1. February'07BRNO Liliana Stankova THE BULGARIAN MODEL Objective: there is a sustained tradition that ophthalmic optics and optometry in Bulgaria have always been healthcare professions.

2. February'07BRNO Liliana Stankova Flashback: Tsarist Bulgaria 1936 1936: the Ministry of Public Health and Interior proclaimed a Decree on the profession Tsar Boris 3 rd ’s Decree no.5 on opticianry. Tsar Boris 3 rd ’s Decree no.5 on opticianry.

3. February'07BRNO Liliana Stankova Flashback contd.: Pre- and post Sept 9 th 1944 Time reference: Sept 9 th 1944 The post-nationalization period: first public optical shop opened in 1948.

4. February'07BRNO Liliana Stankova Vocational training for ophthalmic opticians 1958: the birth year of professional training for opticians; specialized school.

5. February'07BRNO Liliana Stankova Flashback contd.: The time of national socialism The profession was regulated by the Ministry of Public Health. Network of optical shops throughout the country, united and governed by the State Pharmacist Union.

6. February'07BRNO Liliana Stankova Legal status The profession is treated as a pure healthcare profession one by the Public Health Act.

7. February'07BRNO Liliana Stankova Training Daily tuition – 2 years post high school education. Graduation with a state examination in the specialty Ophthalmic and Dispensing Optics.

8. February'07BRNO Liliana Stankova Optometry training 1990-1991: First one-year course in optometry post graduation in Ophthalmic Optics was arranged on the initiative of the optical department at the State Pharmacist Union in collaboration with the Ministry of Public Health and the Ministry of Education

9. February'07BRNO Liliana Stankova Optometry training programme Syllabus: I. General medical subjects 1.Latin language studies 2.Anatomy and Physiology of Man – theory and practice 3.Social Hygiene and Epidemiology II. Specialized subjects 1.Internal Diseases 2.Pharmacology 3.Ocular Diseases – theory and practice 4.General Optics 5.Specialized Optics 6.Economy and Organization of Optical Services Provision III. Practice course

10. February'07BRNO Liliana Stankova Democracy reinstalled 1989: the public network of optical shops disintegrated and the first private-owned optical shops appeared

11. February'07BRNO Liliana Stankova Organized optics 1996: first organization forms of opticians: Bulgarian Optical Union 1997: the Association of the Private Employers in the Optical Branch was established, later renamed the National Association of Bulgarian Optometrists and Opticians -NABOO

12. February'07BRNO Liliana Stankova Globalization of the profession 1998: close contact to the profession in Germany; cooperation with ZVA and the Koblenz Handwerkskammer – Sofia office Valuable exchange of ideas related to the organization and the legal institution and regulation of the profession

13. February'07BRNO Liliana Stankova Adoption of the German model The MoH neglected our professions and we attempted to transpose the German model in Bulgaria and cultivate a local form of professional union: NABOO becomes member of the National Handicrafts Chamber - 1998

14. February'07BRNO Liliana Stankova ECOO membership 2000: NABOO becomes member of ECOO. Initiation in the best practices, background traditions and trends of the profession(s). Start of a successful and all-level communication with other ECOO members. The “healthcare” model received strong impetus owing to the close interaction within ECOO and as a result of the development of the industry and the sector.

15. February'07BRNO Liliana Stankova Handicrafts Act: pros and cons 2000: The profession is integrated in the Handicrafts Act where there was subject to an inadequate and rather questionable legal treatment (e.g. any university diploma holder was entitled to qualify for a Master’s Certificate and exercise the profession of ophthalmic optician) (e.g. any university diploma holder was entitled to qualify for a Master’s Certificate and exercise the profession of ophthalmic optician)

16. February'07BRNO Liliana Stankova Changed legal framework 2001: Regulation of the MoH entitling both ophthalmologists and ophthalmic opticians to the professional management of optical shops. Court action of NABOO supported by the BOU against the above provision. Court ruled our claim was bad and unjustifiably monopolistic. We lost the case.

17. February'07BRNO Liliana Stankova Handicrafts Act: pros and cons contd. Unhealthy application of the provisions of the Handicrafts Act which also compromised the level of professional practices. => The transposition of the German model proved unsuccessful in our situation. => The transposition of the German model proved unsuccessful in our situation.

18. February'07BRNO Liliana Stankova Education & Regulation Regulation no.23 / 15-12-2005 on the order to qualify in the profession “technician in ophthalmic optics” which introduced the minimal State Educational Requirements to a professional optician. The Ministry of Labour and Social Policy endorsed a new National Classification of Professions: ophthalmic optics and optometry are grouped under caption “applied- and associated-healthcare* specialists” *paramedical

19. February'07BRNO Liliana Stankova Re-definition of the course 2006 - Having learned our lesson and being more prepared with the experience gained, the “healthcare” view of ophthalmic optics and optometry was again on the table. NABOO took on intensive and comprehensive action, incl. institutional action, publicity and lobbying, to re-instate the profession(s) under the Health Act.

20. February'07BRNO Liliana Stankova Lobbying with decision and policy- makers 2006 - Consultations and discussions face a face with the various governmental institutions: specialized parliamentary commissions and Ministries

21. February'07BRNO Liliana Stankova Reinstitution! 06.10.2006: Health Act amendment: our two professions were again integrated and re-defined as healthcare professions. Thus also the Handicrafts Act was amended to exclude our professions from the Act’s scope.

22. February'07BRNO Liliana Stankova In perspective Underway on our immediate agenda: - develop a Regulation on the structure and activity of optical shops which should streamline and regulate the practice of our professions; - develop a framework for continuing (life- long) education in ophthalmic optics.

23. February'07BRNO Liliana Stankova Thank you for your attention!