1. The Economic and Political Background to Eye Health Care Andrew Haldenby, Director, Reform 4 November 2010

2. About us

3. UK deficit as share of GDP Worst structural deficit in OECD in 2011 I.e. excludes effects of the recession Second biggest increase in public spending in OECD 2000-10 15 percentage points of GDP, from 35 to 50 Only Ireland greater

4. UK government debt as share of GDP “Danger zone” throughout this Parliament Source: Office for Budget Responsibility, June 2010 Bound to be underestimate

5. Impact on economic growth Debt depresses growth Why? Need higher taxes to fund public spending Reduces incentives to earn more and make profits

6. Interest payments on government debt Cash terms, £bn For comparison: Schools spending is around £35 billion Police is about £12 billion

7. The Spending Review – opening up public services “Increasing the diversity of provision helps share that responsibility across society, and drives innovation and efficiency by increasing competition and consumer choice.” “The Government will pay and tender for more services by results rather than be the default provider; look to set proportions of specific services that should be delivered by non-state providers … in community health services.”

8. The optical sector is a perfect example of public service reform Guaranteed service for all, financed by government and private sector Two-thirds of the 20 million sight tests administered annually are financed by the taxpayer Innovation and local leadership provided by private sector management 2009: 10,734 ophthalmic providers in the UK

9. Crucial for NHS reform NHS reform turns on the rebalancing of healthcare from treatment to prevention The revised 2010-11 Operating Framework supports a shift towards primary and community care Only 4 per cent of sight tests result in a referral to a GP or consultant Other NHS services should be better integrated with optical care.

10. Deregulation Vince Cable, 10 June 2010: “The regulatory burden is a check on business growth and everything we can do to lighten it will help” Opportunities for deregulation: Duplication of regulation between NHS and GOC General Ophthalmic Mandatory Services Model Contract Self-regulation by Local Optical Committees

11. Optical sector action plan Take the story of the optical sector to the heart of government Present the optical sector as an example of the Big Society – that is, the idea that public services should be delivered by a partnership between government and other organisations Present the optical sector as an integral part of NHS reform Use the Government’s commitment to deregulation to support the development of the sector