PROFESSIONS SUPPLEMENTARY TO MEDICINE ACT 1960 (AMENDMENT) (Hansard, 22 June 1976)

§ Mr. John Corrie (Bute and North Ayrshire)

I beg to move, That leave be given to bring in a Bill to amend the Professions Supplementary to Medicine Act 1960 to include chiropody. I want to ensure that in future the public will know that everybody who practises chiropody has a qualification recognised by statute. This is not the position today.

It may seem strange that a "Foot" Bill should emanate from the Conservative Benches, particularly in these difficult days, but this Bill would be an important step forward in chiropody.

The Bill has crossed the floor of the House because the hon. Member for Ealing, Southall (Mr. Bidwell) first raised the issue in the Chamber on 21st October 1969. It has all-party support today and I hope that it will not be opposed. It is also opportune that Age Concern—that body which does so much for our elders—has brought out a report this week entitled "Step on It". It is a report on the chiropody services which strongly supports the provisions in my Bill.

Under the heading "Discussion points", Age Concern states that chiropody should become a closed profession so that only those with State qualifications can set up as practising chiropodists. That would facilitate the use of less highly skilled but competent aides to assist in the National Health Service chiropody service who would provide the guarantees that members of the profession are anxious to secure for the protection of their own status and, more important, the safety of their patients.

Chiropody is important to people of all ages, not just to the elderly. At present chiropodists are registered under the Professions Supplementary to Medicine Act along with physiotherapists, radiographers and members of other supplementary professions. Chiropodists differ from other professions that are registered in two important ways. First, chiropodists' patients come directly to them and are not normally referred by the medical profession. Secondly, a large percentage of chiropodists are in private practice.

1378 To be employed within the National Health Service chiropodists must be State registered but there is no restriction about private practice and, therefore, no real standard or qualification. Anyone can buy a pair of scissors, a nail file and, I hope, a bottle of disinfectant and, with a short correspondence course at best, put up a plate and become a chiropodist.

My Bill would make it compulsory for those in private practice to be registered or enrolled by the Chiropodist Board. Why should there be dual standards for the public and private sector? Why should those who are entitled to treatment within the National Health Service receive treatment by the fully trained and qualified while those who are not entitled to treatment within the National Health Service have to resort to someone without any form of training at all? Only a minority of the population receives National Health Service treatment in chiropody.

Because the Secretary of State accepts responsibility only for priority groups of patients—the elderly, the handicapped and pregnant women—almost all the working population have to seek private treatment. They have no choice. Should they not be protected from less qualified treatment? Should they not be given a guarantee that the chiropodist that they attend has a recognised professional qualification? A limited service is provided for school children by the National Health Service and I am pleased to say that most of that work is done in Scotland.

In order to become State registered, a chiropodist has to take a three-year course of training which includes life science, relevant medical subjects and detailed anatomy of the lower limbs. The course also ensures thorough clinical training and practice. Examinations are held every year. At the end of the course examinations are conducted by independent examiners in each subject.

It is important to remember that chiropodists do not only cut nails and treat corns but are also responsible for a comprehensive foot care service for all ages from the young to the old. Since their patients are not referred to them by medically qualified men, the chiropodist is often the first person to see diseases with symptoms occurring in the feet which require medical investigation. He has to decide whether it falls within his 1379 province to treat that patient or to refer his patient elsewhere. That is one of the most important parts of his work. How can an unqualified practitioner in private practice hope to be able to send on a patient with such a problem if he cannot recognise the problem in the first place? How many people today suffer health problems because their unqualified chiropodist does not recognise that there is a complication somewhere else in the body?

My Bill would enrol any practitioner who has practised chiropody as his principal means of livelihood for five years out of the preceding seven years. That could probably be reduced in Committee. No more administration would be necessary, since the enrolment of practitioners would be by the existing Council for the Professions Supplementary to Medicine. Such enrolled chiropodists might then become eligible for employment in the National Health Service and help to overcome the present shortage of chiropodal manpower in the service. It would make little immediate difference to the profession but it would result in a better trained profession in the future because it would end the situation in which anyone can practice. It would mean that a chiropodist was the same wherever he worked, inside or outside the National Health Service. They would all be recognised as qualified professional people.

Care of the feet as part of medical practice is as old as medicine itself. Chiropody as a separate art began during the eighteenth and nineteenth centuries and, with the passing of the Professions Supplementary to Medicine Act in 1960, reached full professional status.

A large proportion of the population suffer from some kind of foot trouble—and that is not mean to be a pun. Those people are not as efficient as they should 1380 be either at work or at play. Most of the conditions that cause their disability can be treated by chiropodists. They cannot all be cured but they can be improved and made symptom free. Money spent on improving the facilities and organisation of the chiropodal service would produce handsome returns in terms of the well being and efficiency of the population. Many feet are ruined by badly fitting, poorly made shoes from abroad. Fashion is the chiropodists' worst enemy.

I accept that there is little chance of the Bill reaching the statute book this Session but it is a serious matter which would have far-reaching consequences for both people in the profession and the general public. I give notice that I shall seek to reintroduce it at an early stage in the next Parliament—irrespective of which party is in power. I would like to see only those on a register or roll established and maintained by the Chiropodist Board using the title "chiropodist" or practising chiropody. I hope that the House will support me.