December has arrived. The month where we should look forward to merriment and festive fun. A time to come together, reflect on our blessings and look back at the year gone. We celebrate, while also looking forward to the new year and planning for greater successes. There will be no doubting that, for some, 2024 has been a good year. But can that be said for everyone?
Many reading this column will be reviewing plans they had for 2025 in light of the recent budget. For some, planned investments in new equipment, employment of new staff, and support and training of existing staff may well now have been put on hold considering the increased costs of running a small business inflicted upon business owners by the Chancellor of the Exchequer.
Whatever the government may try to say, small businesses, including the vast majority of independent optometrists, will have been hit hard financially. This may well sound the death knell for some. For others with older owners, this may be the last straw, and they just may cease trading.
There will be those that say ‘tough’, that’s the law of the jungle and only the fittest will survive. But what will closures mean to the employees within those businesses or the patients who have, for years, sought the advice and care of those practices?
According to the government, it will make no difference at all because their salary slips remain unaffected. Only politicians or governments can utter such crass nonsense and pretend they believe it. The harsh truth is that since the budget, many will have had to take a serious look at the new financial reality coming in 2025.
With these decisions in mind, I looked at the media coverage following the budget. There can be little doubt in people’s minds that the medical, dental and pharmaceutical professions have highlighted very serious concerns about the financial state they now find themselves in.
Pharmacists have voted overwhelmingly to work to contract as they just can’t afford to carry on with the level of NHS funding they currently receive. There is also talk of working to contract by GPs in their surgeries. However, there appears to be a deafening silence in the media from within the optometry sector.
Surely, we are not immune to these financial strictures. I have looked for anything that refers to the problems facing optometry practices. Many of the arguments aired by pharmacists are exact parallels to those that could be made public by our profession – not least the pittance paid for their contracted services that has been so poorly uplifted over the years, meaning viable funding is now decades behind where it should be.
Evidence that these arguments are hitting home can be shown by the squirming seen in the government. The Prime Minister has commented that he will review GP remuneration to offset the National Insurance changes by the end of the year.
There is clearly a rethink going on within the financial circles of government as they realise the funding shortcomings heaped upon GPs and pharmacists over the decades. But where is our voice? Have we been making our case heard in the media or the press? If we have, I have yet to see it. It will be interesting to see what our negotiators achieve as a fee uplift for GOS services this time around, especially given the Budget.
It is time, as I have suggested in the past, optometrists are balloted about working to contract. Why the Optometric Fees Negotiating Committee has never done this before has long been a mystery to me.
Potentially more worrying is that, while there is nothing apparently happening to address the profoundly serious funding issue in many practices, there seems to be a great deal happening around what we are prepared to do going forward. I am a great advocate for professional advancement within the primary care sector but, as I have always said, only provided that any NHS contracts offer financially viable funding.
At the recent fourth Westminster Eye Health Day on October 29, where MPs, policymakers and experts from the eye health sector got together, the chief executive of the Association of Optometrists stated: ‘Now is a particularly important time to push forward the eye health agenda and a national plan for eye care. The 10-year plan for health, which is being created, also gives us an opportunity to promote eye care, eye health and optometry. This is why having this type of open forum to speak to MPs directly on the solutions that work for patients is a vital step.’
While these are laudable sentiments, our priority in 2025 must be to make it clear that none of this can happen unless viable funding is forthcoming first. If not, we must withdraw until it is met.
We simply must make the government, and the public understand that viable funding is at the very heart of all that happens going forward. I beg those who have the responsibility of securing our future within the NHS to ensure financial viability as their prime objective for 2025.
I wish you all a festive time for December and a financially viable 2025.
