I was going to make my annual comment on the GOS fee negotiations. However, given yet another imposition of a disgusting award by a government that clearly is set upon privatising eye health care along with other health sectors, I see little point. Suffice to say, until we follow the example of so many other sectors of the NHS and fight this stance taken by the government in the press and media, we will never get close to a settlement that reflects what we actually do for the NHS.
Mealy mouthed platitudes from health ministers no longer cut any ice with so many in our sector. We have a so-called fee negotiating committee, but year after year it cannot achieve anything because we have a government which does not even bother to pretend it negotiates. I remember being told by a mandarin within the department some 20 years ago that prior to a meeting with the optometry representatives to discuss GOS Fees, the office drew lots to see who got the honour of shouting ‘boo’ at the optometrists prior to watching them run from the room.
It was clear way back then that there was little, if any, respect for our profession within the department and it would seem nothing has changed since. The sooner we see a change in government the better. We may then see a change in attitude, but only if we are prepared to bare our teeth and show we are truly prepared to fight for the nation’s eye health care using the media and press, like so many others do, to fight our corner.
So, annual rant over, I now turn to another interesting event that happened recently. Over the past few years new activities have become commonplace within optometry. Two of the main areas for this are myopia control and dry eye management. Many stands at 100% Optical this year were taken by companies working in these sectors. In particular the dry eye management sector was in high evidence with an ever-increasing range of equipment and medications to treat and manage dry eye.
There can be little doubt that, for people living with the effects of dry eye each day can be a misery, and it is important that we assist these people to live more normal comfortable lives. There is also little doubt that the financial benefits of working in this area can be beneficial to a practice. As usual then, where there is opportunity and financial benefit available, there may be, for some, a temptation to stray into areas beyond their understanding or ability. The GOC take a very dim view of this and rightly so.
The reason I mention this is that I was approached the other day by a family who had all been for their routine check-ups. Mum, dad and their 20-something daughter, all practising good healthcare habits. Each attended for their sight test being completely asymptomatic reporting no problems at all, least of all any dry irritable, stinging, itchy eyes. Each left having been required to purchase a heat bag and a plethora of ‘lotions and potions’ to treat their dry eye syndrome that each had been told they were suffering from.
No explanation was offered as to why they had all mysteriously developed this annoying distressing eye condition that they were all entirely unaware of. No advice was given on how to ameliorate the conditions that would cause this to arise or advice on what to do to prevent exacerbation. Understandably, conversations had taken place between them all as to why they had all been asked to purchase all that they had, and just how much they had all paid.
I have to say I was surprised they had all been diagnosed with the same problem, of which none of them was aware. I was also somewhat taken aback at what it had cumulatively cost them to treat their phantom conditions. The reason I highlight this is that it can sometimes be easy to look at lucrative avenues that open up to us to create new revenue sources, especially when the NHS sight test is such a large loss-making financial burden, but, at all times, the needs of the patient must remain paramount.
If we enter these areas of work, we must always sit down and explain at length why we are taking the actions we are and why they will benefit the individual concerned. Only by total transparency and demonstration of clinical competence to the patient will we be seen to fulfil our roles in these areas of work. Otherwise, we will run the risk of being seen as some form of modern opportunist charlatan.
Ironically, while this may have seemed a lucrative encounter for the practice, the three patients, prior to talking to me, vowed never to return and the one who had needed some very expensive varifocals had decided to purchase them elsewhere costing the practice way more than it gained in the first place. Truly a moral for us all.