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     FrontPage Edition: Fri 20 July 2007

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Optometrists and Opticians Bill 2007 passed


Parliamentary Speech for the Second Reading of the Optometrists and Opticians Bill 2007

17 Jul 2007
By Mr Heng Chee How
Venue: Parliament
Like other countries, eye care in Singapore is provided by ophthalmologists, with auxiliary support from optometrists and opticians. Our ophthalmologists are highly trained and enjoy an international reputation with many foreign patients as their clientele.
However, unlike most other countries, we have largely left the practice of optometry and opticianry unregulated. This is historical.
Some years ago, the Health Ministry decided that we should bring the practice of optometry and opticianry under regulation and started to prepare the industry for it.
In 1994, we took the first major step when the Singapore Polytechnic launched a diploma course in optometry and certificate courses in ophthalmic dispensing.
This was to provide the industry with well-trained optometrists and opticians to help raise the standard of eye care by these allied health professionals.
Over the years, the Singapore Polytechnic has graduated about 600 optometrists and provided training for about 300 opticians. We now have an active market in such eye care practices with competitive prices.
In 1995, we took the second major step when the Contact Lens Practitioners (CLP) Act was introduced to regulate contact lens practice. This was a priority to ensure public safety by allowing only properly trained practitioners to fit and dispense contact lens.
We are now ready to take the third major step by bringing legislation to bear on the remaining practices of optometry and opticianry which fall outside of the CLP Act.
This is an important piece of legislation particularly because myopia is rather common in Singapore.
Our prevalence rate is high at 40% among Chinese adults over 40 years old, as compared to say, 15% among Australians and 27% among Americans in the same age group.
The problem will grow as our population ages. There are several reasons why we need to regulate the practice of optometrists and opticianry.
First, the public will then be better assured of high standards of primary eye care, refraction and optical aid dispensing.
Second, practitioners will be required to maintain high standards in their professional practice through mandatory continuing professional education (CPE).
Third, errant practitioners may be disciplined for, amongst other things, professional misconduct or negligence, or any improper act or conduct which brings disrepute to his profession, arising from a complaint brought by an aggrieved patient.
Our Approach to Regulation
The regulation of optometrists and opticians is, however, not straight-forward. In most other countries, there is a clear division of labour between optometrists and opticians, depending on their training.
Optometrists are trained to perform refraction and basic eye examination procedures such as examining eyeball pressure, visual field and retina (innermost lining of the eyeball essential for vision).
On the other hand, opticians are trained to prepare, adjust and fit optical aids and perform other retail duties.
However in Singapore, there is much overlap between the practices of these two groups of eye care professionals, with opticians doing refraction and optometrists dispensing optical aids.
As a result, our public has become accustomed to having both refraction and dispensing provided by the same optical service provider rather than being served by separate providers as is practised in developed western countries.
In developing our regulatory framework, our principal objective is to ensure that optometry and opticianry services are safe for our public.
While we want to regulate the optometrists and opticians as two distinct professions, we want to take into account market realities and avoid unnecessary disruption to the way that the public uses the services of these professionals.
Our legislation will therefore enable opticians to continue to perform refraction provided that they are properly trained.
But we propose to exclude children under 8 from the persons whom an optician may refract. Young children are more difficult to refract and may have eye anomalies that opticians are not trained to detect.
With our legislation, refraction services for such young children will require the higher skills of an optometrist. In addition, optometrists will be formally recognised for their ability to perform basic eye examination procedures and diagnose certain eye problems.
We are mindful that regulation may cause some disruption to the practices of some existing optometrists and opticians, and we seek to minimise this as far as possible.
Some opticians currently only perform dispensing and have no intention to learn refraction. We accept this as part of market reality and will register such opticians to perform only dispensing so as to allow them to continue their practice.
Nonetheless, there is a competing need to ensure that opticians attain a reasonable level of competence.
To achieve this balance, existing opticians will be registered under the Act according to their experience, qualifications and competence. Those who do not satisfy certain minimum requirements will be required to undergo upgrading courses in order to qualify for registration.
Based on this approach, we have drafted the Optometrists and Opticians Bill which is now before this House.

Source: News Release 17 Jul 2007

Related Article:
- Two in three Primary Six students have myopia

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