Omen writes

The deregulation of dispensing in 1985 and the removal of the universal right to a NHS eye exam in 1989 have and, indeed, are still having a fundamental effect on the cost and delivery of eye care.

Kenneth Clarke, Secretary of State for Health in 1989, prophesied that no optician would be charging for non-NHS eye exams such would be the competition injected by the removal of restrictions on advertising and dispensing. Although there are ongoing offers of sight tests which are below NHS re-imbursement fees Mr Clarke has been proved wrong. However, does Tesco's recent announcement of free eye exams for all, for ever, mark a watershed? Probably not, as most will see it for precisely what it is, an attempt to increase market share which together with its £10 offer for spectacles represents an enormous loss leader. Nevertheless it will cause further damage to future negotiations for a realistic sight test fee and will only increase the cost of spectacles and widen the price gap between professional and unqualified supply. The intervention of the RNIB's chief executive in support of Tesco's move is less than helpful, not recognising that the lack of proper remuneration for eye care results in corners being cut and is an impediment to developing a truly comprehensive primary eye care service.