Anyone who breaches the law and the regulations over restricted functions should be subject to punitive and deterrent sanctions in order to safeguard the system which protects the public. The General Optical Council (GOC) as the body responsible for the profession should take action against those who infringe the law in order to raise standards and improve public protection.
Defining illegal practice
Illegal practice1 means carrying out restricted functions without required qualifications or necessary registration with the GOC. Restricting certain functions to registered practitioners provides the public with the assurance that their needs are serviced by trained professionals who have invested time, money and effort in achieving expertise in their field. It also provides practitioners assurance that competitors are working to the same standard.
A risk for patients
The most common mode of illegal practice that carries the greatest risk to patients is the unlawful supply of contact lenses – both prescription and zero-powered 2. The supply of zero-powered and prescription contact lenses – without appropriate fitting and advice on hygiene, care and use – carries health risks due to poor hygiene and care regimes and over-wear. Sale of cosmetic lenses through unregistered outlets encourages users to view lenses as toys – often sharing them with friends – and risking their health. The manufacture of illegally supplied zero-powered lenses may not be to the same high standard as prescription lenses, both with regard to the manufacturing environment, process and the materials used.
Enforcing greater control
Supply of contact lenses is difficult to control because of the ease with which internet suppliers from outside the UK can circumvent UK legislation. We believe as action is very rarely taken, the law provides little deterrent to those engaged in illegal practice. As a result, this undermines confidence in regulation and provides little protection to the public. Furthermore it doesn’t provide incentive for those engaged in illegal practice to gain the required qualifications and register with the GOC. Better enforcement would give unregistered suppliers dispensing spectacles to, for example, restricted groups such as children, an incentive to register.
Effectively tackling illegal practice
The AOP believes that, if illegal practice of all types, is to be tackled effectively, the GOC needs to take a strong stance against those involved, demonstrating that sanctions can and will be taken against those who break the law. Such actions, although possibly financially costly on an individual basis, will act as a deterrent especially to small retailers who supply zero-powered lenses and are often unaware that they’re breaking the law.
As a minimum, if a UK-based company carrying out restricted functions, whether misusing a protected title or supplying contact lenses, the GOC should write a warning letter, underlining the illegality of the supplier’s actions and the possibility of legal action. This would encourage suppliers to register with the GOC in order to gain access the market and associate themselves with high standards of safety. The safety of the public would be enhanced due to a withdrawal of sale of contact lenses sold through unregistered UK-based outlets, including retail, internet and wholesale. In addition, confidence in the GOC as a regulator would increase and it would strengthen the value of registration for the benefit of the public.
Limitations to internet supply control
We understand there are limitations to what the GOC can do about illegal supply over the internet, as many of the websites administering illegal supply are located outside the UK where the GOC has no legal jurisdiction. The GOC’s proposed new voluntary code for the online supply of contact lenses rightly acknowledges these limitations, but also takes action to protect patients and the public. The way this code is promoted to the public and monitored to ensure compliance will be important to its success. We look forward to working with the GOC towards implementation of the code, and more widely in reducing illegal practice and protecting the public.
Read about the risk of using cheap cosmetic lenses in 'One hell of a price'.
- GOC (2014) Statement on the outcome of the consultation on our illegal practice strategy
- Ophthalmology (2008) The Incidence of Contact Lens–Related Microbial Keratitis in Australia
Position statement published January 2016
Read the rest of the AOP position statements.