Cataract surgery rates in developed countries have increased dramatically over the past two decades. In England, the crude surgical rate in 1990 was around 2/1000,¹ by 1997 this had risen to around 3/1000² and by 2005 peaked at around 6/1000,³ an increase of close to 300% over 16 years. In Sweden, rates have been even higher; over a 9-year period, the demand for cataract surgery rose steadily from 4.5/1000 in 1992 to 7.3/1000 in 2000.⁴ Encouraged by the “Action on Cataract” initiative in 2000, National Health Service units streamlined practice and massively increased surgical throughput. For a time, health policy became so obsessed by capacity building that fixed and travelling independent sector treatment centre facilities were set up irrespective of local need. Publicity and political hype far outstripped the actual capacity of these treatment centres, which contributed a …