NHS: Chiropody Provision (Hansard, 16 July 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, there h As been a welcome and steady increase in the provision of NHS chiropody services over several years. The total number of people receiving chiropody treatment in the NHS increased by 22 per cent. between 1982 and 1988, and the number of chiropodists on a whole-time equivalent basis employed in the NHS increased by 20 per cent over the same period.

Lord Wallace of Coslany
My Lords, I thank the noble Baroness for reading her brief so accurately. As regards chiropody, I suggest that considerable hardship is arising in the National Health Service. Chiropody is an easy service to cut, and cuts are being made. Is the noble Baroness aware that chiropody does not mean only the cutting of toenails but includes also the treatment for callouses and corns? Is she also aware that a wait of three months, or no treatment at all, means considerable hardship for a number of elderly women who have suffered and who are still suffering through lack of mobility? Why should those people have to suffer? I accept that the noble Baroness has given the facts, but the fact is that cuts are taking place.

§ Baroness Hooper
My Lords, as in all health service matters, the health authorities determine the level of chiropody provision in their areas. I am well aware of the training and qualifications which full time chiropodists require. At 30th September 1988 there were 3,330 chiropodists employed by the NHS, an increase of 550 or 20 per cent. over the 1982 figure. Furthermore, the number of students qualifying increased from 264 to 385—some 46 per cent.—over the same period. I understand that the problem is rather that there are too many qualified people rather than not enough.

§ Lord Molloy
My Lords, notwithstanding the figures which the noble Baroness has given, is she aware that there is great strain on the London Foot Hospital which is known worldwide? Would it be possible for the department to offer some assistance to enable that hospital to overcome some of its problems?

§ Baroness Hooper
My Lords, the department is fulfilling its role by concentrating on the training aspects of this matter. As I said, it is for health authorities to provide the level of services required in their areas. However, I recognise that the London Foot Hospital has a worldwide reputation.

§ Lord Ennals
My Lords, does the Minister accept that her department recently published the results of a survey which showed that the requirement was not for fewer but for twice as many chiropodists? Is she aware that at present there is a tremendous growth in the number of elderly people requiring chiropody services? Is she aware also that the NHS chiropody service in London is almost at crisis point? She sounded as though there is a marvellous success story. She should speak to the old people because there is no such success story.

§ Baroness Hooper
My Lords, as in other areas of provision, expectations are on the increase. However, I submit that provision is also on the increase. If the noble Lord was referring to the Cartwright Report called More Trouble with Feet, which was published in 1986, I agree that the report confirmed that the level of chiropody provision at that time was insufficient to meet all need. That has resulted in the steady improvement in the number of treatments given, the number of chiropody students in training and the number of chiropodists and footcare assistants employed in the National Health Service since 1986.

§ Lord Donaldson of Kingsbridge
My Lords, for information only, perhaps I may ask whether there is a registration system. Are you allowed to call yourself a chiropodist without satisfying somebody else that you know what to do?

§ Baroness Hooper
My Lords, I understand that there is a fairly wide use of the word "chiropodist". However, any chiropodist employed in the National Health Service is required to be state-registered. In essence, that means that only those people who have successfully completed a three-year training course approved by the Chiropodists Board of the Council for the Professions Supplementary to Medicine are eligible for NHS employment.

§ Lord Donaldson of Kingsbridge
My Lords, I thank the Minister for that reply. However, will the noble Baroness discuss with her colleagues the importance of having standards for all activities in relation to health, not only for the National Health Service?

§ Baroness Hooper
Yes, My Lords.

Lord Wallace of Coslany
My Lords, there may be more chiropodists, but many of them are operating in the private sector. If one cannot afford £5 to £10 a month, one has to do without. That is the position.

§ Baroness Hooper
My Lords, I referred to the figures for students in training. That is an important factor.

§ Viscount Hanworth
My Lords, does it not appear that a three year training course is ridiculously long? If it were not so long it may be that those who at present practise without qualifications would take those qualifications.

§ Baroness Hooper
My Lords, a three year qualification period for the type of work undertaken by chiropodists in the National Health Service is not considered excessive. Nevertheless there are foot care assistants being trained and employed in the National Health Service whose training requirements are somewhat shorter.