Lumen writes

England expects…

Today’s world is seemingly dominated by Wayne Rooney’s 4th metatarsal and Sven-Goran Eriksson’s selection of 17-year-old Theo Walcott, a player with undoubted potential but as yet untried in Premier football. Should Rooney play any part in the World Cup, his foot will undoubtedly become the target for every opponent. How much protection will his flimsy and over-priced boots afford him then? Should Walcott play any part, it will inevitably form part of Eriksson’s legacy – for good or bad.

Where in that heady (or is that footy) external world would our realm of optics feature at this moment? We seem to have difficulty getting ourselves any mention even in the English Health Bill and equally, while finally being granted a review of the General Ophthalmic Services, we are told in no uncertain terms that there is no more money with which to support the outcome. How motivating is that?

Most parties (even ophthalmology if they were honest enough not to worry about their dwindling income from private cataract surgery, etc) believe that much of the non-surgical management of chronic eye conditions could and should be handled in a primary care setting by the high street optometrist. The key to this, as ever, will be the fair and adequate remuneration for the additional service provision. However, while accepting that (for me at least) its omission would be a ‘show-stopper’, it needs to be remembered that much more than that will be needed in addition, if this concept is to reach national reality.

We need access to the ‘electronic patient record’, we probably need initial ophthalmological support in terms of training and accreditation (to pump prime the process and prove it works) and we certainly need our profession to provide the shrinking strategic health authorities and primary care trusts with proven and adaptable solutions to local needs.

Of course there will be some clinicians who would rather not ‘get involved’. That is their choice. But all other ducks have been lined up (optometrist prescribing, co-management and direct referral, etc) and there is a certain inevitability about the future.

We also need to be big, bold and brave enough to believe in ourselves that we can provide, our soon to be, 10 SHAs and 152 PCTs with the answers to their eye care problems: and we need to do that together. It needs a working party formed of the key mover and shaker clinicians within the College, AOP and FODO with support from others (eg, RNIB etc as required) to formulate a plan that can be implemented easily by a hard-pressed PCT.

Only in this way can the pen pushers in PCTs see a way ahead that complies with the latest whim of the DoH.

On the subject of trying to help those that have a problem, nigh on the whole profession has tried to help the GOC to see sense over Ron Hamilton’s latest offering in the shape of Daysoft. Offering something similar (but not exactly the same) can only be a bargain to those who don’t care about (a) their patients and (b) the law. Presented in the guise of helping the independent to compete, I am hoping a degree of innocence has been dampened with a huge dose of naivety.

By the time you read this, the GOC will have met to discuss this issue. Ebay apart, their challenge lies in making a decision – any decision, for right or for wrong. Perhaps the GOC should consider that they have a Council made up of those who see enough sense to hear that an issue exists but are not big enough to do anything substantial about it. That is easily resolved. Choose a new one.

Anyway, back to the football. The English will be glued to their TVs while our other local nationalities will more than likely be supporting anyone else the English play. I am not surprised at that. Let’s face it, our Scottish and Welsh colleagues have already got one over on the English with respect to their eye examination, but for the next month or so (while our colleagues at the DoH read the submissions in support of the GOS review), all eyes will be on the World Cup.
I will be fully supporting my national team, irrespective of Rooney’s foot or Walcott’s selection.