Moneo writes: Ophthalmology referrals and the cost to the NHS

I was unsurprised to see the article in the BMJ by Michael Clarke. There has been a lot said by various organisations about this article but I would like to just stop and think about what he was saying. Our professional bodies have been quick to jump to the defence of optometry and point out all the good points of what optometry offers. But the replies show yet again a sad lack of ability to reflect upon what was really being said in the original article resulting in an almost tacit denial of the assertions being made.

I well remember a few years ago asking a group of optometrists how much an optometry referral cost. The result was sadly predictable. Some talked of the cost of the time to write the letter, some of the cost of the ink, the paper, and the envelope, some of the cost of the stamp. Overall the consensus was it cost about £3 to refer a patient. There was absolutely no grasp of the fact that there was a much higher cost to the NHS. In an era when a first appointment at an eye clinic was in the region of £200 this cost never even entered the heads of any optometrist in the room. When the cost to the NHS was pointed out, the universal view of all attending was that it had nothing to do with them and it was not their responsibility. A complete denial of any part played in the costs accrued to the NHS through their actions.