LONDON, ENGLAND - The British Parliament has taken the first step towards passing a law requiring tougher standards, formal training, and accreditation for laser eye surgeons and clinics. In mid-February, Member of Parliament (MP) Gwyneth Dunwoody used the 10 Minute Rule Bill-by which individual MPs can speak for 10 minutes in support of new legislation they would like to see introduced-to ask the House of Commons to bring in a Bill to regulate laser eye surgery.
The Bill is the result of a report from a committee of MPs, the All Party Parliamentary Panel of Enquiry on Laser Eye Surgery, who set themselves the goal of making the United Kingdom the safest place in the world to have laser eye surgery. The panel had the help of laser eye surgery pioneer Professor John Marshall. Its report highlighted what it saw as worrying gaps in patient counseling, advertising, patient consent forms, and physician training. The panel concluded that British patients are not adequately protected at present, and Dunwoody summarized their main recommendation, saying:
“It is essential for each clinic to have a senior consultant with specialist knowledge, training, and experience in cornea and refractive techniques. We considered it important for all surgeons in this specialty to be suitably trained to an agreed standard. It is essential to have a United Kingdom-wide training programme for ophthalmologists, and the Royal College of Ophthalmologists (RCO) should approve individual clinic and manufacturer system-based training.”
It seems that there is a move from all sectors of the industry, led by the RCO, to implement key recommendations from the report ahead of legislation. It is reported that the RCO plans to have a surgeon curriculum and accreditation programme ready for implementation by the autumn.
This is the second call for tighter regulations in just a few months. In December 2004 the National Institute for Clinical Excellence (NICE) issued guidance on laser in situ keratomileusis (LASIK). The institute raised concerns about the procedure’s safety in the long term and decided that “current evidence does not appear adequate to support its use within the National Health Service without special arrangements for consent and for audit or research.” NICE also called for adequate training to be undertaken by all practitioners.
The Eye Laser Association, which represents the companies that carry out the majority of the UK’s eye laser treatments, has commented on both the NICE guidance and the new Bill. Christopher Neave, chairman of the ELA, said, “We applaud the level of interest and awareness shown by NICE but we do wish to make it clear that, since 1990, some 280,000 people in the UK have been treated and we estimate that fewer than 0.1% have experienced persistent problems.”
Adding that ELA also applauded the efforts of the panel and the RCO, he said, “Our priority, like that of the Royal College, is patient safety. Through the combined efforts of expert surgeons, clinics, laser manufacturers, and consumer lobby groups, we will see a better regulated more stable and vibrant industry. That’s ultimately the best outcome for the consumer and the industry.”
Dunwoody’s bill is due to be read for the second time on March 18. If voted through, it will go on to the committee stage before receiving its third and final reading in the House of Commons.