It is not my intention, however, to seek to minimise the sad tale recounted by Mr Harrop. Seemingly, in the event of his undertaking a private domiciliary visit to someone over 60, the latter is able to call on the NHS to refund his outlay. The NHS, in turn, deducts the difference between the private and NHS fees from Mr Harrop's remuneration for other work. He is prompted, therefore, to enquire what Nemo has to say about this questionable modus operandi. Unfortunately, I have no expertise to offer in relation to the arcane world of NHS bureaucracy. In addition I have to confess to not having heard previously of the procedure described by Mr Harrop. What does concern me, however, is its legality, which suggests that he should consult his solicitor or professional body in an attempt to discover whether such action is ultra vires. My reservations relate to the NHS's powers to make deductions from contractors' professional private earnings, particularly as to do so results in a failure to pay the statutory rate for the job for the other work in question. Finally I turn to the wider implications of Mr Harrop's letter - the alleged inadequacy of NHS optical fees, a view to which most practitioners subscribe. As I have indicated on previous occasions, logic dictates that if NHS remuneration is demonstrably (and I repeat, demonstrably) uneconomic, the only solution is to refuse to do it. The dental profession has shown the way forward in this regard, and if ophthalmic opticians are convinced of the justice of their cause and, as indicated, are able to prove it, individually or collectively, why do they not have the courage of their convictions to follow suit?
Peter Harrop's letter (March 16) brings to mind the old and highly relevant aphorism that words, like eyeglasses, blur everything that they do not make clear. I refer to his description of the 'extreme servitude' inflicted on ophthalmic opticians by an uncaring NHS officialdom. He seeks to equate their plight with that of the servitude proposed for the medical profession, previously referred to in this column, ie a ban on newly appointed consultants from undertaking private work (March 9). So glaring an example of a restriction on personal freedom is surely servitude in the fullest sense of the term. Resentment over a deduction of remuneration, however justified, is clearly in a very different category.