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More balanced legislation needed in B.C.
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At first, I did not think it was possible. How could any legitimate governing body unilaterally reclassify spectacles and contact lenses from the realm of prescription medical device to over-the-counter? How could it do so without input from any of its constituents? Yet this is just what the British Columbia Ministry of Health did on March 19, when it released a statement announcing that a valid prescription was no longer necessary for the purchase of contact lenses and eyeglasses. That’s right, no prescription necessary. Just order what you want, when you want. An interesting concept.
How could this happen? Historically, the Canadian government required certain stipulations for legislation of this magnitude to be enacted. First, it mandated a consultation period, during which all interested parties debated the merits and dangers of the legislative agenda. Second, it required cabinet approval. However, the Canadian Health Professions Act was modified in 2007 so that cabinet approval is no longer necessary. Now the Minister of Health has the right to arbitrarily abbreviate the consultation period. Sadly enough, the Minister of Health elected to exercise both options – announcing that the proposed changes go into effect May 1. An interesting process.
What was the impetus for change? It is not clear to me. The British Columbia Association of Optometrists, the British Columbia Society of Eye Physicians and Surgeons and the Opticians of British Columbia apparently had no ongoing dialogue with the Ministry of Health regarding this legislative agenda. When Primary Care Optometry News contacted the Ministry of Health, we were told, “If we had not acted, then this B.C. company [an Internet vendor of contact lenses and eyeglasses] with 120 employees, doing over $100 million a year in business, selling around the world, would have to relocate out of B.C.” An interesting rationale.
What does this mean? For starters, eyeglasses and contact lenses can be sold without confirmation of a valid prescription. The legislation also permits opticians to perform “sight testing” on “healthy” patients. The stipulation is the patient be between 19 and 64 years of age and have had at least one eye exam before their 19th – and again – 40th birthday. Granted, patients with certain systemic or ocular diseases are excluded from sight testing. However, with a recommended eye examination every 20 years, disease detection might come too little, too late. An interesting public health policy.
As I write this editorial, the fate of this legislation remains uncertain. My hope is that all interested parties are given an opportunity to present their opinions, that a healthy debate ensues and that a more balanced legislation emerges. That would be more than just interesting. That would make sense.