To ask the Secretary of State for Health how many people in (a) 1989, (b) 1990 and so far this year received an eye examination under the NHS; and if he will show the percentage change since the introduction of charges for an examination.

Eye examinations are carried out in the community by optometrists who refer any cases of suspect eye disease, via the patient's general medical practitioner, to a consultant ophthalmologist in the hospital eye service. The total out-patient attendances at NHS hospital eye clinics for NHS ophthalmological treatment are:

	England (millions)
1988–89	2·839
1989–90	2·888
1990–91	2·931

Attendances increased by 3·2 per cent. between 1988–89 and 1990–91. Community-based optometrists carried out 12·493 million NHS sight tests in 1988–89. Changes were introduced in April 1989 whereby those who could afford to, paid for their own private sight test. Some 40 per cent. of the population including children and adults who either cannot afford it or who have special medical needs continue to be entitled to free NHS tests. There was a surge in the number of sight tests carried out in 1988 as people rushed to "beat the charges" and a corresponding drop immediately after April 1989. The last vestiges of this surge continue to show in the figures for 1989 which include 1·7 million sight tests done but not paid for under the "old system". The figures for NHS tests for 1989–90 and 1990–91 are—5·572 million and 4·425 million respectively. Figures from surveys published by the optical profession show that after an initial drop, levels for total sight test figures have returned to 1987 levels—the last "normal" year before the changes were made.