GOC abdication
Returning to my previous concerns with the lack of GOC interpretation that should have accompanied the recent changes to contact lens legislation, several of my associates have recently been discussing the weaknesses that are so evident as a direct consequence of this GOC abdication.
These included:
The provision (or lack of provision) of aftercare by the supplier
The verification (or lack or verification) of the specification by the supplier
The meaning of general direction (as opposed to supervision) of unregistered supply.
You will recall that the Section 60 Orders now place a responsibility on the seller of the contact lens to 'make arrangements for the individualÉto receive aftercare in so far and for as long as is relevant in their individual case'.
I have had it pointed out to me that, as far as the wording of the Section 60 goes, these Orders make no differentiation between the aftercare requirements incumbent on sale by a GOC or a non-GOC registered supplier.
However, because the GOC has thus far failed to explain what their intention was and what their meaning of aftercare was, we should now all be asking how the internet or supermarket sellers of contact lenses can provide aftercare to the same extent as the registered supplier. Does the optical profession provide too high a service?
I would argue not. Does/do the internet/supermarkets provide too low a service? I would argue yes. This latter point is a definite 'patient safety' issue in waiting. Some of my friends and associates have conducted test purchases from the various modalities of unregistered supply and universally report that, with the exception of one seller, verification is not taking place prior to sale and supply.
Suppliers beware
The likes of Johnson & Johnson, Bausch & Lomb and CIBA Vision should be made very aware that they are willingly supplying such cowboys with product that is being illegally sold with absolutely no checking procedures taking place. Do they condone this?
Interestingly, in one case that verification actually did take place, the wrong product was supplied. Brilliant incompetence. Yet another 'patient safety' issue waiting to happen, I am sure the GOC would be interested in receiving that evidence.
Mind you, I am less than convinced that the GOC has the ability to prosecute given its inaction over evidence supplied to them over six months ago around the issues with the supply of spectacles by Specs Direct. I bet eBay are quaking in their boots.
If the GOC is truly interested in patient safety it must take note and action before patient harm takes place, This issue of the lack of verification by the unregistered supplier raises issues surrounding the whole 'General Direction' concept (or misconcept').
Presumably there is a registrant 'somewhere within the management chain and responsible for what goes on between supplier and customer'. Who are they? I can only hope that their professional indemnifier is aware of the additional risk they are insuring as a consequence of this lack of verification and provision of aftercare.
Lord Warner's words are clearly being ignored. If (for example) the generally-directing registrant is indemnified by the AOP (like most optometrists), then I can only hope that the AOP are aware.
Mind you if the quality of the recent AOP's published advice on the Section 60 Order is anything to go by, total accuracy or a grasp of the detail is not important. I hope its fees don't have to increase to cover the increased risk of such potential transgression.
Lessons from our neighbours
On another issue, from what I hear of the result of negotiations of a small, but seemingly effective, band of Scottish optometrists, we south of the border have much to learn about 'joined-up' and 'agenda-free' negotiation.
If the level of fees come to fruition that I have heard have been negotiated for the 'free for all' eye examinations (as opposed to sight tests) in Scotland, then the recently-announced GOS Review in England has much to live up to.
The Health Bill will provide the mechanism for the devolution of the uncapped GOS sight test fee to local PCTs as a cash-limited and (a probably downwardly) negotiable fund and it has been stated that the GOS review must be within existing budgets.
This is a joke, unless arguments around patient benefits and budgetary savings from the secondary care cost of £130 per out-patient visit can be realised.
These, together with the lessons from Scotland (and Wales), are essential if the English GOS is to benefit from the potential service improvement that optometry can provide.
Unlike the dentists, we must say what we want - not just what we don't want. Our professional and representative bodies must converge on an effective and successful long-term plan.
Like the Scots, they must learn to leave their own agendas and historical baggage at the negotiation door. It cannot have escaped the profession's notice that the three main professional negotiators could also have been seen to have seamlessly represented the AOP, FODO and the College.