Health Bill

moved Amendment No. 91:"Page 31, line 15, leave out from ““all”” to end of line 23 and insert ““persons””" The noble Baroness said: In moving Amendment No. 91, I shall speak also to Amendment No. 94, which is grouped with it. Primary ophthalmic services are perhaps one of the most effective services throughout the NHS. They work extremely well and they are extremely efficient in their role of prevention and early detection. They are also one of the parts of the health service for which there is no waiting list. Access to ophthalmic services is rapid, easy and open to everyone. The amendments that we have tabled reflect in part the concern of optometrists, ophthalmologists and dispensing opticians that their services, which to date have worked extremely well, would be changed and tinkered with in such a way that their overall efficacy would be damaged. Amendments Nos. 91 and 94 serve as a hook on which to hang a debate about provision of general eye tests. Prior to 1989, eye tests were free for everyone. Thereafter, they have been free only for some exempt categories of the population, such as older people, and others must pay for them. Our concern about the Government’s proposed changes to ophthalmic services and the contract to be awarded by PCTs is that the current, on the whole satisfactory, ophthalmic services may become limited and less effective. I say that not least because other parts of the health service that are also involved in primary eye care seem to have changed. I am given to understand that pre-school children and children entering their first school no longer automatically receive eye tests to detect conditions such as squints. It is against that background that we want to probe the Government’s intention on access to the general sight test. We want to make sure that it remains the responsibility of a PCT that there is adequate provision in the area, and we want to make sure that such discretion as the Bill affords it to alter contractual arrangements for primary ophthalmic services will not lead to the introduction of charges by the back door. Amendment No. 94 deals specifically with glaucoma referral services. It is well known—so I do not need to spend a considerable amount of time explaining to noble Lords—that one of the most important things about the general sight test is that it serves as a means to detect other conditions such as tumours, glaucoma, the onset of diabetes, and eye conditions such as macular degeneration. We want to ensure that those services remain within this contract, which PCTs are required to provide. That is the basis of our argument. I beg to move.