Chiropody: Recognition and Careers Advice (Hansard, 20 March 1985)

§ Lord Gainford
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)
My Lords, we fully recognise the value of the services provided by chiropodists. Members of this profession in the National Health Service and in private practice play an important part in helping to maintain a person's mobility. We provide careers advice and publicity on chiropody which is widely used by local authority careers officers.

§ Lord Gainford
My Lords. I thank my noble friend the Minister for that encouraging Answer. Will Her Majesty's Government pay particular attention to the encouragement and importance of the chiropody profession in view of the problem of mobility for the ever-increasing number of veteran citizens?

§ Lord Glenarthur
Yes, my Lords, I can tell my noble friend that we understand that the chief chiropodists of district health authorities and all members of their staff are actively involved in disseminating information to school children by taking part in career talks. I hope that that will help to achieve what my noble friend wants.

§ Lord Wells-Pestell
My Lords, are we to understand from the Minister's reply that the National Health Service will use the services of any chiropodist? Is it not a fact that there are several professional organisations of chiropodists whose qualifications vary considerably, and that it is only wise to accept chiropodists who hold a particular qualification?

§ Lord Glenarthur
My Lords, the noble Lord is partly right, but there are no proposals to restrict the practice of chiropody generally to state registered practitioners. We are considering advice from officials based on discussions which they had last year with bodies representative of all the professions supplementary to medicine (including both registered and unregistered chiropodists) on the question of the protection of title. However, I cannot anticipate the outcome of that consideration. I can assure the noble Lord that there are no Government proposals to impose restrictions on the practice of any of the professions concerned which would have the effect of depriving anyone of his livelihood.

§ Baroness Seear
My Lords, is it the case now—as it used to be—that grants for training for chiropody are only discretionary and not mandatory? If that is so, as I believe it to be, is it not very foolish, when we bear in mind that there is a shortage of chiropodists and that it is a profession that appeals to a large number of 548 very competent young people who could qualify very satisfactorily if they could raise the funds for the training?

§ Lord Glenarthur
My Lords, I am afraid that I am not in a position to comment on grants for training as such, but I shall certainly find out about them and let the noble Baroness know. However, so far as the question of possible increases in pay are concerned—which is another factor which some people consider will encourage greater entry into the profession—I can say that only state registered chiropodists are eligible to work in the National Health Service. Indeed. I think that that comment adds to the answer which I gave to the noble Lord, Lord Wells-Pestell. On the 1983 figures, approximately 67 per cent. of such chiropodists worked in the National Health Service on a whole-time or part-time contractual basis. That represents a 10 per cent. increase over the 1982 figures.

§ Lord Broxbourne
My Lords, as one who has taken a sympathetic interest in this matter since the passage of the Professions Supplementary to Medicine Act 1960. I ask my noble friend to do everything possible—and indeed urge his colleagues so to do—to assist and promote the praiseworthy efforts of this profession to keep the country on its feet.

§ Lord Glenarthur
My Lords, I note my noble friend's remarks.

Lord Wallace of Coslany
My Lords, is the noble Lord aware that I strongly support the noble Lord, Lord Gainford, in his tribute to the value of this profession? Is the noble Lord aware that that value is being eroded at present because of severe reductions in services to patients? In some areas the reduction has been as high as 50 per cent. Therefore, although we have a valuable service, it is being eroded at present.

§ Lord Glenarthur
My Lords, I note the noble Lord's remarks and, yes, there is a shortage of chiropodists. As I indicated to my noble friend Lord Gainford, we are doing what we can to encourage recruitment to the profession. A number of schools for chiropody have opened. Since 1978 four have opened, at Plymouth, Huddersfield, Belfast and Sussex, and that has led to a 52 per cent. increase in student output. A fifth school will open later this year at Northampton and there are plans to open another at Southampton in 1987. I understand that plans for schools at Preston and Ipswich are being considered, and that is quite encouraging.

Lord Wallace of Coslany
My Lords, I think that the noble Lord has misunderstood me. The reduction in services is due not to a shortage of chiropodists but to the financial restrictions on the use of chiropodists in various services. That is the problem. I am well aware that there is a shortage of chiropodists. However, the present reduction in services is due not to that shortage but to financial considerations.

§ Lord Glenarthur
My Lords, I note the noble Lord's remarks, but I do not think that I can necessarily go along with him on all that he said.

Lord Winstanley
My Lords, will the noble Lord recognise that the patients concerned were very satisfied indeed with the work done by the home chiropody service which was provided for elderly people in many areas? Is it not a matter of great regret that the home chiropody service for the elderly has now virtually disappeared? Can anything be done now to restore the service?

§ Lord Glenarthur
My Lords, I do not know off the top of my head whether or not anything can be done to restore it. No doubt it was stopped for perfectly adequate reasons, and I shall look into it and familiarise myself with all the arguments.

The Lord Bishop of Norwich
My Lords, as a tailpiece, or rather as a footnote, to the Minister's helpful answers, may I ask whether he knows that one of our own bishops in the Church of England is married to a highly qualified and practising chiropodist? Does he feel that the fact that the bishop looks after the souls and his wife looks after the soles enhances the view of the nation about the bishops and encourages this magnificent profession of chiropody?

§ Lord Glenarthur
My Lords, I am greatly encouraged by all that the right reverend Prelate said and I take note of it. As one who has to do a certain amount of thinking on my feet, I do not think that I can really comment further than that.

§ Lord Ennals
My Lords, in order not to put my foot in it again, may I also be associated with those who congratulated the chiropodists on the excellent work they perform, in particular for the elderly and the handicapped? Is the noble Lord aware that my noble friend Lord Wallace is right in two respects? Would the noble Lord not agree that there is a great shortage of chiropodists, partly because of shortage of funds but also, contrary to what he said, simply because of a shortage of trained chiropodists? Is he aware that there are 10 applications for every place in the training schools in the country? With an ageing population and therefore a steadily increasing demand for chiropody, is it not essential that more places are made available for people who are anxious to be trained in this important task so as to help elderly people keep on their feet?

§ Lord Glenarthur
My Lords, I have described to the noble Lord, Lord Wallace, how we are taking steps to increase the number of places available. However, the fact remains that, at the end of the day, the number of chiropodists employed and the ways in which they are employed is primarily a matter for individual health authorities to determine in the light of local needs and available resources; and that I am sure the noble Lord will understand.

§ Lord Wells-Pestell
My Lords, notwithstanding the fact that there may be a shortage of qualified chiropodists, will the noble Lord assure the House that only qualified chiropodists will in fact be used, otherwise there may be more people taken off their feet?

§ Lord Glenarthur
My Lords, it is the case, as I said earlier, that only state registered chiropodists may operate within health authorities.