I read with interest your comments and those of Frank Norville in last week’s Optician. As the immediate past chairman of the Optical Confederation (OC) I felt compelled to add weight to the points made by Frank Norville.
I do not believe my OC colleagues will be offended if I make it clear that I did not stand down as chair because I lacked either the drive or initiative to pursue the changes needed in the way the OC is both structured and operate, but simply that I quickly realised the role of an independent chair is a wholly impossible task until there is a genuine thirst for change. The sector does need a ‘single voice’ and there are some huge elephants in the room that must be addressed but the first step in the process of change is the want for change.
This is not an open criticism of the chief executives. They too are caught in no-man’s land, each of them representing membership organisations that fiercely protect their own identities and must be seen giving value for the membership fees they command.
Removing sovereignty in the pursuance of a single voice is impossible under such circumstances and in a structure where any one of the organisations can veto the will of the majority, progress is all too often one step forward simply to have to take one step back.
That said, it must be remembered that the OC only exists because the five membership organisations that constitute it, make voluntary financial contributions to fund it. It must also be said that there are other key sector bodies which have never become fully paid up members of the OC, the College of Optometrists being the most significantly noticeable. In consequence, the OC can never really claim to be the single voice of the sector.
Then we come to the very important task of having a single voice to government. During my time as OC chair I witnessed first-hand the tremendous amount of energy that went in to lobbying and communicating with MPs and ministers in the vain hope that government would see eye health as something more than just the Cinderella at the health ball. Frustratingly, I also witnessed just how frequently major players within the sector chose to structure their own parliamentary receptions and lobbying completely divorced from the OC.
You cannot have a single voice concept if members only want to keep one foot in and one foot out and to alternate which way they step whenever it suits them.
We are not best serving the interests of the sector now. There is a growing unrest among optometrists and dispensing opticians who want a profession less dependent on the whims of successive governments. With UK Optometrists currently paid £21.31 for an NHS eye examination and increases in fees from government continuing to be well below inflation or frozen (a figure that represents less than half the real cost of providing the service) it falls on product sales to subsidise the shortfall. A situation which has not changed in over two decades.
GOS Services account for around £500 million in a product and services market worth more than £3billion yet discussions around the NHS continue to take centre stage.
The sector strategy is totally focused on seeking to encourage the government to view high street practices as an opportunity to commission optometrists for more primary eye care services particularly in the field of minor eye conditions (Mecs). The big danger – especially for the independent sector – is that realistic funding from the NHS does not follow the increased transfer of primary care into the high street practices or that, over time, cash-strapped local commissioners will progressively erode payments in real terms and that this will be yet another aspect of eye care that will ultimately be supplemented by the sale of optical goods and services.
It also poses the two key questions. Firstly, will optometrists really have sufficient chair time to handle both current refraction volumes and increased volumes of time consuming Mecs patients? Secondly, will this strategy ultimately provide the opportunity for those who seek to break the monopoly of refraction only by optometrists with the introduction of technology? Because, like it or not, technology can now throw serious challenge to this situation by providing a profitable alternative for both refraction and sophisticated retinal screening methods.
Is the new model for eye health we so desperately need to address going to emerge from within or appear as a new threat from outside? Driven by those who see a chance to break into a £3 billion market opportunity through the application of modern digital technology? We already have a generation well versed in using technology for personal needs and another following that will never have known anything different.
Strange though it may sound, the sector needs visionaries because there has never been a more urgent need for strong leadership from those with the courage to see beyond the individual sovereignty of their own organisations and put the elephants on the table. So much is at stake, we must achieve this progress together. With the General Optical Council embarking on an Education Review, which will undoubtedly reveal that the optometrists of the future must have greater skills and competencies to take on an increased clinical role. Perhaps it is also time to look at a genuine disassociation between the clinical and commercial.
One thing is certain. Working in isolation of each other, putting individual organisation sovereignty before the modernisation of the sector, not bringing the progressive thinkers together from across the sector, is doomed for failure. The OC can be the forum for such change so let us all get behind it and encourage it to structure for success.