Debate has raged over the level of the eye examination fee since it was introduced but its withdrawal could prove painful indeed.
Resignation best sums up the reaction within the profession to the news that the fee will be frozen. Practices may have come to terms with a low level of fee but its removal has the potential to change the market beyond recognition.
The sight test fee is negotiated as part of a raft of allowances and voucher values the Department of Health pays or, in the case of dispensing opticians and CET, doesn’t pay to those in optics. Members of the Optical Fees Negotiating Committee will rightly point out that there is more to the annual round of talk than the level of the sight test fee.
If sources are correct the government side was looking for a reduction in the sight test fee this year but the OFNC saw that off. What the OFNC was told was that next time the DoH wants budget control.
In the late 1940s the then editor of this journal, Bill Hardy, was asked by Aneurin Bevan how many people he thought would need a free eye exam. Hardy estimated seven million only to be told by Bevan that his advisors had estimated two million. No prizes for guessing who was right.
Then, as now, the budget remained uncapped. The fee is set and the volume flows. If the DoH decides to set fixed budgets optics enters new territory. Bidding could see local commissioning groups taking the view that funds should go towards testing for particular groups, or not on product, perhaps other fees could be sacrificed. Who gets the free eye exam?
A stampede away from NHS testing may well ensue and not just at the top end of the market.