Our modern health care system has a number of mysteries associated with it. Among them are; why are all hospitals left to manage their own supply chains – resulting in widely disparate charges to the NHS for the same product, why do only around 60% of NHS staff take up free flu injections and why can I not get an appointment with my GP for two weeks? However the biggest mystery to me is why there is a complete lack of focus on eye health issues within our public health agenda, either nationally or locally.

We are all used to seeing national campaigns relating to high profile health issues such as cancer, obesity and smoking. There are then regular news information stories, on what I would term the next tier of health topics, such as sexual health and recognising the signs of stroke. These are all very sensible and worthy initiatives and my assumption is that these will have been put together through cross agency work, between Public Health England and NHS England and then distributed to the media. We also see lower profile, but still important issues, that come to the fore as new figures become available and highlight a problem.

An example of this was one recent Saturday, when the first story in the news that morning was that children in some areas of the UK were having to have all their teeth removed due to tooth decay. The messaging was clear, that this was due to inappropriate amounts of sugar in their diet and not visiting a dentist early to seek treatment before things had gone too far and get advice on what to do and not to do.

Again, this was common sense advice and clearly a good message to get over to parents. It was not obvious who had placed the media coverage, but there were certainly messages there from Public Health England, NHS England, plus the British Dental Association. The former are taxpayer funded organisations who have the ability to commission health initiatives, so here we have a high profile media campaign, relating to teeth and dentistry.

Have we ever seen a similar campaign aimed at children’s eye health, or for that matter eye health in general? Teeth are very important, but more important than our sight? Would the general public be happier losing their teeth or their sight?

It is interesting to look at the Public Health England website and in particular their campaigns page, which lists each campaign they run, together with links to available support material for each one. There are 28 campaigns in total, featuring all the high profile topics you would expect together with a pharmacy and dental campaign, however, there is not one mention of eye health.

Consider the evidence as to why eye health should get greater profile from a public health perspective. Good vision is obviously important to everyone. We know that most causes of poor eye health are a consequence of getting older, people are living longer and hence this is a problem that is going to increase over time.

There is a cost of poor vision in terms of additional social care, treatment due to falling as a result of poor vision and of course the less quantifiable cost of depression and loss of independence. A central theme of the NHS and Public Health moving forward is to promote wellbeing, prevention, independence and self-care, preventing illness and frailty to enable people to live healthy and independent lives. A central tenet to being able to live independently is surely to have good vision?

We also know the RNIB tell us over 50% of blindness is avoidable and so this is a situation that can be improved given focus and energy from the organisations in a position to make it happen. It is difficult to put a finger on why we appear to be the poor relation in NHS services. I assume our representative bodies together with the charitable sector, who will give a degree of independence, put forward a coherent message covering the issues raised above. It remains then a mystery as to why this is not picked up and we do not seem to make any headway.

We have to keep putting forward a vociferous case nationally and, as another mystery of the NHS and public health is the question of why there is not greater central guidance, I am sure there will be opportunities for local optical committees and eye health networks to influence locally.