While it is true that they have invested in the discussion process and made some money available for pilots there is no sign that the DoH will role out any schemes on a national basis. To quote, 'the report is being issued as commissioning guidance to PCTs and, with the pathways, provides a resource to draw upon in planning the modernisation of eye care services locally'.
From this it is clear that whatever the pilot studies show, it will be up to individual PCTs whether or not they implement the pathways. This from a government pledged to abolish postcode health lotteries. Although the DoH has made £4m available for pilot schemes, this hardly seems generous and rumour has it that some of the proposals are not limited to the eye care pathways.
There is also the question of the need for pilot schemes. Successful pilots have already been completed in and have shown the value of optometry becoming the recognised primary eye health care profession. Many have withered on the vine through lack of ongoing funding. What guarantee is there that this will not happen again?
The benefits of involving optometrists in cataract schemes have been demonstrated by projects such as Peterborough and £53m made available to reduce waiting lists. How much of this had been directed towards primary care funding? Islington PCT has just cancelled a proposal to develop a cataract pathway due to lack of infrastructure and resources, this serves to reinforce my concerns about the future.
Finally, I gained the distinct impression that ophthalmologists are not wholeheartedly behind the proposals. Comment was made that consultants had not been informed by their Royal College about the pathways and that there is considerable concern that there will be attempts to divert funding from the secondary to the primary sector. There was even one who tried to prove that care could be provided as cheaply in hospitals as in the high street!
There is no doubt that many ophthalmologists are trying to retain control within the secondary sector, which is contrary to general health policy. One also gets the impression that there are worries about their private income. As the cataract waiting list reduces so will some of their opportunities for lucrative private surgery.
Unclear code
The long awaited consultation paper on the reform of the GOC and the consequent amendment of the Opticians Act 1989 has now been published and there are few surprises. Unfortunately the document is full of drafting errors, which reflects badly on the DoH.
The emphasis is on changes demanded by the Government following the Kennedy report and these largely concern fitness to practise regulations. The professional protective bodies will be scrutinising these to ensure that they are as fair to the practitioner as they are to the patient.
Considerable interest will centre on the proposals for regulating the supply of contact lenses. While the responsibility of the practitioner is emphasised with a duty to provide a prescription, aftercare and proper information on use and care, the controls on the supply of lenses are loosened and direct supply legalised subject to certain controls. The proposals on plano cosmetic tinted lenses are very confused. Despite assurances that these lenses would be subject to the same control as powered lenses the amendment states explicitly that the definition of a contact lens does not include a zero powered contact lens. A later section then talks vaguely about the sale of plano contact lenses where prescribed conditions are satisfied, but fails to specify the prescribed conditions. This is clearly a response to deregulatory pressures from other government departments.
Suffice it to say that a contact lens is a contact lens, is a contact lens and that the same examination for suitability, instructions on insertion and removal and advice on care are needed as for a powered lens.Pie in the sky?
This month has seen the publication of two major documents affecting optometry and dispensing optics by the Department of Health. The first was the consultation document on the proposed changes to The Opticians Act 1989 and the second dealt with the proposed eye care pathways.
The London launch of the career pathways was delivered to a capacity audience consisting of a majority of primary care trust administrators together with a fair sprinkling of ophthalmologists, optometrists and dispensing opticians plus, of course, the great and the good of the professional bodies.
There is no doubt that a tremendous amount of work has been devoted to developing this project and its four pathways and equally one cannot deny the common sense and enthusiasm that has gone into the proposals. However, I think that we all learned a long time ago that when it comes to common sense, particularly common sense that has a price tag attached, then it does not necessarily apply to the NHS.
I am sure that my views will be seen as cynical and unhelpful but realism has to be brought to the situation and get people's feet back on the ground. I am not alone in this, Arthur Swain, the outgoing chairman of the Federation of Ophthalmic and Dispensing Opticians, made similar comments at the FODO annual general meeting.
I have very little criticism of the proposals that are made in the pathways, they are well thought through and would, if implemented, make an immense difference to the effective delivery of primary and secondary eye care services. The problem lies in finding the funding, convincing ophthalmologists, the time it will take to implement them and the refusal to impose implementation. It seems that once again the NHS is paying lip service to optometry and dispensing optics.
While it is true that they have invested in the discussion process and made some money available for pilots there is no sign that the DoH will role out any schemes on a national basis. To quote, 'the report is being issued as commissioning guidance to PCTs and, with the pathways, provides a resource to draw upon in planning the modernisation of eye care services locally'.
From this it is clear that whatever the pilot studies show, it will be up to individual PCTs whether or not they implement the pathways. This from a government pledged to abolish postcode health lotteries. Although the DoH has made £4m available for pilot schemes, this hardly seems generous and rumour has it that some of the proposals are not limited to the eye care pathways.
There is also the question of the need for pilot schemes. Successful pilots have already been completed in and have shown the value of optometry becoming the recognised primary eye health care profession. Many have withered on the vine through lack of ongoing funding. What guarantee is there that this will not happen again?
The benefits of involving optometrists in cataract schemes have been demonstrated by projects such as Peterborough and £53m made available to reduce waiting lists. How much of this had been directed towards primary care funding? Islington PCT has just cancelled a proposal to develop a cataract pathway due to lack of infrastructure and resources, this serves to reinforce my concerns about the future.
Finally, I gained the distinct impression that ophthalmologists are not wholeheartedly behind the proposals. Comment was made that consultants had not been informed by their Royal College about the pathways and that there is considerable concern that there will be attempts to divert funding from the secondary to the primary sector. There was even one who tried to prove that care could be provided as cheaply in hospitals as in the high street!
There is no doubt that many ophthalmologists are trying to retain control within the secondary sector, which is contrary to general health policy. One also gets the impression that there are worries about their private income. As the cataract waiting list reduces so will some of their opportunities for lucrative private surgery.
Unclear code
The long awaited consultation paper on the reform of the GOC and the consequent amendment of the Opticians Act 1989 has now been published and there are few surprises. Unfortunately the document is full of drafting errors, which reflects badly on the DoH.
The emphasis is on changes demanded by the Government following the Kennedy report and these largely concern fitness to practise regulations. The professional protective bodies will be scrutinising these to ensure that they are as fair to the practitioner as they are to the patient.
Considerable interest will centre on the proposals for regulating the supply of contact lenses. While the responsibility of the practitioner is emphasised with a duty to provide a prescription, aftercare and proper information on use and care, the controls on the supply of lenses are loosened and direct supply legalised subject to certain controls. The proposals on plano cosmetic tinted lenses are very confused. Despite assurances that these lenses would be subject to the same control as powered lenses the amendment states explicitly that the definition of a contact lens does not include a zero powered contact lens. A later section then talks vaguely about the sale of plano contact lenses where prescribed conditions are satisfied, but fails to specify the prescribed conditions. This is clearly a response to deregulatory pressures from other government departments.
Suffice it to say that a contact lens is a contact lens, is a contact lens and that the same examination for suitability, instructions on insertion and removal and advice on care are needed as for a powered lens.Pie in the sky?
This month has seen the publication of two major documents affecting optometry and dispensing optics by the Department of Health. The first was the consultation document on the proposed changes to The Opticians Act 1989 and the second dealt with the proposed eye care pathways.
The London launch of the career pathways was delivered to a capacity audience consisting of a majority of primary care trust administrators together with a fair sprinkling of ophthalmologists, optometrists and dispensing opticians plus, of course, the great and the good of the professional bodies.
There is no doubt that a tremendous amount of work has been devoted to developing this project and its four pathways and equally one cannot deny the common sense and enthusiasm that has gone into the proposals. However, I think that we all learned a long time ago that when it comes to common sense, particularly common sense that has a price tag attached, then it does not necessarily apply to the NHS.
I am sure that my views will be seen as cynical and unhelpful but realism has to be brought to the situation and get people's feet back on the ground. I am not alone in this, Arthur Swain, the outgoing chairman of the Federation of Ophthalmic and Dispensing Opticians, made similar comments at the FODO annual general meeting.
I have very little criticism of the proposals that are made in the pathways, they are well thought through and would, if implemented, make an immense difference to the effective delivery of primary and secondary eye care services. The problem lies in finding the funding, convincing ophthalmologists, the time it will take to implement them and the refusal to impose implementation. It seems that once again the NHS is paying lip service to optometry and dispensing optics.
While it is true that they have invested in the discussion process and made some money available for pilots there is no sign that the DoH will role out any schemes on a national basis. To quote, 'the report is being issued as commissioning guidance to PCTs and, with the pathways, provides a resource to draw upon in planning the modernisation of eye care services locally'.
From this it is clear that whatever the pilot studies show, it will be up to individual PCTs whether or not they implement the pathways. This from a government pledged to abolish postcode health lotteries. Although the DoH has made £4m available for pilot schemes, this hardly seems generous and rumour has it that some of the proposals are not limited to the eye care pathways.
There is also the question of the need for pilot schemes. Successful pilots have already been completed in and have shown the value of optometry becoming the recognised primary eye health care profession. Many have withered on the vine through lack of ongoing funding. What guarantee is there that this will not happen again?
The benefits of involving optometrists in cataract schemes have been demonstrated by projects such as Peterborough and £53m made available to reduce waiting lists. How much of this had been directed towards primary care funding? Islington PCT has just cancelled a proposal to develop a cataract pathway due to lack of infrastructure and resources, this serves to reinforce my concerns about the future.
Finally, I gained the distinct impression that ophthalmologists are not wholeheartedly behind the proposals. Comment was made that consultants had not been informed by their Royal College about the pathways and that there is considerable concern that there will be attempts to divert funding from the secondary to the primary sector. There was even one who tried to prove that care could be provided as cheaply in hospitals as in the high street!
There is no doubt that many ophthalmologists are trying to retain control within the secondary sector, which is contrary to general health policy. One also gets the impression that there are worries about their private income. As the cataract waiting list reduces so will some of their opportunities for lucrative private surgery.
Unclear code
The long awaited consultation paper on the reform of the GOC and the consequent amendment of the Opticians Act 1989 has now been published and there are few surprises. Unfortunately the document is full of drafting errors, which reflects badly on the DoH.
The emphasis is on changes demanded by the Government following the Kennedy report and these largely concern fitness to practise regulations. The professional protective bodies will be scrutinising these to ensure that they are as fair to the practitioner as they are to the patient.
Considerable interest will centre on the proposals for regulating the supply of contact lenses. While the responsibility of the practitioner is emphasised with a duty to provide a prescription, aftercare and proper information on use and care, the controls on the supply of lenses are loosened and direct supply legalised subject to certain controls. The proposals on plano cosmetic tinted lenses are very confused. Despite assurances that these lenses would be subject to the same control as powered lenses the amendment states explicitly that the definition of a contact lens does not include a zero powered contact lens. A later section then talks vaguely about the sale of plano contact lenses where prescribed conditions are satisfied, but fails to specify the prescribed conditions. This is clearly a response to deregulatory pressures from other government departments.
Suffice it to say that a contact lens is a contact lens, is a contact lens and that the same examination for suitability, instructions on insertion and removal and advice on care are needed as for a powered lens.