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The Economic and Political Background to Eye Health Care
Andrew Haldenby, Director, Reform
4 November 2010
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About us
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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
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UK government debt as share of GDP
• “Danger zone” throughout this Parliament
• Source: Office for Budget Responsibility, June 2010
• Bound to be underestimate
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Impact on economic growth
• Debt depresses growth• Why? Need higher taxes to fund
public spending• Reduces incentives to earn more
and make profits
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Interest payments on government debt
• Cash terms, £bn• For comparison:
• Schools spending is around £35 billion
• Police is about £12 billion
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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.”
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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
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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.
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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
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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