Opticians Act 1989

Lord Newby Excerpts

Monday 8th February 2016 Lords Chamber

Asked by

[Lord Newby]

To ask Her Majesty’s Government whether they will amend the Opticians Act 1989 to allow certain adjustable-focus eyewear to be sold over the counter as is already the case with reading glasses.

[Lord Newby (LD)]

My Lords, adjustable-focus eyewear are pairs of glasses that allow consumers to adjust the focus of each lens separately. They achieve the desired focus for each eye by turning a dial located at the side of each lens. The quality of definition achieved is extremely good, and to demonstrate this I am wearing a pair of these glasses this evening.

[Noble Lords]

Hear, hear!

[Lord Newby]

They are produced by Adlens, an Oxford-based company. They are sold in some 57 countries worldwide, but the largest markets are Japan, where some 650,000 units have been sold, and the US, where some 500,000 units have been sold, many without a prescription. They are particularly valuable for people whose eyesight varies from day to day—for example, diabetics or those who have had cataract surgery—but they have many other uses, such as emergency substitutes for glasses that have been lost or damaged until permanent replacements are produced, or as a spare pair while travelling. They sell for approximately the same price as a pair of high-end ready-to-wear reading glasses—a few tens of pounds.

The concept of an individual adjusting the power of the lens in glasses until it reaches an optimal level is already the way in which we decide on the strength of the glasses that we get, the only difference being that, if I go to an optician, it is the optician who presents a series of lenses before my eyes and asks, “Which is better, lens one or lens two?”. With these glasses, I physically make the adjustment myself. So we are talking about a product that is quite cheap, of extremely high quality and for which there is an obvious demand. So far—but only so far—so good.

The logical next step for Adlens would be to sell its glasses in pharmacies and supermarkets in the UK in the same way in which reading glasses have now been sold for 27 years. In order for this to happen, an exemption needs to be specified under the Opticians Act 1989 to allow them to be sold without a prescription. Framing such an exemption is relatively straightforward and so, having seen a demonstration of the Adlens glasses, I suggested while in government that an amendment to that effect might be made to what is now the Deregulation Act 2015. I contacted the right honourable Oliver Letwin, the Minister in charge of the Bill. He, in turn, contacted the General Optical Council for its advice. The GOC is the standard setter for the optical sector. Its response was stark. The risks to the public of allowing adjustable eyewear to be sold without prescription was so grave, it believed, that it claimed:

“We do not believe that the proposed changes warrant further consideration”.

The council formed this view without seeking or obtaining any expert evidence whatever.

Undeterred, Adlens sought a meeting with the GOC staff, which took place in June last year. The GOC agreed at the meeting to commission an expert report on the Adlens glasses and Dr Charman of the University of Manchester was duly appointed and reported last October. His conclusions were broadly that the glasses worked well; that the risks were the same as for over-the-counter sales of fixed-focus spectacles with similar powers; and that there was no fundamental reason why Adlens glasses with the same characteristics as reading glasses should not be made available over the counter. However, he also made the point that Adlens needed to rebut the argument that such sales might result in fewer people having a full eye examination where they needed one on health grounds.

The GOC standards committee met on 8 October to consider Dr Charman’s paper. It turned a very balanced and positive assessment into a litany of objections, some of which were, frankly, ludicrous. My favourite was the following:

“It was noted that these products were originally developed for use in the developing world – it was felt that a solution for a developing world problem was not transferable for the UK”.

This statement was made, despite the fact that more than 1 million pairs of the glasses have been sold in Japan and the USA. However, buried among the criticisms, the GOC agreed that,

“if the product were restricted to 0 to +4 D”—

the D is for dioptres—

“(as ‘ready readers’ currently are) the view of the Committee was that this might be acceptable, as it would reflect the parameters of the current legislation”.

The GOC objections have subsequently been endorsed by the Optical Confederation, the trade body for the sector. Its concerns, when boiled down, essentially amount to two. First, if sold over the counter, the product would reduce the number of people who have eye tests and that therefore a number of eye diseases would go undiagnosed. Secondly, if used for driving, they would be unsafe.

On the first objection, the evidence shows that, since over-the-counter reading glasses became available in 1989, the number of eye tests has been on a steadily rising curve and has continued to rise steadily over the past 15 years, despite the growth of online contact lenses and online glasses. The GOC basically believes that restricting access to eyewear will force the public to have their eyes tested more regularly. However, this approach has failed in almost every public health initiative to which it has been applied, whether for the management of hypertension, obesity, diabetes or alcohol abuse. If we want people to have their eyes tested more often, the evidence suggests that the way to do so is by consumer education programmes such as the National Eye Health Education Programme, the Think About Your Eyes campaign and the EyeSmart campaign.

As for the second objection, there is no evidence that the product is unsafe to use while driving. There have been literally zero reported cases of driving accidents in Japan and the USA involving the million-plus consumers who wear variable focus eyewear. Indeed, when this issue was contested in court in Arizona in a case brought last year by the State Board of Dispensing Opticians, evidence submitted by Adlens persuaded the Assistant Attorney-General to support its arguments and the board of opticians to abandon their action. The case was lost simply because the evidence did not support it.

If I were a cynical type, I would think that some of the arguments put forward by the GOC and the Optical Confederation were designed to maintain the current rules in order to require people to go to an optician who did not need to do so. That may be harsh, but throughout my discussions with the industry there seems to be a distinct lack of interest in putting the interests of consumers first. There is certainly no appetite for reform and without a big push from the Government, reform simply will not happen.

The judgment which now needs to be taken boils down to what I think of as the paracetamol test. Paracetamol is a product which can be purchased cheaply over the counter to treat pain in a manner which is effective for the vast majority of its users. It can however, if abused, kill you and, as the instructions helpfully point out, it can cause many other potentially harmful side effects. We tolerate this situation because we believe that, on balance, over-the-counter purchase of paracetamol is hugely beneficial to consumers. There is no evidence whatever that adjustable eyewear can have the same deleterious effects as paracetamol if abused. I therefore believe that they do pass the paracetamol test and that it is in the consumer interest for them to be sold in the same way as reading glasses.

Can the Minister confirm that a decision about the type of amendment to the Opticians Act which I am seeking is at the discretion of the Government and cannot in effect be vetoed by the General Optical Council? Secondly, will the Department of Health now review the matter? Thirdly, subject to their being satisfied that the risks of making the proposed change are greatly outweighed by the disadvantages, will the Government agree to bring forward at an early legislative opportunity the amendment to the Opticians Act which I seek?