§ Angela SmithTo ask the Secretary of State for Health what percentage of NHS chiropody and podiatry services were provided to ethnic minority patients in each of the last three years. [22555]
§ Mr. BoatengInformation about the ethnic background of patients receiving National Health Service chiropody and podiatry services is not collected.
§ Angela SmithTo ask the Secretary of State for Health what measures he is taking to ensure ethnic minorities with non-insulin diabetes have full access to NHS chiropody and podiatry services. [22554]
§ Mr. BoatengThe Department of Health established a task force in 1993 to look at ways of securing better and more cost-effective chiropody services within the National Health Service. The recommendations were widely disseminated to the service with the emphasis being on the provision of services to "at risk" groups—for example diabetics and those with acute clinical need. Information about the ethnic background of patients receiving NHS chiropody and podiatry services is not collected.
It is currently the responsibility of health authorities and general practitioner fundholders to assess the health care needs of their population, and to secure a range of hospital and community health services, including chiropody services, to meet those needs. Most health authorities give priority to meeting the chiropody needs of older people, those with "at risk" conditions, and certain other groups such as children, pregnant women, and people with learning disabilities.
Under the Chronic Disease Management Programme for diabetes, participating GPs (currently 94 per cent.) are required to give patients a full review, including checks for potential complications, at least annually and to refer them promptly to other services where appropriate. Health Service Guidelines HSG(97)45 on "Key features of a good diabetes service", issued to the NHS in November 1997, gives guidance on developing a structured programme of care, including surveillance for, and management of, the risk factors and complications of diabetes. It also flags up the importance of a responsive service, sensitive to different needs and states:
prevalence of diabetes is generally much higher in all non-Europid ethnic groups, particularly the South Asian and African-Caribbean groups. It is important that consideration is given to the language and cultural barriers that may exist between health professionals and people with diabetes".The Department of Health has commissioned new national clinical guidelines for non-insulin dependent diabetes, and other clinical effectiveness publications, which we expect to be available by the end of 1999. Copies of Health Service Guidelines HSG(97)45 are available in the Library.
§ Angela SmithTo ask the Secretary of State for Health (1) what assessment his Department has made of limitations on the availability of chiropody services to particular age groups; what representations he has received on the subject; and if he will make a statement; [22551]
196W(2) pursuant to his answer of 13 November 1997, Official Report, column 662, what assessment he has made of the extent to which health authorities' decisions to provide chiropody services are determined according to the need of the population served. [22557]
§ Mr. BoatengThe Department of Health established in 1993 a task force to look at ways of securing better and more cost-effective chiropody services within the National Health Service. The recommendations were widely disseminated to the service with the emphasis being on the provision of services to "at risk" groups and those with acute clinical need.
It is currently the responsibility of health authorities and general practitioner fundholders to assess the health care needs of their population, and to secure a range of hospital and community health services to meet those needs. Decisions about health care and the use of resources are best taken at local level because it is there that people's needs are best known and services can be tailored accordingly.
Ministers have received a number of representations and communications on the subject and have responded individually.
§ Angela SmithTo ask the Secretary of State for Health, pursuant to his Department's answer of 13 November 1997,Official Report, column 662, how many health authorities have consulted with their local residents during the last 12 months over the proper priority for chiropody within purchasing priorities. [22559]
§ Mr. BoatengThe information requested is not routinely collected.
§ Angela SmithTo ask the Secretary of State for Health how many health authorities have notified his Department of(a) reductions and (b) increases in chiropody services in the last two years; and what other sources are utilised to collate trends in the level of services. [22558]
§ Mr. BoatengThe information requested is not routinely collected. Health authorities are not required to notify the Department of changes in activity in particular services. Although the Department wishes to see health authorities and general practitioner fundholders provide the full range of National Health Service services including chiropody, detailed planning decisions on levels of provision are taken locally according to the needs of the population served.
Information from health authorities about patient contacts with their chiropody services is collected on Department of Health annual return KT23. This information is published each year and copies of the summary information booklets are available in the Library.
§ Angela SmithTo ask the Secretary of State for Health what was the budget for each trust in England for NHS chiropody and podiatry services in(a) 1997–98, (b) 1996–97, (c) 1995–96 and (d) 1994–95. [22560]
§ Mr. BoatengFigures on National Health Service trust budgets are not available centrally. Expenditure on community chiropody services by health authority directly managed units and NHS trusts in England for the years 1994–95 to 1996–97 have been placed in the Library.
197WExpenditure figures are compiled at the end of the financial year and therefore figures for 1997–98 have not yet been collected.
§ Angela SmithTo ask the Secretary of State for Health, pursuant to his answer of 13 November 1997,Official Report, column 662, what methods his Department employs to communicate to health authorities the requirement for chiropody to be included within the full range of NHS services. [22556]
§ Mr. BoatengIt is currently the responsibility of health authorities and general practitioner fundholders to assess the health care needs of their population, and to secure a range of hospital and community health services, including chiropody services, to meet those needs. Health authorities were informed, in the 1997–98 NHS Priorities and Planning Guidance, of the need to ensure, in collaboration with other local authorities and organisations, that integrated services are in place to meet needs for continuing health care for older people, people with disabilities, vulnerable people and children.
§ Angela SmithTo ask the Secretary of State for Health what measures his Department takes to ensure that the foot health needs of the elderly population are met; and what indicators measure levels of access to chiropody and podiatry services by those aged over 65 years. [22553]
Thousands Years Total Age 0–4 5–15 16–54 55–64 65–74 75–84 85 and over 1994–95 975.4 17.4 75.4 137.0 109.2 268.1 256.4 111.9 1995–96 950.6 15.6 65.6 147.9 109.5 255.8 246.3 109.9 1996–97 975.4 16.5 68.9 158.2 115.7 253.7 250.0 112.4 Information about the source of referral of NHS chiropody and podiatry patients for chiropody and podiatry services has not been collected centrally since 1991–92. In 1991–92, approximately 50 per cent. of the patients seen by chiropody services were self referrals.