Last month I wrote that there is an imbalance between the fee charged for an eye examination and the prices charged for spectacles and how it came about. If you remember, the government, through the NHS, originally made sight tests and basic spectacles free at the point of need for everyone but had to start charging for spectacles in order to limit demand. Having had to introduce charges for spectacles it was politically impossible to introduce charges for sight tests as well, at least until Mrs Thatcher was in power. Instead, over the last seventy years, they have continued to claim that sight tests are free for those entitled to them while paying the optometrist less and less of the actual cost of performing an adequate eye examination, expecting the difference to be made up by opticians charging extra for spectacle frames and lenses. It always seemed wrong to me that we were expected to make excess profit on frames and lenses in order to subsidise the ‘free’ sight test. In effect we were expected to charge spectacle wearers more to provide non-wearers’ free tests.

Through my whole career I battled the clear dilemma this produced. Should I continue doing something that I thought was wrong? The obvious solution would be to opt out of the NHS. This would allow the practice to use whatever eye examination techniques are most appropriate at the time and to charge accordingly, for both eye examinations and for spectacles. Eye exams would no longer need to be subsidised by spectacle sales and consequently the practice would be rid of the ridiculous situation that applies at present where spectacle wearers pay part of the actual cost of the eye exams of those who don’t yet need them.

Dentists have found a way to do it by only accepting limited groups of NHS patients.  Unfortunately, because of the way that Optometrists’ NHS contracts are written, unlike Dentists there is no freedom to accept some NHS groups and not others. For Optometrists it has to be all NHS patients or none. This means that if we abandoned the NHS then we could no longer examine school children other than privately This was always the sticking point for me in the past but now things have just got too out of balance for it to make any economic sense to remain with the Health Service any longer.

So from Autumn this year Richard Petrie Optometrists Ltd. Is planning to switch to a subscription service. In return for a small monthly subscription you will get the same, or better, eye examination that you always have while at the same time seeing a reduction in the price of spectacles. This, of course, will be very familiar to the large number of RP4 patients who have been using a very similar service for up to 19 years now. Large, corporate Opticians may be happy to keep the quality of a sight test down to a price, Richard Petrie Optometrists is no longer prepared to.