Published: 06/05/2004, Volume II4, No. 5904 Page 19

Back in March, I made a mental note to check an odd health-related incident which took place across the Commons dispatch box during prime minister's question time.

Not once, but twice. On Wednesday 3 March and again on the 10th.

What, I wondered, had prompted Opposition leader Michael Howard to interrupt his routine tormenting of prime minister Tony Blair on Iraq, immigration and the rest, to ask about the Royal National Institute for the Blind's complaint that a policy intervention by the Department of Health was leading an estimated 100 people a week to go blind?

You may remember the row;

thanks to Mr Howard it got some publicity.What it boiled down to was this. Back in September, the National Institute for Clinical Excellence had finally accepted lobbying from RNIB and others that would allow NHS treatment to people suffering from all types of lesions that produce wet agerelated macular degeneration.

But the DoH had rapidly intervened to extend the normal NICE implementation period from three months to nine.

'As a result, the RNIB estimates that 2,800 people [over six months] will go blind unnecessarily. Can the prime minister explain why the secretary of state [for health, John Reid] took that action?'

asked Mr Howard, in his rough way, on 3 March.

Mr Blair didn't have the case on his file, but Mr Reid was on the bench nearby to whisper that NICE had 'agreed to' the postponement, which arose from what Mr Howard said was an alleged 'lack of trained personnel'.Yet, the leader of the Opposition continued, according to RNIB, there were nearly 50 centres across the country able to do the photo-dynamic therapy needed to stop sufferers going blind in as little as six months from diagnosis.Would Mr Blair instruct Mr Reid to change tack?

No, said Mr Blair.

A week later Mr Howard returned to the theme.Mr Blair was better briefed and said the delay was NICE's own idea and that the delay was indeed to allow time to 'build up the proper capacity'.He accused Mr Howard of getting his information from 'a private firm'. No, said the Conservative leader, it was from RNIB, which was accusing ministers of a 'sham' and of 'dragging their feet'.

And there it rested.When I rang RNIB, its expert, Steve Winyard, was selfishly on leave to get married. But colleagues are unappeased.

Spokesman Dan Scorer explained that it has been campaigning hard on this issue with stalls at the party conferences last year. It was then that John Baron, the CambridgeSandhurst-and-City MP for Billericay since 2001(now a junior Tory health spokesman), became interested.

It was he who involved Mr Howard. In the interval since the March stalemate, RNIB has changed tack.Unable to make Mr Reid relent, it is harrying individual primary care trusts to make sure that when NICE's revised deadline for compliance arrives on 24 June they have the skills and equipment to do the job.

For the procedure, as you may know, doctors inject the necessary dye into the bloodstream where it highlights leaky blood vessels, then deploy low level lasers to interact with the dye and seal those leaky vessels. It is day surgery and requires several visits, but is safer than the old-tech, whose lasers can leave scar tissue.

Gosh. I am always impressed when I hear what the NHS can or will do after 24 June, though RNIB says the prospects remain patchy. In Whitehall, officials are standing by the Blair-Reid line.

Contrary to what their critics say ('they wanted to delay implementation until the new financial year') it really was about skills, not budgetary constraints.

'We are rolling it out as fast as humanly possible, but We are looking to the long term, to creating a national programme that will work for everyone, ' a spokesman told me. The 50 hospitals than can currently carry out photo-dynamic therapy do not have that capacity, he insisted.

Mr Howard and Mr Blair have moved on, doubtless confident that each was right. The PM believes the Tories want to privatise the NHS. Senior Tories like Mr Howard are increasingly confident that Mr Blair is a waffler who can't deliver on his promises.

That was what the row was about in March - even more so today as Mr Blair looks vulnerable.

How many people have actually gone blind as a result of the delay? At least 100 a day on RNIB's calculations. But no-one offers exact figures, which is probably wise.