Chamber
Plenary, 28 Apr 2004
28 Apr 2004 · S2 · Plenary
Item of business
Chiropody
I congratulate Mary Scanlon on securing this important debate and wish happy returns to the deputy minister. I hope that, as he grows old, he will do so graciously.
From the comments that have been made so far, it seems that the issue boils down to capacity. To resolve that issue, more manpower is required. There are also the overlying problems about whether services are available through the NHS, about rationing of resources within the NHS and about what can be delivered through the NHS.
Many members have spoken about a new emerging profession that will include people who have degree skills and who are at a new entry level. I agree with many others that, as with other professions, there is a tremendous need to regulate standards of entry and of the people who are currently in practice. I agree with Mike Rumbles and other members that people sometimes pass themselves off as having skills that they do not have. There is also a danger that people in the health sector, including in my profession—pharmacy—are offering patients assistance that might actually compound their problems; in this case, by handing out lifts and so on. They do not necessarily have the essential skills to allow the long-term view to be taken, and people can end up being given foot supports or braces that might lead to greater problems in later life.
Many people have, in previous debates, heard me talk about early intervention, particularly with regard to children. We politicians need to grow up and realise that not everything can be delivered tomorrow, and we need to move away from the idea that it is sufficient to treat elections as the only target. We need instead to invest for the future and look to longer-term health benefits. I know from experience that someone's gait can be thrown because of a damaged instep. That person can have back problems as a result of that, which can go on for the rest of their life, which costs a fortune in care. We have to balance that when we look at the whole picture.
People have talked about inequality of access, ability to pay and where such treatment leads into free personal care. I look forward to hearing the minister's answer to the questions that Shona Robison put to him.
Private practice is not regulated properly at the moment. Therefore, there is a risk that the public are being exposed to certain dangers. Unfortunately—to pick up on comments that were made earlier—there is no tiering in the profession; there is accreditation according to skill base. A person can say that they are qualified to do one particular task, but nothing else. There is more specialisation in the profession, so it is important that we label people appropriately in order that there is no danger to the public and so that the health service knows how best to access specialist care.
Biomechanics and gait represent a huge issue. There is a proliferation of sports medicine and injury clinics, many of which would benefit from the highly skilled people who are coming into podiatry, who have modern degrees and who can assess the corrective aids that are available and teach people how best to transport themselves and how to deal with some of their injuries, which can come back to haunt them in later life. As members will know, Bill Aitken had a problem that went back many years to his days as a professional footballer. His knees eventually gave out when he had an accident at the end of last year. Such things catch up with people, so we should try to nip them in the bud.
I call on the minister to recognise the need for mapping of the profession and the skills of the individuals in it. The information from such a mapping exercise would tell us what skills are out there and, perhaps, how best to apply them. That must be balanced against the changing demography of Scotland and the increase in chronic conditions such as diabetes, but if we are to do that, as well as modernise the profession and get the legislation and accreditation correct, we will be able to move on to decide what should be delivered in the NHS and what could be contracted out by the NHS to private practice. That brings us back in a full loop to accreditation.
From the comments that have been made so far, it seems that the issue boils down to capacity. To resolve that issue, more manpower is required. There are also the overlying problems about whether services are available through the NHS, about rationing of resources within the NHS and about what can be delivered through the NHS.
Many members have spoken about a new emerging profession that will include people who have degree skills and who are at a new entry level. I agree with many others that, as with other professions, there is a tremendous need to regulate standards of entry and of the people who are currently in practice. I agree with Mike Rumbles and other members that people sometimes pass themselves off as having skills that they do not have. There is also a danger that people in the health sector, including in my profession—pharmacy—are offering patients assistance that might actually compound their problems; in this case, by handing out lifts and so on. They do not necessarily have the essential skills to allow the long-term view to be taken, and people can end up being given foot supports or braces that might lead to greater problems in later life.
Many people have, in previous debates, heard me talk about early intervention, particularly with regard to children. We politicians need to grow up and realise that not everything can be delivered tomorrow, and we need to move away from the idea that it is sufficient to treat elections as the only target. We need instead to invest for the future and look to longer-term health benefits. I know from experience that someone's gait can be thrown because of a damaged instep. That person can have back problems as a result of that, which can go on for the rest of their life, which costs a fortune in care. We have to balance that when we look at the whole picture.
People have talked about inequality of access, ability to pay and where such treatment leads into free personal care. I look forward to hearing the minister's answer to the questions that Shona Robison put to him.
Private practice is not regulated properly at the moment. Therefore, there is a risk that the public are being exposed to certain dangers. Unfortunately—to pick up on comments that were made earlier—there is no tiering in the profession; there is accreditation according to skill base. A person can say that they are qualified to do one particular task, but nothing else. There is more specialisation in the profession, so it is important that we label people appropriately in order that there is no danger to the public and so that the health service knows how best to access specialist care.
Biomechanics and gait represent a huge issue. There is a proliferation of sports medicine and injury clinics, many of which would benefit from the highly skilled people who are coming into podiatry, who have modern degrees and who can assess the corrective aids that are available and teach people how best to transport themselves and how to deal with some of their injuries, which can come back to haunt them in later life. As members will know, Bill Aitken had a problem that went back many years to his days as a professional footballer. His knees eventually gave out when he had an accident at the end of last year. Such things catch up with people, so we should try to nip them in the bud.
I call on the minister to recognise the need for mapping of the profession and the skills of the individuals in it. The information from such a mapping exercise would tell us what skills are out there and, perhaps, how best to apply them. That must be balanced against the changing demography of Scotland and the increase in chronic conditions such as diabetes, but if we are to do that, as well as modernise the profession and get the legislation and accreditation correct, we will be able to move on to decide what should be delivered in the NHS and what could be contracted out by the NHS to private practice. That brings us back in a full loop to accreditation.
In the same item of business
The Deputy Presiding Officer (Trish Godman):
Lab
The final item of business is a members' business debate on motion S2M-1144, in the name of Mary Scanlon, on chiropody care. The debate will be concluded wit...
Motion debated,
That the Parliament recognises the importance of regular chiropody and foot care in keeping Scotland's elderly population mobile, pain free and independent; ...
Mary Scanlon (Highlands and Islands) (Con):
Con
I thank everyone who has supported the motion and those who have remained in the chamber to hear the debate. Not only is this the first debate on chiropody i...
Carolyn Leckie (Central Scotland) (SSP):
SSP
I am delighted to support Mary Scanlon's motion; it is unfortunate that I will have to leave the debate early. However, I am a wee bit concerned about the me...
Mary Scanlon:
Con
My point is that, under the national service framework for people with diabetes—which I think most members would support, given the complex issues relating t...
Maureen Macmillan (Highlands and Islands) (Lab):
Lab
I thank Mary Scanlon for lodging a motion for debate on chiropody. She has been concerned about the issue for a long time and probably knows more than most o...
Mary Scanlon:
Con
That is what always happens—it is difficult to get an answer. I cite the example of Alex Bochel in Nairn, who was asked to have his toenails removed in order...
Maureen Macmillan:
Lab
I agree. However, enhanced training means that nurses can do other things; podiatry might be one of the areas that they could develop.
Shona Robison (Dundee East) (SNP):
SNP
I thank Mary Scanlon for securing this important debate. My concern is that, as with so many other important services, we are yet again seeing a postcode lot...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
First, I have an interest to declare, in as much as my wife is a state-registered podiatrist who has a private practice in Banchory.I, too, congratulate Mary...
Fergus Ewing (Inverness East, Nairn and Lochaber) (SNP):
SNP
I warmly congratulate Mary Scanlon on securing the debate, which I believe is the first debate on the topic in any Parliament in the United Kingdom. Mary Sca...
Mr David Davidson (North East Scotland) (Con):
Con
I congratulate Mary Scanlon on securing this important debate and wish happy returns to the deputy minister. I hope that, as he grows old, he will do so grac...
Brian Adam (Aberdeen North) (SNP):
SNP
Maureen Macmillan was right to refer to Mary Scanlon's known interest in this subject. She did not go quite so far as to accuse Mary of being a foot fetishis...
The Deputy Presiding Officer:
Lab
I call Tom McCabe to respond to the debate. Happy birthday, minister; I know that you are growing old gracefully.
The Deputy Minister for Health and Community Care (Mr Tom McCabe):
Lab
Words fail me to express my appreciation for those kind remarks, Presiding Officer. I am grateful for the kind wishes that my colleagues have expressed, but ...
Mike Rumbles:
LD
It is my understanding that, although we are rightly moving to protect the terms podiatry and chiropody, unqualified people will still be able to say that th...
Mr McCabe:
Lab
Such matters are reserved but I will seek more information on that subject and I assure Mike Rumbles that I will relay that information to him. I want to spe...
Mary Scanlon:
Con
How many of the extra 1,500 allied health professionals will be podiatrists, given that there is a chronic shortage of workers in that profession?
Mr McCabe:
Lab
It is for each board to assess the level of need in its area and to recruit appropriately up to the targets that are set by the Scottish Executive. In a few ...
Meeting closed at 17:47.