Lumen writes

An optical juggernaut?
Just as the many optometric and optician 'ostriches' start to take their heads out of the sand, having hoped that all the recent raft of changes 'have all gone away' or that they were 'just having a dream/nightmare', around the corner comes a huge juggernaut.

While the profession settles into a new world of compulsory CET, ophthalmic and supplementary list changes, dual signatures and a soon-to-be-produced new GOS 1, along comes James Murray-Wells and his internet specs, together with Tesco and its internet and pharmacy contact lenses, now joined by Next specs. But the potential show-stopper of all is the seemingly innocuous Health Improvement and Protection Bill.

This Bill, introduced in the Queen's Speech on May 17, will make the vast majority of enclosed public places and workplaces smoke-free (no problem there). It will introduce anti-MRSA measures in an attempt to reduce healthcare-associated infections (about time too), respond to post-Shipman recommendations (the management of controlled drugs, right of PCT entry to healthcare premises, and oblige co-operation between healthcare organisations and the likes of the police), and modernise pharmacy and ophthalmic services. It is this last and well-hidden point, seemingly tagged on to the end of the Bill, that may ultimately prove to be the largest cause for concern for the optical profession.

While we all still await a true review of the whole GOS in England, possibly in line with the WECI and the agreements reached in Scotland, the far-reaching proposals in this Bill (which actually affects both England and Wales) offer no such hope and in fact have the potential to create chaos in the whole optic sector.

The new ophthalmic and supplementary lists only came into force on July 1, but the Bill proposes to replace this new system with lists of 'providers' and 'performers' with whom the PCTs will contract. At the same time the Bill will do away with 'grandfathering'. Thus PCTs will control who enters the GOS market and who does not. PCTs will control who gets a contract and who does not. PCTs will set a time limit on that contract which may or may not be renewed (currently, the NHS seems to favour three-year contracts). As almost 70 per cent of sight tests are currently NHS, this will create havoc in manpower planning requirements in a sector that already has much competition and true patient choice and provides an excellent service for a subsidised pittance of a sight test fee.

The uncapped and central GOS budget will need to be devolved down to the PCTs and will thus be cash-limited in nature. Do not expect the sight test fee to rise!

While there is a large consultation process for the smoking elements of the Bill ending in September, our professional bodies were given exactly four weeks to respond by July 19. Let us hope their response has been effective. The PCTs have not enjoyed huge success in implementing change in the dental sector. In fact many dentists have left the NHS completely. Let us crystal ball gaze for the future of optometrists and opticians. In terms of timescales the Bill will reach the statute books by mid-2006 and will be implemented from April 2007.