THE BULGARIAN MODEL

1. THE BULGARIAN MODEL • Objective: there is a sustained tradition that ophthalmic optics and optometry in Bulgaria have always been healthcare professions. BRNO Liliana Stankova

2. Flashback:Tsarist Bulgaria 1936 • 1936: the Ministry of Public Health and Interior proclaimed a Decree on the profession Tsar Boris 3rd’s Decree no.5 on opticianry. BRNO Liliana Stankova

3. Flashback contd.:Pre- and post Sept 9 th 1944 • Time reference: Sept 9th 1944 • The post-nationalization period: first public optical shop opened in 1948. BRNO Liliana Stankova

4. Vocational training for ophthalmic opticians • 1958: the birth year of professional training for opticians; specialized school. BRNO Liliana Stankova

5. Flashback contd.:The time of national socialism • The profession was regulated by the Ministry of Public Health. Network of optical shops throughout the country, united and governed by the State Pharmacist Union. BRNO Liliana Stankova

6. Legal status • The profession is treated as a pure healthcare profession one by the Public Health Act. BRNO Liliana Stankova

7. Training • Daily tuition – 2 years post high school education. Graduation with a state examination in the specialty Ophthalmic and Dispensing Optics. BRNO Liliana Stankova

8. Optometry training • 1990-1991: First one-year course in optometry post graduation in Ophthalmic Optics was arranged on the initiative of the optical department at the State Pharmacist Union in collaboration with the Ministry of Public Health and the Ministry of Education BRNO Liliana Stankova

9. Optometry training programme Syllabus: I. General medical subjects • Latin language studies • Anatomy and Physiology of Man – theory and practice • Social Hygiene and Epidemiology II. Specialized subjects • Internal Diseases • Pharmacology • Ocular Diseases – theory and practice • General Optics • Specialized Optics • Economy and Organization of Optical Services Provision III. Practice course BRNO Liliana Stankova

10. Democracy reinstalled • 1989: the public network of optical shops disintegrated and the first private-owned optical shops appeared BRNO Liliana Stankova

11. Organized optics • 1996: first organization forms of opticians: Bulgarian Optical Union • 1997: the Association of the Private Employers in the Optical Branch was established, later renamed the National Association of Bulgarian Optometrists and Opticians -NABOO BRNO Liliana Stankova

12. Globalization of the profession • 1998: close contact to the profession in Germany; cooperation with ZVA and the Koblenz Handwerkskammer – Sofia office • Valuable exchange of ideas related to the organization and the legal institution and regulation of the profession BRNO Liliana Stankova

13. Adoption of the German model • The MoH neglected our professions and we attempted to transpose the German model in Bulgaria and cultivate a local form of professional union: NABOO becomes member of the National Handicrafts Chamber - 1998 BRNO Liliana Stankova

14. ECOO membership • 2000: NABOO becomes member of ECOO. Initiation in the best practices, background traditions and trends of the profession(s). Start of a successful and all-level communication with other ECOO members. • The “healthcare” model received strong impetus owing to the close interaction within ECOO and as a result of the development of the industry and the sector. BRNO Liliana Stankova

15. Handicrafts Act: pros and cons • 2000: The profession is integrated in the Handicrafts Act where there was subject to an inadequate and rather questionable legal treatment (e.g. any university diploma holder was entitled to qualify for a Master’s Certificate and exercise the profession of ophthalmic optician) BRNO Liliana Stankova

16. Changed legal framework • 2001: Regulation of the MoH entitling both ophthalmologists and ophthalmic opticians to the professional management of optical shops. • Court action of NABOO supported by the BOU against the above provision. Court ruled our claim was bad and unjustifiably monopolistic. We lost the case. BRNO Liliana Stankova

17. Handicrafts Act: pros and cons contd. • Unhealthy application of the provisions of the Handicrafts Act which also compromised the level of professional practices. => The transposition of the German model proved unsuccessful in our situation. BRNO Liliana Stankova

18. Education & Regulation • Regulation no.23 / 15-12-2005 on the order to qualify in the profession “technician in ophthalmic optics” which introduced the minimal State Educational Requirements to a professional optician. • The Ministry of Labour and Social Policy endorsed a new National Classification of Professions: ophthalmic optics and optometry are grouped under caption “applied- and associated-healthcare* specialists” *paramedical BRNO Liliana Stankova

19. Re-definition of the course • 2006 - Having learned our lesson and being more prepared with the experience gained, the “healthcare” view of ophthalmic optics and optometry was again on the table. • NABOO took on intensive and comprehensive action, incl. institutional action, publicity and lobbying, to re-instate the profession(s) under the Health Act. BRNO Liliana Stankova

20. Lobbying with decision and policy-makers • 2006 - Consultations and discussions face a face with the various governmental institutions: specialized parliamentary commissions and Ministries BRNO Liliana Stankova

21. Reinstitution! • 06.10.2006: Health Act amendment: our two professions were again integrated and re-defined as healthcare professions. • Thus also the Handicrafts Act was amended to exclude our professions from the Act’s scope. BRNO Liliana Stankova

22. In perspective • Underway on our immediate agenda: - develop a Regulation on the structure and activity of optical shops which should streamline and regulate the practice of our professions; - develop a framework for continuing (life-long) education in ophthalmic optics. BRNO Liliana Stankova

23. Thank you for your attention! BRNO Liliana Stankova