Optrafair is over for another year. Whatever may be said about whether attendances were up or down on previous years there can be no denying that these events do attract a lot of people.

Whilst many major exhibitors were conspicuous by their absence those that were there sent a very clear message for the future. It is clear that, given the annual abject failure of the OFNC to make progress with NHS fees, the equipment manufacturers were out in force again.

I was speaking to overseas optometrists at one point who were saying that it seems as if British optometry is moving away from refraction and into an ever more clinically diagnostic role. Indeed there are some who would now appear to be leading the charge to bail out the secondary NHS sector by finding a new role for optometry in the clinical arena.

Of course, the ultimate cynic might ask why there is this seemingly sudden lurch to the clinical stance by certain players. Given that the fees for these new clinical services are just as uneconomic as the NHS sight test itself can there really be a mass outbreak of altruism in optometry or is there a move afoot to take optometry away from refraction altogether and then launch a coup to take over the refraction vacuum created?

Given that this could be a real possibility Moneo has to ask whether it is time to call the bluff of these people and get optometry to change its ancient stance whereby refraction is the mainstay of all we do. Maybe the time has come to do away with refraction altogether.There have been many in this profession who, for a long time, have advocated deregulation of the refraction function. In fact each time it is debated at various conferences there is always a majority in favour of considering this.

The trouble is our professional bodies fight the idea tooth and nail. Whilst there is no clinical evidence to support this objection it is clear that any change to the Optician’s Act in favour of deregulation would mean a major shrinkage in the number of Optometrists and hence a major reduction in income to the professional bodies. Therefore the question has to be asked, are the professional bodies just arguing against such a move to protect themselves? With another university announcing the start of an optometry course meaning even more optometrists hitting the High Street this can only mean increased membership revenues so why kill the Golden Goose? But is any of this good for either the service user or the profession itself?

What is needed at the moment is truly enlightened thinkers to move optometry forward. We do not need the same old hackneyed faces appearing time after time to tell us how frustrated they are at “no progress”. This annual pilgrimage to the Department of Health has long been viewed by the Department as sport. Year after year the OFNC appear with no mandate from the profession. Year after year they arrogantly think they know better than anyone else and year after year they come away with nothing and then tell us all how “frustrated they are”.

And year after year the DoH sit back and laugh at us. This year we hear that at least they avoided a 6% reduction that was given to pharmacists. However, what they do not tell us is that most CCG’s now insist on one month prescribing of medicines only instead of the old method of giving patients a two or three month supply of their medication. This has meant that pharmacists who are paid on a “per item” basis have doubled or tripled their income prior to a mere 6% cut. In other words in the last six months they have creamed it whilst we have continued to be shafted. Why then did the OFNC feel it was not necessary to tell us of this amidst their “frustration?”

It is clear we will make no headway at all with the DoH. What is required is radical thinking with new faces leading the way. The sooner this happens the better the chance that Optometry in this land will not only survive but will flourish.

I would like to finish this month’s Moneo column with a totally upbeat news item. Many of you will remember with affection one of the most dynamic and inspirational people that we were lucky enough to know in this profession. I speak of Nick Loan, once leader of such august organisations as Bausch & Lomb, Ultravision and Rodenstock.

Nick left the world of optometry after many years of great leadership and influence not only on optometrists but on the many staff that were lucky enough to come under his wing. Whilst Nick has left the field of optometry he has not been idle. I know he will not mind me saying that this year saw him turn sixty. So what did he do to celebrate this milestone?

Well last weekend he ran the Paris Marathon with his daughter Melissa to raise funds for a most amazing national charity, The Spinal Injuries Association. Not only did Nick break all his targets for sponsorship but, true to his lifelong form, he came through in searing heat to succeed. Maybe it is people like him that we need to show this profession the way forward.