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Bringing Dickens into eye care.

THE BBC dramatisation of Little Dorrit portrayed an invented government department, the Circumlocution Office. It generated forms and memoranda with no purpose, and was awash with paper and a large staff who achieved nothing. First published in 1855, who would have thought that the English Department of Health would bring it to life in 2009?

Using the new GOS contract as an excuse, PCTs are busy unleashing a torrent of forms, questionnaires and instructions, apparently to check compliance with a contract that is only six months old. These unreasonable and often badly framed demands are disproportionate to any risk and often outside the terms of the GOS contract, but they have become oppressive to our members, and therefore the main area of work for the AOP, our FODO colleagues and the LOC Support Unit--and of course our legal advisers.

The government say they had no idea this would happen when they negotiated the new contract. I want to believe that, but if we are to take that assurance at face value then they need to act to stop this expensive and damaging paper chase. Primary Care Contracting does not generate this work in isolation, and with sensible guidance they could be turned into a force for good. Of course we are advising and assisting our members through the process, and we will seek the protection of the law where that is feasible. But legal action is not the threat that should concern the government most, rather that this over-zealous and largely pointless exercise is in danger of damaging the delivery of eye care. It should play on their minds that optometrists did not come into the profession to see that happen, and many will now contemplate walking away from the NHS.

Regrettably this farrago is aided and abetted by some Optometric Advisers. Clearly most act reasonably and work with their LOCs to establish good professional relationships. However, some are rude and judgemental in ways that are entirely inappropriate and make demands on the profession that extends way beyond common sense or the powers of the PCT. Everyone knows who these people are. They carry no respect in the profession and ill-serve the interests of their employers, the PCTs.

George Bernard Shaw said of Little Dorrit that "... when the English nation realises that it is a great and true book, there will be a revolution in this country". He may be proved right. How many will deliver GOS for 19.80 [pounds sterling] to have all this dumped on their head? The profession has delivered a good service to NHS patients for more than 50 years, but it cannot do so against unaffordable and unnecessary demands that damage their ability to work, and will not do anything to protect patients.

Bob Hughes

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Title Annotation:COMMENT; Charles Dickens' Little Dorrit
Author:Hughes, Bob
Publication:Optometry Today
Article Type:Column
Geographic Code:4EUUK
Date:Feb 27, 2009
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