Remember NHS Specs?

Ian Evans
Ian Evans
Ian Evans

Ian Evans, HCS NOPC

This is my first time at writing a blog, so, I apologise for the rambling and poor grammar. 

I suppose it’s with a sense of irony that I’m struggling to write this as I’m wearing my newly prescribed, quite expensive, glasses. This is largely due to the fact that my prescription has changed again and I‘m still getting used to them. It doesn’t help when you have to wear varifocals, “not uncommon”, as I once informed by the young optometrist (it could have been an optician, but I couldn’t read the sign on the door!), “for someone of my age”! There’s another irony to this too. The glasses that best suit us always seem to be the most expensive ones. But, with the greatest irony of them all is, they look like the free glasses that used to be given out under the NHS! 

For the younger people (much like my optometrist), the NHS provided free eye tests and glasses between 1948 and 1985. A service widely used and appreciated, though, with a stigma of mockery attached to it. It was a form of healthcare that provided early diagnosis reducing the need for more costly treatment if a condition, like any other, went unrecognised. 

It has always been recognised that the best medicine is preventative medicine. I appreciate that this open for debate, but not today. It’s beneficial in many ways. It’s good for the individual in a physical and mental way. Something I would to come back on later in this piece. It makes sense financially, again, for the individual, but also the employer and the economy.

So why I’m I going on about someone that was denied us 30 years ago under a Thatcher government now, I hear you cry? Good question, I retort. A campaign to bring back NHS glasses is a good and noble cause, but I would like to focus one other treatment that is currently available, though, maybe for not much longer.

The Health and Social Care Act, originally made it available for health provisions to any willing provider, and later changed to any qualified provider, though, it’s difficult to see the difference, as an alternative to the NHS. This opened up “healthy” competition stopping that evil monopolistic corporation called the NHS being the sole provider and giving us choice to pick someone on the High St to give us the care we so richly deserve. The private sector (apparently the heroes and saviours of free healthcare for all) can cherry pick which services they can provide, unlike the NHS (the Darkside employing coasters on gold plated pensions) who have to do what they are told, at a tariff that doesn’t reflect the actual cost of the test.  

There is one area where you may, or may not have noticed, I’m going for the latter. Audiology services have come under significant attack in recent years, with, opticians bidding for the service (yet more irony). However, these guardians of good virtue have seen it fit to only take non-complex, age related cases. It’s good that there is a recognition that as we get older, we have a tendency to lose our hearing and we have the facility to be able to do something about it. Admittedly, we already have this in place, but that’s surely not the point. We had, I use the past tense deliberately, a convenient High St provider readily available to furnish us with a NHS paid for hearing test and device, if required. Of course, you had the opportunity to upgrade if you wanted to (an additional payment is required).

With the High St providing these service this gave the NHS Trusts the opportunity to realise that they no longer required Audiologists, as the work was now being done by private providers, and could let them go and therefore reduce the wage bill. Then there was the moment of clarity that hadn’t foreseen. They still get patients! The complex, time consuming patients. This meant they couldn’t get rid of the Audiologists after all. The safe staffing levels had to be maintained but with dramatically reduced income. I’m sure you have heard the phrase, “being set up to fail”? Well, this is the case indeed. 

This, also, still doesn’t really meet the needs to the private sector, so, something must done about that too. As things stood they were providing a NHS service and therefore making little if no profit whatsoever. That just isn’t good enough, so what should they do? Of course, withdraw from offering free NHS service and just sell their own products.

You’re probably thinking now, that doesn’t matter the patient can go back to the NHS and get tested there as the service would be repatriated.
Here comes the real kicker. Even if a Trust managed to keep sufficient highly qualified Audiologists and was able to provide a service, it ain’t going to make a jot of difference if you’re in North Staffordshire. The Clinical Commissioning Group (CCG) has decided that it doesn’t want to spend (tax payers) money on providing treatment for patients with “mild” hearing loss. This equates to, no treatment, no test, no hearing aid.

Those considered to have “moderate” hearing loss will have to go through new eligibility criteria and judged whether they are worthy. The rest of Staffordshire, including Stoke, are considering on doing the same. This’ll make you laugh. The criteria (judgement) on whether you qualify as moderate loss of hearing is based on a questionnaire written in 1984. Ignoring the Orwellian coincidence, you would have thought that being tested normally meant identifying which range of frequency is being denied by the hearing loss, rather than being required to fill in a survey. May be you should answer in block capitals saying “CAN YOU SPEAK UP PLEASE”

So, let’s weigh up the options. You can go to your doctors, tell them you are struggling to hear people (mild hearing loss), this most likely because of age (and therefore paid your taxes and national insurance all your life) and told you’ll just have to cope until it becomes more severe (moderate hearing loss) and you can then be judged. 

There is another choice. The private sector (the heroes I mentioned earlier) still provide a free, or, at least, an affordable hearing test. Hooray, I hear you cry! They will give a thorough examination assess your needs and guide towards a device that is best for you. They will tell you about all the device you like the most. What they probably won’t tell you straight away that the cheapest hearing on the market (that I could find) is £495 and most are over £1000. I forgot to mention, they do offer optional extras too!

Much like free eye tests, and dentistry come to think of it, and free NHS specs, the provision of free hearing tests and the device will be denied. This, like dentistry and optometry, will mean people will not attend an appointment due the fear of how much there have to pay. They may even buy a cheap alternative, not realising they could be doing more harm than good. We’ve all seen those £10 spectacles at the supermarket. Or, worst of all, pretend the problem doesn’t exist and accept that people will have to speak slowly and with a raised tone.

I was deaf as a child and remember all too well the isolation and frustration you experience, with added the reliance on others to help you through normal day to day activities. Can this be guaranteed for the elderly? Will we see people, with no fault of their own, be afraid to venture out because they don’t want to be a burden?

I fear I already know the answer to this, as we have seen all before. The British are renowned for their dodgy gnashers, and it’s not that uncommon to see people wearing glasses that are a throwback to the 80’s. Do you we just accept the same fate for our ears, or do we make a stand and try to reverse this worrying trend?

I know what I’m going to do. Please join me.