Go back to article: Rather unspectacular: design choices in National Health Service glasses

Context

Twentieth-century social history in Britain is largely shaped by the philosophy demonstrated in the social project of the Welfare State. Prior to this nationalised system early twentieth-century healthcare provision was through private funding, charitable trusts, and health insurance schemes. Medical and optical services were offered on a localised basis, availability varied according to geographical location, and the level of service was linked to the financial status of the patients. The National Health Insurance Act of 1911 had established an insurance scheme that allowed those in employment to make financial contributions towards health care and provision in case of unemployment.[8] This scheme covered the fees for a panel doctor, maternity, convalescence or sick pay. Ophthalmic aid was not included until 1923, when the Approved Societies who administered the Act had a substantial cash surplus and funded eye examinations and offered a grant for corrective eyewear.[9] This grant would cover a free pair of ‘utility’ spectacles, but with an option to pay the difference for a more expensive frame. This extension of the National Health Insurance scheme in 1923 to cover optical benefit provided the optical world with a problem. As there was no statutory recognition of optical qualifications or register of opticians it was unclear who could or should provide benefits. A new body was established from three optical associations: the British Optical Association (BOA), the Spectacle Makers Company (SMC), and the Institute of Ophthalmic Opticians (IOO); they joined together to form the Joint Council of Qualified Opticians (JCQO). The BOA and the SMC were examining bodies that offered diplomas, whereas the IOO had a strong branch system throughout Britain and close links with the refraction hospitals (eye hospitals) (Smith, 1996, pp 11–15). Between them these organisations represented a large proportion of the optical practitioners. The JCQO brought together all qualified ophthalmic opticians, created an ethical code, and formed the first register of practitioners. The JCQO also selected and approved the range of ‘utility’ spectacle frames available under the National Insurance scheme (see Figures 4 and 5). Despite measures taken by the JCQO regarding representation and qualification, there were expressions of discontent and the problem of registration of opticians remained an issue of concern to the profession.[10]

Figure 4

Colour photograph of a display case showing various styles of NHS spectacles

Specimens of ‘Utility’ spectacle frames available under national health insurance – Joint Council of Qualified Opticians (JCQO) display case at the British Optical Association Museum

Figure 5

Colour photograph of a pair of Windsor style NHS spectacles with Xylonite covered rims

Example of a JCQO-approved Windsor frame with Xylonite covered rims

For those patients who did not contribute to an insurance scheme there were other outlets to obtain optical appliances. Spectacles could be bought at chemists, through untrained retail opticians (who were not optometrists), and from certain department stores and mail-order catalogues.[11] During the Second World War the optical profession worked to provide vision aids for servicemen and spectacles for wear with gasmasks, and although NHI frames were described as ‘utility’, government records do not show any explicit links in the optical profession to the strategies of the British Utility Design Scheme introduced by the Board of Trade as part of wartime austerity measures.

Component DOI: http://dx.doi.org/10.15180/170703/002