The route to realistic fees

Further to letters in optician July 1, I shall continue to see patients without notifying the LHB and on the same day as the request if I feel so moved. I give clients an estimated time of arrival, give or take half an hour, and ring them just before arriving. Whether or not they require spectacles is immaterial as they pay a private fee of £90. They tend to be in because they are paying for the service and appreciate it has a value.

All in all a very pleasant experience.

I do have to get them to sign to say they understand that is a private test, that they could have a free test if they contact the LHB and that no refund for the test is available from the NHS. I feel that is a lot of work required by the NHS for a client nothing to do with the NHS, but having had several hundred pounds withheld from other monies due me in the past I comply. (All patients who are entitled to have an NHS test can have a private test, claim a full refund of the private fee and the NHS will sequester the difference between the NHS fee and the private fee from other monies due you.) The NHS fees are based not on cost of providing the service, but recruitment and retention. While optometrists are prepared to do £90 of work for £45 NHS fee, the NHS will let them. If our negotiators can point to people leaving and what a realistic fee is, the more chance we have of achieving realistic fees in the NHS. How else do you think out-of-hours NHS GPs can be paid a salary of £1,200 per night plus pension?

Peter Harrop
Caernarfon