Chiropody (Hansard, 26 July 1977)

§ Mr. Moyle

We have carefully considered the implications of specific proposals from within the chiropody profession for amending legislation to fix the standards of entry required to practice privately as a chiropodist and have come to the conclusion that Government support for such proposals would not be justified in present circumstances. The proposals would have established a secondary "roll" below State registration level for certain unregistered chiropodists with defined levels of practical experience; would have restricted the practice of chiropody to State-registered chiropodists or to those on the proposed new roll; and would have allowed those on the roll to practice within the National Health Service under the supervision of State-registered chiropodists. The issues raised by these proposals are complex, and ministerial consideration of them has been greatly assisted by the help and co-operation afforded by the professional bodies directly concerned.

The Government take the view that closure of the profession in present circumstances would unnecessarily restrict the available supply of chiropody services at a time when expansion is seen as a matter of high priority. There are encouraging signs that the output of registered chiropodists from the training schools is expanding; for example, a new school opened in Durham in 1975, and my right hon. Friend the Secretary of State for Education and Science has very recently approved finance for a new school in Huddersfield which will take its first students this autumn. The Health and Education Departments keep under continual review possible ways for further increasing the supply of registered chiropodists as available resource constraints permit but we remain a long way short of a position where closure could be accommodated without undue contraction of services.

The main argument in favour of closure is the possible risk for the public in allow- 120W ing unregistered chiropodists who may have had little or no formal training to give chiropody treatment. This risk is one the Government are bound to recognise, but the evidence available to the Government about services in the private sector does not suggest a serious or widespread problem, and some risk could arise from the contraction in services that would be brought about by closure. The Government are, however, taking steps to restrict the freedom of practice of unregistered chiropodists where lack of training would create special problems. For example, regulations will shortly be put before Parliament to restrict a chiropodists's right to administer local analgesics by injection to suitably-trained state-registered practitioners.

Finally, on the question of expanding chiropody services within the NHS, health departments have recently issued guidance to health authorities which suggests possible ways of improving the effectiveness of services even within existing resource constraints. One suggestion was that the expertise of a registered chiropodist could be more effectively deployed if he were supported by unqualified foot-care assistants to carry out, under supervision, simple foot care and hygiene which a fit person could normally undertake for himself. In this and other ways the Government will continue to seek continuing expansion of chiropody services as an area of priority development.