We have written to the Minister for Health and Social Services in Wales to oppose the proposal to reduce the value of NHS vouchers towards the cost of glasses. We believe this will have a detrimental effect on access to glasses amongst children, particularly those from disadvantaged backgrounds, further widening health inequalities.

The reduction in the value of vouchers at lower cost bands will affect large numbers of children. For example, the lowest band, being lowered from £39.10 to £22, covers almost 75% of patients. This will result in parents and carers having to cover more of the cost, potentially resulting in fewer children getting the spectacles they need. Not only will this have an immediate impact on the child, such as the impact on their ability to access their education, but it will also undermine the treatment of developmental eye conditions such as amblyopia. leading to further vision problems later in life.

Although increasing the contribution of a sight test from £21.71 to £43.00 could mean that the optical practice would cover part of the cost of the spectacles, with no mechanism to properly mandate this, it seems likely that optical practices will have a very small choice of “free” frames and thus exacerbate the choice difference between children from poorer and more affluent families. As personal preference for the frame can be a major factor for spectacle compliance, this will have implications for visual outcomes for these children.

This approach also lets down patients under hospital eye care, who will have a prescription from the hospital and just need glasses to be dispensed. These patients are unlikely to have a GOS, having already been examined by an ophthalmologist and/or hospital optometrist or orthoptist at the hospital. In this instance, vouchers for these patients are only worth £22 and there is no extra money for the optical practice to utilize, to bring the cost down. This is a very unfair principle, as it makes spectacles even more expensive, specifically for those individuals who have more complex ophthalmic needs and from less affluent backgrounds. This problem may also encourage eye care in Wales to work less efficiently, as in order for the optical practice to fund the price gap between voucher and spectacles, they may give these patients a GOS in order to secure the £43, which in most cases would not be needed.

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