Over the last 15 years successive governments have fundamentally altered the way that healthcare has been delivered in this country. Many of these centrally driven policies have seemingly been foisted with little consultation on hard working health service employees. This lack of consultation with professionals has been particularly felt by ophthalmologists at a time when there is increasing evidence to suggest that the significant reductions in waiting times are due to the earlier initiatives within the NHS (eg Action on Cataracts) rather than recent ISTC programmes.
The lack of consultation over new ways of delivering ophthalmic care to our patients has led to considerable but unnecessary ill feeling amongst healthcare professionals. The lack of proper audit of work of these new surgeons and organisations with no thoughts given as to what would happen to patients once they had had their "minor" cataract operation if all did not go well was bound to cause friction. There was no integration into local health economies, and thus a lack of communication between healthcare professionals locally and central government, causing confusion about ownership of patients with complications. It became apparent that as the Royal College was, because of its charter,unable to act as our advocate with sufficient teeth, a new organisation was needed. This organisation was in born in an environment described as "constructive discomfort" by various policy makers. Our voice as ophthalmologists could not independently be aired. The Association of Ophthalmologists wasborn to fill this vacuum.